Case Manager RN - Social Work

Prime Healthcare; Victorville, Northern (CA, KY); Hybrid; USD 53,000 - 76,000; Full time

Job summary

Desert Valley Hospital is seeking a qualified nurse to lead the quality and resource management of admitted patients from admission onward, coordinating care across the continuum and promoting cost containment.

The role requires a RN license with at least 5 years post-graduate nursing experience and experience in case management or discharge planning. Preferred CCM and knowledge of care criteria are a plus. Day shift, full-time position with competitive benefits.

Qualifications

• Minimum 5 years' work experience post-graduation from an accredited school of nursing.
• Current state Registered Nurse license.
• Experience in case management, discharge planning or nursing management.

Responsibilities

• Quality and resource management of all admitted patients across the continuum of care.
• Promote cost containment and integrate health care providers for seamless delivery of care.
• Review medical records for clinical necessity, intensity of service and severity of illness.

Skills

Case management

Nursing management

Computer skills

Education

RN 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! Desert Valley Hospital, a member of the Prime Healthcare Foundation, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.Desert Valley Hospital is an accredited 148-bed acute care hospital located in Southern California. Desert Valley Hospital is in the top 5% of more than 4,500 hospitals nationwide for clinical performance. The hospital has achieved numerous quality award distinctions including Patient Safety Excellence Award, Women’s Health Excellence Award and Distinguished Hospital Clinical Excellence Award. Desert Valley Hospital, along with Desert Valley Medical Group, offers key services to the community including heart care, emergency services, labor and delivery, surgical services and more. For more information visit www.DesertValleyHospital.com.

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

Pay Transparency

Desert Valley Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $38.50 to $55.21. 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.

Employment Status

Full Time

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

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf