RN Case Manager - Utilization Management - Day Shift

ChristianaCare • Elkton, MD

2d • $41 - $66 • Onsite

About The Position

RN Case Manager - Utilization Management - Day Shift Mon - Fri (Hours: 8 a.m. to 4:30 p.m.) Weekend requirements based on unit needs. Elkton, MD ChristianaCare - Union Hospital is seeking Utilization Management Nurse with experience in Utilization Management and Acute Care. The RN will be responsible for ensuring the delivery of efficient and effective health care while evaluating the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provision of the applicable health benefits plan. SCOPE, PURPOSE, AND FREQUENCY OF CONTACTS: Ongoing contact with patient/families, medical-dental staff, nursing, social work, PI-outcome coordinators, disease management, and ancillary services; additional contact with home health care providers, durable medical equipment providers, insurance/managed care organizations, and community resources.

Requirements

• Maryland or Compact State RN Licensure Required.
• A Bachelor of Science in Nursing (BSN) must be obtained within three years of hiring.
• Candidates with an Associate Degree in Nursing (ADN) will be considered if they have at least six years of experience as a Registered Nurse (RN)
• Maintain documented hours of relevant continuing education related to licensure requirements.
• Some continuing education should be related to role enhancement and changes of clinical practice within the assigned area.
• Current BLS
• Strong interpersonal skills relative to both professional and lay interactions.
• Strong organizational skills.
• Working knowledge of Performance Improvement activities.
• Working knowledge of data management/reporting practices
• Ability to ambulate within the hospital setting (walking, stairs, etc.).
• Ability to utilize computer equipment/programs

Nice To Haves

• relevant work experience in Utilization Management, Case Management, or Home Care is preferred.
• Case Management Certification (CCM) required within 18 months of eligibility.

Responsibilities

• Ensuring the delivery of efficient and effective health care
• Evaluating the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provision of the applicable health benefits plan
• Ongoing contact with patient/families, medical-dental staff, nursing, social work, PI-outcome coordinators, disease management, and ancillary services
• Additional contact with home health care providers, durable medical equipment providers, insurance/managed care organizations, and community resources.

Benefits

• ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees