RN Case Manager

Prime Healthcare•Gadsden, AL

6h•Onsite

About The Position

We are seeking a n RN Case Manager , also referred to as a Registered Nurse Case Manager or RN Clinical Case Manager . An RN Case Manager will oversee and coordinate patient care from admission through discharge to ensure quality, cost-effective outcomes. They assess patients’ needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare systems. Shift’s Available : Days Employment Type : Per Diem/PRN Hours: 8-hour shift; varied days Location : Riverview Regional Medical Center – Gadsden, AL Here are some of the benefits of working at Prime Healthcare: Competitive compensation Medical insurance benefit plan 401K Responsibilities Essential Duties and Responsibilities (includes, but not limited to): Patient Assessment: e valuate patients’ medical, psychosocial, and discharge needs upon admission and throughout their stay Care Coordination: d evelop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions Discharge Planning: c oordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities Utilization Review: m onitor the use of hospital resources and services to ensure appropriate care and avoid unnecessary treatments or extended stays Patient and Family Education: h elp patients and families understand care plans, post-discharge instructions, and available resources Advocacy: a dvocate for patient needs and preferences, ensuring care is aligned with their goals and values Qualifications Education and Work Experience Before we go any further, we do have some deal-breakers. You must have: Valid State RN License BSW or other Bachelor degree in a related field Current CCM or obtained within 6 months of hire Knowledge of InterQual Criteria Up-to-date knowledge on Blue Cross Blue Shield Jiva Portal and BCBS experience Experience and knowledge in basic to intermediate computer skills Behavioral Violence Prevention Training within 3 months of hire and maintain current Additional Qualifications That Are a Plus: Minimum 5 years of acute care experience At least one-year experience in case management, discharge planning or management Current BLS (AHA) certificate Knowledge of Milliman Criteria Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/ #LI-MP1 Employment Status Per Diem Shift Days Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Options Apply for this job online Email this job to a friend Refer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed

Requirements

Valid State RN License
BSW or other Bachelor degree in a related field
Current CCM or obtained within 6 months of hire
Knowledge of InterQual Criteria
Up-to-date knowledge on Blue Cross Blue Shield Jiva Portal and BCBS experience
Experience and knowledge in basic to intermediate computer skills
Behavioral Violence Prevention Training within 3 months of hire and maintain current

Nice To Haves

Minimum 5 years of acute care experience
At least one-year experience in case management, discharge planning or management
Current BLS (AHA) certificate
Knowledge of Milliman Criteria

Responsibilities

Evaluate patients’ medical, psychosocial, and discharge needs upon admission and throughout their stay
Develop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions
Coordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities
Monitor the use of hospital resources and services to ensure appropriate care and avoid unnecessary treatments or extended stays
Help patients and families understand care plans, post-discharge instructions, and available resources
Advocate for patient needs and preferences, ensuring care is aligned with their goals and values