Case Manager - (RN)

Prime Healthcare; Mesquite (TX); On-site; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a dedicated Case Manager (RN) to join their award-winning team. This role involves overseeing the quality and resource management of patients from admission through their healthcare journey. You will lead initiatives to promote cost containment while ensuring seamless care delivery. The ideal candidate will have a strong background in nursing or social work, with experience in case management and a passion for improving patient outcomes. If you are ready to make a meaningful impact in a dynamic healthcare environment, this opportunity is for you.

Qualifications

• Minimum 5 years post-graduation experience in nursing or social work required.
• Current BCLS (AHA) certification is mandatory upon hire.

Responsibilities

• Manage quality and resources for all admitted patients.
• Facilitate cost-effective outcomes and comprehensive medical reviews.

Skills

Case Management

Nursing Management

Discharge Planning

Computer Skills

Behavioral Violence Prevention

Education

Registered Nurse License

Accredited School of Nursing Graduation

Licensed Clinical Social Worker

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! Dallas Regional Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Dallas Regional Medical Center is a 202-bed acute care hospital accredited by The Joint Commission that offers a wide range of medical services including 24/7 emergency care, cardiology, wound care, surgical services, cardiac catheterization, and imaging. The hospital is the only Certified Stroke Center, Accredited Chest Pain Center, and Labor and Delivery Unit in the area. In addition, Dallas Regional is the only Trauma Center for 13 miles and was the first Accredited Geriatric Emergency Room in Dallas County. The hospital is a recipient of Healthgrades Patient Safety Excellence Awards, 15 Healthgrades Five-Star ratings over the past three years, and Straight 'A' Hospital Safety Grades from The Leapfrog Group since 2018. For more information visit www.dallasregionalmedicalcenter.com.

Responsibilities

The Case Manager (RN) is 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.
• Working on behalf of the advocate, promoting cost containment and demonstrating leadership to integrate the health care providers to achieve a perceived seamless delivery of care.
• Facilitating and ensuring the achievement of quality, clinical, and cost-effective outcomes and performing a holistic and comprehensive admission and concurrent review of the medical record for medical necessity, intensity of service, and severity of illness.

Qualifications

Education and Work Experience:

• Starting April 1, 2015: Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
• Grandfathered prior to April 1, 2015: Minimum 5 years post-graduation of an accredited school of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.
• Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning, or nursing management preferred.
• Current BCLS (AHA) certificate upon hire and maintain current.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Experience and knowledge in basic to intermediate computer skills.
• Behavioral Violence Prevention Training within 3 months of hire and maintain current.

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