Case Manager - RN

Prime Healthcare; Garden City (MI); On-site; USD 90,000 - 110,000; Full time

Job summary

Garden City Hospital, part of Prime Healthcare, is seeking an experienced nurse to manage patient care quality and resources from admission through the continuum of care. You will lead discharge planning and care coordination with interdisciplinary teams to ensure cost-effective, high-quality outcomes.

The role emphasizes clinical leadership, utilization review, and collaboration with medical staff, with Per Diem status and Day shifts in a hospital setting.

Qualifications

• Minimum 5 years' work experience post-graduation from an accredited school of nursing.
• 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 of admitted patients from admission through continuum of care.
• Promote cost containment and coordinate with health care providers to ensure seamless delivery of care.
• Perform holistic admission and concurrent reviews for medical necessity, intensity of service and severity of illness.

Skills

RN experience

Case management

Discharge planning

Nursing management

Computer skills

Education

Registered Nurse license

Tools

Milliman Criteria

InterQual Criteria

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden City Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

At Garden City Hospital, we pride ourselves on community involvement and commitment to preserving access to quality and compassionate healthcare. We are a state-of-the-art medical facility with over 300 licensed beds and a teaching hospital, offering medical education to students, residents and fellows from across the country. The residency and fellowship programs offer graduate medical education to more than 80 trainees in specialties. Garden City Hospital has an award-winning staff of over 350 of the area's best and brightest physicians from almost every specialty. Learn more at www.gch.org.

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:

• 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.

Preferred Qualifications:

• Five years of acute care nursing experience. preferred
• CCM or obtained within 1year
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Current BCLS certificate, preferred

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