Case Manager RN - Social Work Services

Prime Healthcare; Lake Arrowhead (NJ); On-site; USD 85,000 - 104,000; Full time

Job summary

Saint Clare's Health, part of Prime Healthcare, is seeking a dedicated nurse leader to oversee quality and resource management for admitted patients across care continuum. You will advocate for cost containment while guiding clinical teams to deliver seamless care.

Ideal candidate has 5+ years as a registered nurse, with case management or discharge planning experience, and familiarity with Milliman/InterQual criteria. CCM or BCLS credentials are preferred.

Qualifications

• Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state RN license.
• At least one year experience in case management, discharge planning or nursing management.
• Experience and knowledge in basic to intermediate computer skills.
• CCM or obtained within 1 year preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred.
• Current BCLS certificate, preferred.

Responsibilities

• Responsible for the quality and resource management of all patients admitted to the facility across the care continuum.
• Promotes cost containment and demonstrates leadership to integrate healthcare providers for seamless care delivery.
• Performs admission and concurrent review of the medical record for medical necessity and severity of illness.

Skills

Nursing

Case management

Discharge planning

Healthcare IT

Education

RN License

Job description

Overview

At Saint Clare's Health, our dedicated team of professionals is committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, Saint Clare's Health is actively seeking new members to join its award-winning team!

Saint Clare's Health includesCMS 5-Star Ratedhospitals and is an award-winning provider of safe, high quality, compassionate care, serving the communities of Morris, Warren and Sussex counties. Its network of hospitals and healthcare facilities include Denville Hospital, Dover Hospital, Behavioral Health Centers in Boonton, Denville, and Parsippany, and an Imaging Center in Parsippany, among other satellite locations. The hospitals have received multiple quality awards including Leapfrog "A" ratings for patient safety; Healthgrades recognition for orthopedic surgery, treatment of stroke, heart care, various surgical procedures, and more. For information, visit www.saintclares.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:

1. Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license2. At least one year experience in case management, discharge planning or nursing management3. Experience and knowledge in basic to intermediate computer skills.Preferred Qualifications:

4. Five years of acute care nursing experience. preferred5. CCM or obtained within 1year6. Knowledge of Milliman Criteria and InterQual Criteria preferred.7. Current BCLS certificate, preferred

Pay Transparency

Saint Clare's Health 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. Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $84,926.40 to $104,000.00 on an annualized basis. 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