RN Case Manager - Acute Care & Discharge Specialist

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

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.