Acute Care RN Case Manager – Day Shift

Prime Healthcare; Philadelphia, Northern (Philadelphia County, KY); Hybrid; USD 68,000 - 95,000; Full time

Job summary

Roxborough Memorial Hospital in Philadelphia, part of Prime Healthcare, seeks a qualified registered nurse with case management experience to join our full-time team. The role emphasizes admission quality, resource management and collaboration across care teams.

Responsibilities include leading discharge planning, applying Milliman and InterQual criteria, and ensuring safe, cost-conscious patient transitions in a compassionate community hospital setting.

Qualifications

• Minimum 5 years work experience post-graduation and an active RN license.
• Five years acute care nursing experience preferred; at least one year in case management, discharge planning or nursing management.
• Current BCLS (AHA) certificate on hire and maintain current.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Basic to intermediate computer skills.
• Behavioral Violence Prevention Training within 3 months of hires and current.

Responsibilities

• Responsible for quality and resource management of all admitted patients across the care continuum.
• Promote cost containment and coordinate with health care providers to ensure seamless care delivery.
• Perform holistic admission and concurrent review of medical records for medical necessity, intensity of service and illness severity.

Skills

RN license

Case management experience

Discharge planning experience

Nursing management experience

Computer skills

Behavioral Violence PreventionTraining

Education

RN license (state)

AHA BCLS certificate

Tools

Milliman Criteria

InterQual Criteria

Job description

Roxborough Memorial Hospital in Philadelphia, part of Prime Healthcare, seeks a qualified registered nurse with case management experience to join our full-time team. The role emphasizes admission quality, resource management and collaboration across care teams.

Responsibilities include leading discharge planning, applying Milliman and InterQual criteria, and ensuring safe, cost-conscious patient transitions in a compassionate community hospital setting.