Case Manager Registered Nurse

Case Manager, RN

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!

Responsibilities

Essential Duties and Responsibilities (includes, but are not limited to):

• 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.

Qualifications

Education, Work Experience & Qualifications:

• Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
• 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.
• Behavioral Violence Prevention Training within 3 months of hires and maintain current.

Employment Status

Per Diem

Shift

Variable

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: