Case Manager RN

Prime Healthcare; Elgin (IL); On-site; USD 51,000 - 68,000; Part time

Job summary

Saint Joseph Hospital - Elgin is seeking a qualified nursing professional to oversee quality and resource management for admitted patients, ensuring a seamless continuum of care through admission and concurrent record reviews.

This Per Diem role requires a current RN license, at least 5 years post-graduation experience, and exposure to case management or discharge planning, with proficiency in basic to intermediate computer skills.

Qualifications

• Minimum 5 years' post-graduation nursing experience
• At least one year experience in case management or discharge planning
• Proficient computer skills
• Current RN license

Responsibilities

• Oversee the quality and resource management for admitted patients across the continuum of care
• Promote cost containment and lead integration of health care providers for seamless delivery of care
• Perform holistic admission and concurrent review of medical records for medical necessity, intensity of service and severity of illness

Skills

Case management

Discharge planning

Nursing management

Computer skills

Education

RN license

Tools

Milliman Criteria

InterQual Criteria

Job description

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 license


• 2. At least one year experience in case management, discharge planning or nursing management


• 3. Experience and knowledge in basic to intermediate computer skills.

Preferred Qualifications:

• 4. Five years of acute care nursing experience. preferred


• 5. CCM or obtained within 1year


• 6. Knowledge of Milliman Criteria and InterQual Criteria preferred.


• 7. Current BCLS certificate, preferred

Pay Transparency

Saint Joseph Hospital - Elgin offers competitive compensation and a reasonable compensation estimate for this role is $43.00. 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.

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Employment Status

Per Diem

Shift

Variable

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