Case Management Nurse

Lower Bucks Hospital; Bristol Township (Bucks County); On-site; USD 70,000 - 90,000; Full time

Job summary

Lower Bucks Hospital in Bristol Township seeks a Registered Nurse with at least 5 years of experience, preferably in acute care and case management. This role focuses on the quality management of patient admissions, ensuring a seamless delivery of care and reviewing medical records for necessary services. Candidates should possess a BCLS certificate and knowledge of Milliman and InterQual Criteria to enhance care outcomes. This position demands leadership skills to integrate care delivery effectively.

Qualifications

• Minimum 5 years work experience post-graduation of an accredited school of nursing.
• Five years acute care nursing experience preferred, including one year in case management or nursing management.
• Current BCLS (AHA) certificate preferred.

Responsibilities

• Manage quality and resources for patient admissions.
• Promote cost containment and coordinate health care provider efforts.
• Review medical records for necessity and severity of illness.

Skills

Acute care nursing experience

Case management

Discharge planning

Basic to intermediate computer skills

Education

Registered Nurse license

Graduation from an accredited school of nursing

BCLS (AHA) certificate

Job description

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. The methodology is designed to facilitate and insure 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.

Education and Work Experience

• 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.
• Current BCLS (AHA) certificate, preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Experience and knowledge in basic to intermediate computer skills.