Registered Nurse - Case Management

Roxborough Memorial Hospital; Philadelphia (Philadelphia County); On-site; USD 85,000 - 115,000; Full time

Job summary

Roxborough Memorial Hospital, a 131-bed community hospital, seeks an experienced RN Case Manager to oversee admission and discharge processes and ensure high-quality, cost-effective patient care. The role emphasizes collaboration with nursing and social work to coordinate care from admission through discharge.

The position requires a Registered Nurse license and several years in acute care, with preference for case management experience and familiarity with approved criteria and documentation

Qualifications

• Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state RN license.
• Must have 5+ years post graduate experience in social work for LCSW; RN Case Manager preferred.
• Five years acute care nursing experience; at least one year in case management, discharge planning or nursing management.
• Current BCLS (AHA) certification at hire and maintain it.
• 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.

Responsibilities

• Responsible for quality and resource management of all patients admitted to the facility across the care continuum.
• Promote cost containment and demonstrates leadership to integrate health care providers for seamless delivery of care.
• Perform holistic admission and concurrent review of medical records for medical necessity, intensity of service and severity of illness.

Skills

Nursing experience

Case management

Discharge planning

Computer skills

Education

Registered Nurse license

Licensed Clinical Social Worker (LCSW)

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! Roxborough Memorial Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Roxborough Memorial Hospital is a 131-bed community hospital. The hospital has been serving the medical and health care needs of the Roxborough, Manayunk, East Falls and northwest section of Philadelphia communities for more than a century, having first opened its doors in 1890. Roxborough Memorial Hospitals School of Nursing has been educating nurses since 1898. The hospital is accredited by the Joint Commission on the Accreditation of Healthcare Organizations, the nation's oldest and largest hospital accreditation agency.

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

• 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 graduate 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 hires and maintain current.

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