Case Manager RN
About The Position
The RN Case Manager is responsible for the quality and resource management of 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 in support of seamless care delivery. Its methodology is designed to facilitate quality, clinical, and cost-effective outcomes. The Case Manager performs holistic and comprehensive admission and concurrent reviews of medical records to assess medical necessity, intensity of service, and severity of illness.
Requirements
- At least five years of work experience after graduation 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.
- Certified Case Manager (CCM) certification, or obtain it within one year.
- Knowledge of Milliman Criteria and InterQual Criteria.
- Current BCLS certificate.
Responsibilities
- Manage the quality and resources of admitted patients from admission throughout the continuum of health care management.
- Advocate on patients’ behalf and promote cost containment.
- Provide leadership to integrate health care providers and support seamless care delivery.
- Perform holistic and comprehensive admission and concurrent medical-record reviews for medical necessity, intensity of service, and severity of illness.
- Facilitate quality, clinical, and cost-effective outcomes.
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What This Job Offers
Education Level
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