Registered Nurse -Case Manager
About The Position
The Registered Nurse - Case Manager is responsible for the quality and resource management of patients admitted to the facility, from admission through the continuum of healthcare management. The role advocates on behalf of patients, promotes cost containment, and demonstrates leadership in integrating healthcare providers to support 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 medical-record reviews to assess medical necessity, intensity of service, and severity of illness. The position is based at Central Maine Medical Center in Lewiston, Maine. Central Maine Healthcare is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through more than 40 primary and specialty care locations. Its system includes Central Maine Medical Center, Bridgton Hospital, Rumford Hospital, and the Maine College of Health Professions.
Requirements
- For the RN qualification pathway, at least five years of work experience after graduation from an accredited school of nursing and a current state Registered Nurse license.
- For the grandfathered pathway prior to April 1, 2015, at least five years after graduation from an accredited school of social work and Licensed Clinical Social Worker credentials.
- Basic to intermediate computer skills and experience.
Nice To Haves
- Five years of acute care nursing experience.
- At least one year of experience in case management, discharge planning, or nursing management.
- Current BCLS certificate.
- Knowledge of Milliman Criteria and InterQual Criteria.
- RN Case Manager preferred.
Responsibilities
- Manage the quality and resources of admitted patients from admission throughout the continuum of healthcare management.
- Advocate on behalf of patients and promote cost containment.
- Integrate healthcare providers to 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.
Benefits
- A comprehensive, competitive benefits package with options to customize benefits to individual needs.
- Resources, programs, and voluntary options supporting individual growth and well-being.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
