Case Manager RN
About The Position
The RN Case Manager is responsible for quality and resource management for patients admitted to the facility, beginning at admission and continuing across the continuum of health care management. The role advocates on patients’ behalf, promotes cost containment, and provides leadership to integrate health care providers for a seamless delivery of care. The case-management methodology is designed to support quality, clinical, and cost-effective outcomes. The Case Manager conducts holistic and comprehensive admission and concurrent medical-record reviews to assess medical necessity, intensity of service, and severity of illness.
Requirements
- At least five years of work experience after graduating from an accredited school of nursing.
- Current state Registered Nurse license.
- At least one year of experience in case management, discharge planning, or nursing management.
- Basic to intermediate computer skills and knowledge.
Nice To Haves
- Five years of acute care nursing experience.
- CCM certification, or obtain it within one year.
- Knowledge of Milliman Criteria and InterQual Criteria.
- Current BCLS certificate.
Responsibilities
- Manage the quality and use of resources for patients from admission across the continuum of health care management.
- Advocate on behalf of patients and promote cost containment.
- Provide leadership to integrate health care providers and support seamless care delivery.
- Conduct holistic and comprehensive admission and concurrent reviews of medical records for medical necessity, intensity of service, and severity of illness.
- Support the achievement of quality, clinical, and cost-effective outcomes.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Career Level
Mid Level
Education Level
No Education Listed
