Case Manager RN

Mission Regional Medical Center • Mission, TX

5d

About The Position

The Case Manager RN is responsible for the quality and resource management of patients admitted to the facility, from admission throughout the continuum of healthcare management. The role advocates on behalf of patients, promotes cost containment, and provides leadership to integrate healthcare providers for a seamless delivery of care. The position facilitates quality, clinical, and cost-effective outcomes by conducting holistic and comprehensive admission and concurrent reviews of medical records for medical necessity, intensity of service, and severity of illness.

Requirements

• A BSW or another bachelor's degree in a related field.
• At least one year of experience in case management, discharge planning, or nursing management.
• Experience and knowledge in basic to intermediate computer skills.

Nice To Haves

• A minimum of five years of acute care experience.
• CCM certification, or ability to obtain it within one year.
• Current BCLS certificate.
• Knowledge of Milliman Criteria and InterQual Criteria.

Responsibilities

• Manage the quality and resources of patients admitted to the facility from admission throughout the continuum of healthcare management.
• Advocate on behalf of patients and promote cost containment.
• Provide leadership to integrate healthcare providers and support seamless care delivery.
• Facilitate quality, clinical, and cost-effective outcomes.
• Conduct holistic and comprehensive admission and concurrent medical-record reviews for medical necessity, intensity of service, and severity of illness.

What This Job Offers

• Job Type: Full-time