Case Manager Registered Nurse
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At a glance
Requirements
Credentials this posting asks for.
Job overview
Prime Healthcare is hiring a Case Manager Registered Nurse. The role involves quality and resource management of admitted patients, advocating for cost containment, leading integration of health care providers, ensuring clinical and cost‑effective outcomes, reviewing medical necessity, assessing care plans, utilizing analytics, and establishing strong communication channels to deliver seamless, quality care.
Key focus areas include Responsible for quality and resource management of all admitted patients, Promote cost containment and demonstrate leadership to integrate health care providers, and Ensure achievement of quality, clinical and cost‑effective outcomes through admission and concurrent review.
Successful candidates bring Registered Nurse License, Minimum 5 Years Work Experience Post Graduation, and Behavioral Violence Prevention Training. Important skills include Behavioral Violence Prevention Training. Preferred (not required): Quality Management, Resource Management, Cost Containment, and Leadership.
Skills & qualifications
Skills
Qualifications
Full job description
Overview Department: Case Management
Employment Type: Per Diem
Shifts Available: Variable
Location: Providence Medical Center- Kansas City, KS
Are you a seasoned Nurse ready to take your skills to the next level? Join us as a Case Manager, RN , where you’ll play a vital role in shaping patient care and driving quality outcomes. In this position, you’ll be esponsible 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. Work 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. If you’re passionate about improving healthcare standards and thrive in a dynamic environment, we want to hear from you!
Responsibilities Essential Duties and Responsibilities (includes, but are not limited to):
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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.
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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.
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Ensures 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.
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Regularly assess care plans and outcomes to ensure compliance with insurance guidelines and healthcare regulations. Utilize analytics to improve care processes and patient satisfaction.
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Establish strong communication channels between patients, providers, and work teams to deliver quality outcomes and seamless service delivery.
Qualifications Education, Work Experience & Qualifications:
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Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
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Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred.
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Knowledge of Milliman Criteria and InterQual Criteria preferred.
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Behavioral Violence Prevention Training within 3 months of hires and maintain current.
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Employment Status Per Diem Shift Variable 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
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