Registered Nurse Case Manager
About The Position
Join us as a Case Manager, RN, where you’ll play a vital role in shaping patient care and driving quality outcomes. In this position, you’ll be responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Work on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. If you’re passionate about improving healthcare standards and thrive in a dynamic environment, we want to hear from you!
Requirements
- Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
- Behavioral Violence Prevention Training within 3 months of hires and maintain current.
Nice To Haves
- Five years acute care nursing experience preferred.
- At least one year experience in case management, discharge planning or nursing management, preferred.
- Knowledge of Milliman Criteria and InterQual Criteria preferred.
Responsibilities
- Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.
- Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care.
- Ensures the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.
- Regularly assess care plans and outcomes to ensure compliance with insurance guidelines and healthcare regulations. Utilize analytics to improve care processes and patient satisfaction.
- Establish strong communication channels between patients, providers, and work teams to deliver quality outcomes and seamless service delivery.
Benefits
- Health insurance options
- Flexible scheduling options
- Employer 401(k) options
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What This Job Offers
Job Type
Part-time
Career Level
Senior
Number of Employees
251-500 employees
