Case Manager LVN

Prime Healthcare; Lewiston (ME); On-site; USD 47,000 - 63,000; Full time

Job summary

Central Maine Medical Center is seeking a qualified admissions and case management professional to oversee the quality and resource management of all patients admitted to the facility, guiding care from admission through the continuum and ensuring medical necessity and appropriate intensity of service.

This role emphasizes cost containment, advocacy for patients, and leadership to integrate providers for seamless care delivery, with a focus on Milliman and InterQual criteria and ongoing

Qualifications

• BSW or other bachelor's degree in a clinical healthcare related field.
• At least one year experience in case management, discharge planning or nursing management.
• LVN/LPN graduate with current license and 2 years of acute care experience.
• Experience and knowledge in basic to intermediate computer skills.
• Minimum 5 years of acute care experience preferred.
• Case management certification within 2 years of hiring preferred.
• At least one-year experience in case management, discharge planning or management preferred.
• Current BCLS certificate preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.

Responsibilities

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

Education

BSW or other bachelor's degree in a clinical healthcare related field

LVN/LPN license with 2 years acute care experience

Tools

Basic computer skills

Job description

Overview

Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through a network of more than 40 primary and specialty care locations. The system includes Central Maine Medical Center (CMMC) in Lewiston, a 250-bed, not-for-profit regional referral hospital that is home to the region's only Cancer Care Center, an orthopedic ambulatory surgery center, and the Central Maine Heart and Vascular Institute. CMMC also serves as the central Maine base for LifeFlight of Maine, the state's only medical helicopter service.

CMH also includes Bridgton Hospital and Rumford Hospital, two 25-bed critical access hospitals that provide essential care to Maine's rural communities.

As part of its commitment to healthcare education and workforce development, CMH is home to the Maine College of Health Professions, Maine's first nursing and medical imaging school. The private, not-for-profit institution is accredited by the New England Commission of Higher Education and plays an important role in training the next generation of healthcare professionals.

To learn more, visit www.cmhc.org.

Responsibilities

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.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

• BSW or other bachelor's degree in a clinical healthcare related field.
• At least one year experience in case management, discharge planning or nursing management;
• LVN/LPN graduate from an accredited school of nursing, with current LVN/LPN license, and 2 years of acute care experience.
• Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

• Minimum 5 years of acute care experience preferred.
• Case management certification within 2 years of hiring.
• At least one-year experience in case management, discharge planning or management, preferred.
• Current BCLS certificate preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.

Pay Transparency

Central Maine Medical Center offers competitive compensation and a reasonable compensation estimate for this role is $34.42 to $46.32. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status

Full Time

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