Quality Case Manager (RN) - Full-Time | Days | Drive Clinical Excellence

The Staff Pad•Russellville, AL

5d•Onsite

About The Position

The Staff Pad has partnered with a respected healthcare organization in Russellville, AL to hire an experienced Quality Case Manager – RN to support clinical quality, utilization management, and patient care initiatives. This role focuses on concurrent review of medical necessity, appropriateness, timeliness, and utilization of hospital services while ensuring compliance with regulatory standards and supporting positive patient outcomes.

Requirements

Current RN license in the applicable state
Proficiency with EMR/EHR systems
Knowledge of quality measures, healthcare regulations, and HIPAA
Strong patient assessment and clinical decision-making skills
Understanding of medical terminology and clinical documentation
Excellent communication and collaboration skills
Commitment to patient safety and quality care

Nice To Haves

1–3 years of RN experience preferred
Critical care, ICU, emergency medicine, or Level I/II trauma centers experience preferred

Responsibilities

Accurately abstract and submit eCQM & Core Measure records on time; discuss discrepancies with the Quality Resource Management Director prior to submission
Conduct concurrent reviews of electronic documentation for eCQM compliance; complete assessments and update Plans of Care as needed
Participate in the hospital care team, promote high-quality, zero-harm care to patients, and document evaluations of nursing intervention & patient responses
Stay current on accreditation standards, quality measures, quality reporting, clinical outcomes, and performance improvement practices
Maintain the knowledge and skills necessary to care for patients of all ages
Attend Inpatient/Outpatient Quality Program and value-based quality program webcasts and workshops
Provide patient care and treatments considering: Cultural diversity, Age-specific patient populations, Established policies and procedures
Use Language Line to provide clear, culturally sensitive communication with patients who prefer a language other than English
Recognize and address the psychosocial & spiritual needs of patients and their families
Follow established infection control and standard precaution policies and procedures
Maintain accountability for physician orders as needed
Adhere to designated break and meal times
Complete other duties as assigned by Nursing or Hospital Administration