Case Manager RN

Prime Healthcare; Elgin (AL); On-site; USD 51,000 - 68,000; Full time

Job summary

Saint Joseph Hospital - Elgin seeks an experienced nurse case manager to oversee admission quality and resource management across the care continuum. You will promote cost containment and demonstrate leadership to integrate health care providers for seamless care delivery.

The role requires an RN license, 5+ years post-graduation, and experience in case management or discharge planning, with competency in basic to intermediate computer skills.

Qualifications

• Minimum 5 years' work experience post-graduation from 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

Responsibilities

• Oversee quality and resource management for admitted patients across the care continuum.
• Promote cost containment and lead integration of health care providers for seamless care delivery.

Skills

Registered Nurse

Case management experience

Discharge planning

Computer skills

Education

RN license

Accredited nursing program

Tools

Milliman Criteria

InterQual Criteria

Basic computer skills

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