Home Health RN Case Manager

Prime Healthcare; Jethro (OH); On-site; USD 70,000 - 95,000; Full time

Job summary

Ohio Valley Home Health is seeking a Registered Nurse to lead quality and resource management for admitted patients across the care continuum. The role emphasizes cost containment and leadership to integrate providers for seamless care delivery.

The ideal candidate has 5+ years of nursing experience post-graduation, an active RN license, and preferred Home Health experience with BCLS certification and EMR proficiency.

Qualifications

• RN license required (state)
• Minimum 5 years' nursing experience post-graduation
• Home health experience preferred
• BCLS certification preferred
• Knowledge of Milliman and InterQual criteria preferred
• Proficient computer skills/EMR experience

Responsibilities

• Oversee quality and resource management of all admitted patients across the continuum
• Promote cost containment and lead integration of health care providers
• Ensure holistic admission and concurrent chart review for medical necessity, intensity of service and severity of illness

Skills

RN license

Home health experience

BCLS certificate

Computer skills

Milliman criteria

InterQual criteria

Education

Registered Nurse degree

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Ohio Valley Home Health is affiliated with East Liverpool City Hospital, one of the nation’s “100 Top Hospitals” and “A” rated for patient safety. We offer incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

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 insure 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. Previous Home Health experience preferred.

3. Current BCLS certificate, preferred 4. Experience and knowledge in basic to intermediate computer skills.Preferred Qualifications:

5. Five years of acute care nursing experience. preferred6. CCM or obtained within 1year7. Knowledge of Milliman Criteria and InterQual Criteria preferred.

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