Case Manager Registered Nurse

Prime Healthcare Services; Illinois; On-site; USD 74,000 - 111,000; Full time

Benefits offered by this job

401K retirement plan

Medical

Dental

Vision coverage

Tuition reimbursement

Job summary

Prime Healthcare Services is seeking an experienced RN Case Manager / Social Work professional for Olympia Fields Hospital. This role focuses on admission to discharge planning, ensuring quality, cost-effective outcomes, and comprehensive care management across the patient continuum.

You will collaborate with health care providers, apply Milliman and InterQual criteria, and contribute to a robust Total Rewards package. Prior experience in acute care and social work is preferred.

Qualifications

• 5+ years post-graduation nursing experience and current RN license.
• 5 years post-graduate experience for LCSW; RN Case Manager preferred.
• 5 years acute care nursing experience preferred; case management experience desired.
• Current BCLS certificate preferred.
• Knowledge of Milliman and InterQual Criteria preferred.
• Basic to intermediate computer skills.

Responsibilities

• Oversee quality and resource management for all admitted patients.
• Advocate for cost containment and coordinate care integration.
• Lead cross-disciplinary teams to ensure seamless delivery of care.
• Review medical records for necessity, intensity of service, and severity of illness.

Skills

Discharge planning

Case management

Nursing management

Computer skills

Education

Registered Nurse license

Licensed Clinical Social Worker (LCSW)

Tools

Milliman Criteria

InterQual Criteria

Job description

Overview

Department: OFIL Social WorkShift: Full-Time, DaysFacility: Olympia Fields Hospital Location: 20201 South Crawford Ave, Olympia Fields, IL 60461Compensation Range: $73,528 to $111,446.40

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

1. Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license

2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, 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 certificate, preferred.

5. Knowledge of Milliman Criteria and InterQual Criteria preferred.

6. Experience and knowledge in basic to intermediate computer skills.

Pay Transparency

Olympia Fields Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to,

• paid time off
• a 401K retirement plan
• medical
• dental
• vision coverage
• tuition reimbursement
• many more voluntary benefit options

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $73,528 to $111,446.40 on an annualized basis. 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