Case Manager Nurse (Fulltime/Days)

Prime Healthcare; Riverdale (IL); On-site; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking dedicated nursing professionals to join their award-winning team. This role offers an incredible opportunity to work in a non-profit, full-service hospital, focusing on quality patient care and resource management. You will be responsible for overseeing patient admissions and ensuring clinical and cost-effective outcomes. With a commitment to compassion and community, this position allows you to make a significant impact in the lives of patients. If you are passionate about healthcare and want to be part of a supportive environment, this opportunity is perfect for you.

Qualifications

• Minimum 5 years nursing experience with a current RN license.
• Experience in case management or discharge planning preferred.

Responsibilities

• Manage quality and resources for all admitted patients.
• Promote cost containment and seamless delivery of care.

Skills

Leadership

Cost Containment

Clinical Knowledge

Patient Advocacy

Basic to Intermediate Computer Skills

Education

Registered Nurse License

Bachelor's in Nursing or Social Work

Tools

Milliman Criteria

InterQual Criteria

BCLS Certification

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Southern Regional Medical Center, a member of the Prime Healthcare Foundation, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Southern Regional Medical Center is a non-profit, 331-bed full-service hospital serving the residents of Clayton County and southern crescent metro Atlanta communities. The hospital offers a complete line of services including Senior Care and Senior Behavioral Health Services; Emergency Services; Heart and Vascular; Advanced Imaging; Laboratory; Neuroscience Services; Rehabilitation; Sleep Diagnostic Center; Surgery/Robotic Surgery; Wound Care; and Women’s Health Services, including a Level III NICU. The hospital is certified accredited as a Chest Pain Center and Primary Stroke Center. Learn more at southernregional.org.

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

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 ensure 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 and Work Experience:

1. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
2. Minimum 5 years post-graduation of an accredited school of Social Work for Licensed Clinical Social Worker. RN Case Manager preferred.
3. Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management preferred.
4. Current BCLS (AHA) certificate upon hire and maintain current.
5. Knowledge of Milliman Criteria and InterQual Criteria preferred.
6. Experience and knowledge in basic to intermediate computer skills.
7. Behavioral Violence Prevention Training within 3 months of hire and maintain current.