RN Case Manager

Riverview Regional Medical Center; Gadsden (AL); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Full benefits

Job summary

Riverview Regional Medical Center in Gadsden, AL seeks an experienced RN Case Manager for per diem weekends. The role involves coordinating patient care from admission through discharge, conducting assessments, and partnering with physicians and social workers to ensure quality outcomes.

Responsibilities include discharge planning, utilization review, and guiding patients through insurance and healthcare systems. Valid RN license in Alabama and CCM preferred are required.

Qualifications

• RN Case Manager requirements: valid RN license in Alabama, CCM preferred.
• Experience in discharge planning and care coordination.
• Knowledge of utilization review and patient education principles.

Responsibilities

• Evaluate patients’ medical, psychosocial, and discharge needs.
• Develop and implement individualized care plans with the healthcare team.
• Coordinate safe discharge plans and referrals to rehab or home health.
• Monitor resource use to ensure appropriate care and avoid unnecessary stays.
• Educate patients and families on care plans and post-discharge steps.
• Advocate for patient needs and preferences to align with goals.

Skills

Clinical assessment

Care coordination

Discharge planning

Utilization review

Patient education

Education

BSW or related bachelor degree

Current CCM or within 6 months of hire

Valid State RN License

Tools

Milliman Criteria

InterQual Criteria

Basic computer skills

Job description

Employment Status

Per Diem

Overview

Shift’s Available : Day

Employment Type : Per Diem/PRN

Hours: 8-hour shift: weekends only

Location : Riverview Regional Medical Center – Gadsden, AL

We are seeking a n RN Case Manager , also referred to as a Registered Nurse Case Manager or RN Clinical Case Manager . An RN Case Manager will oversee and coordinate patient care from admission through discharge to ensure quality, cost-effective outcomes. They assess patients’ needs, develop care plans, and collaborate with physicians, nurses, social workers, and other providers to manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare systems.

Responsibilities

Essential Duties and Responsibilities (includes, but not limited to):

• Patient Assessment: e valuate patients’ medical, psychosocial, and discharge needs upon admission and throughout their stay
• Care Coordination: d evelop and implement individualized care plans in collaboration with the healthcare team to ensure effective treatment and timely interventions
• Discharge Planning: c oordinate safe and appropriate discharge plans, including referrals to rehab, home health, or long-term care facilities
• Utilization Review: m onitor the use of hospital resources and services to ensure appropriate care and avoid unnecessary treatments or extended stays
• Patient and Family Education: h elp patients and families understand care plans, post-discharge instructions, and available resources
• Advocacy: a dvocate for patient needs and preferences, ensuring care is aligned with their goals and values
  
  

Qualifications

Before we go any further, we do have some deal-breakers. You must have:

• Valid State RN License
• BSW or other Bachelor degree in a related field
• Current CCM or obtained within 6 months of hire
• Experience and knowledge in basic to intermediate computer skills
• Behavioral Violence Prevention Training within 3 months of hire and maintain current
  
  

Additional Qualifications That Are a Plus

• Minimum 5 years of acute care experience
• At least one-year experience in case management, discharge planning or management
• Current BLS (AHA) certificate
• Knowledge of Milliman Criteria and InterQual Criteria
  
  

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/

Pay Transparency

BCBS Of Alabama Interqual Jiva Experience Required

Employment Status

Per Diem

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