RN Care Manager – Sign-On Bonus & Care Coordination

Prime Healthcare Services; Lewiston (ME); Vor Ort; USD 50.000 - 68.000; Vollzeit

Benefits dieser Stelle

Sign-On Bonus Up to $20k (2+ yrs RN)

Sign-On Bonus Up to $10k (New grads)

Zusammenfassung

Central Maine Medical Center in Lewiston, ME is seeking a Registered Nurse (RN) for Care Management. The role focuses on care coordination, medical necessity reviews, and collaboration with physicians and payers to drive quality and cost-effective outcomes.

The RN will handle admission reviews, discharge planning, and documentation, working within a multidisciplinary team to optimize patient flow and outcomes.

Qualifikationen

• Minimum 5 years work experience post-graduation from an accredited school of nursing and a current state RN license.
• RN Case Manager preferred; five years acute care nursing experience preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred; basic to intermediate computer skills.

Aufgaben

• Conduct admission and concurrent reviews for medical necessity, severity of illness, and intensity of service.
• Coordinate patient care across the continuum, including discharge planning and transitions of care.
• Collaborate with physicians, payers, and interdisciplinary teams to ensure quality and cost-effective outcomes.
• Advocate for patients while promoting appropriate resource utilization and cost containment.
• Monitor length of stay, barriers to discharge, and care progression.
• Facilitate seamless care delivery across departments and post-acute settings.
• Ensure compliance with regulatory standards (CMS, payer guidelines) and hospital policies.
• Maintain accurate documentation and support utilization review processes.
• Participate in performance improvement and quality initiatives.

Kenntnisse

Case management

Discharge planning

Interdisciplinary collaboration

Computer literacy

Ausbildung

Registered Nurse license

Tools

Milliman Criteria

InterQual Criteria

Jobbeschreibung

Central Maine Medical Center in Lewiston, ME is seeking a Registered Nurse (RN) for Care Management. The role focuses on care coordination, medical necessity reviews, and collaboration with physicians and payers to drive quality and cost-effective outcomes.

The RN will handle admission reviews, discharge planning, and documentation, working within a multidisciplinary team to optimize patient flow and outcomes.