Case Manager RN

Prime Healthcare; Chicago (IL); On-site; USD 55,000 - 83,000; Part time

Job summary

Resurrection Medical Center in Chicago, IL seeks an experienced Registered Nurse for per diem case management and discharge planning. You will oversee admission reviews, assess medical necessity, and coordinate care across the continuum to support cost-effective outcomes.

Applicants need at least 5 years of RN experience, CCM or plan to obtain within 1 year, and knowledge of Milliman and InterQual criteria is preferred. BCLS certification is encouraged.

Qualifications

• Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
• At least one year experience in case management, discharge planning or nursing management.
• Experience and knowledge in basic to intermediate computer skills.
• Five years of acute care nursing experience (preferred).
• CCM or obtained within 1 year (preferred).
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Current BCLS certificate (preferred).

Responsibilities

• Oversee quality and resource management of all patients admitted to the facility from entry through the continuum of care.
• Promote cost containment and coordinate with health care providers to achieve seamless delivery of care.
• Ensure quality, clinical and cost-effective outcomes via holistic admission and concurrent review of the medical record for medical necessity, intensity of service and severity of illness.

Skills

Nursing experience

Case management

Discharge planning

Nursing management

Education

RN license

CCM certification

Tools

Milliman Criteria

InterQual Criteria

Job description

Overview

• Department: Social Services
• Schedule: Per Diem (as needed)
• Facility: Resurrection Medical Center
• Location: 7435 W Talcott Ave, Chicago, IL 60631

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, EXPERIENCE, TRAINING

Required Qualifications:

1. Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license2. At least one year experience in case management, discharge planning or nursing management3. Experience and knowledge in basic to intermediate computer skills.Preferred Qualifications:

4. Five years of acute care nursing experience. preferred5. CCM or obtained within 1year6. Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate, preferred

Pay Transparency

Resurrection Medical Centeroffers competitive compensation and a reasonable compensation estimate for this role is $XX.XX to $XX.XX. 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

Per Diem

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