Case Manager Registered Nurse

Prime Healthcare; Olympia Fields (IL); On-site; USD 74,000 - 111,000; Full time

Job summary

Prime Healthcare's Olympia Fields Hospital in Olympia Fields, IL is seeking a qualified nurse/case management professional for full-time day shifts. The role focuses on admission and concurrent reviews to ensure medical necessity and efficient care across the continuum.

Qualified candidates will hold an active RN license, and an LCSW is preferred; familiarity with Milliman/InterQual criteria a plus; strong computer skills and experience in acute care and discharge planning are desirable.

Qualifications

• Must hold an active Registered Nurse license in good standing.
• Licensed Clinical Social Worker (LCSW) with at least 5 years post-graduate experience strongly preferred; RN Case Manager preferred.
• Experience in acute care, case management, discharge planning or nursing management is preferred.

Responsibilities

• Oversight of admission quality and resource management across the care continuum.
• Collaborate with health care providers to promote cost containment and seamless care delivery.
• Review medical records for medical necessity, service intensity, and illness severity.

Skills

RN license

LCSW credential

Computer skills

Education

Registered Nurse degree

Licensed Clinical Social Worker (LCSW)

BCLS certification

Tools

Milliman Criteria knowledge

InterQual Criteria knowledge

Job description

Overview

Department: OFIL Social WorkShift: Full-Time, DaysFacility: Olympia Fields Hospital Location: 20201 South Crawford Ave, Olympia Fields, IL 60461

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, and vision coverage, tuition reimbursement, and 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