Case Manager RN

Prime Healthcare Services - North Las Vegas, NV

Full-time - Mid Level

North Las Vegas, NV

101-250 employees

Ambulatory Health Care Services

About the position

The Case Manager RN at North Vista Hospital is responsible for overseeing the quality and resource management of patients admitted to the facility. This role involves advocating for patients, promoting cost containment, and ensuring a seamless delivery of care across the healthcare continuum. The Case Manager will perform comprehensive reviews of medical records to assess medical necessity and the intensity of services provided, aiming for high-quality clinical outcomes.

Responsibilities

• Manage the quality and resource allocation for all patients admitted to the facility.
• Advocate for patients while promoting cost containment.
• Integrate healthcare providers to ensure seamless delivery of care.
• Conduct holistic and comprehensive admission and concurrent reviews of medical records.
• Ensure achievement of quality, clinical, and cost-effective outcomes.

Requirements

• Minimum 5 years of work experience post-graduation from an accredited school of nursing with a current state Registered Nurse license.
• Preferred: RN Case Manager with at least 5 years of acute care nursing experience.
• At least 1 year of experience in case management, discharge planning, or nursing management is preferred.
• Current BCLS certificate is preferred.
• Knowledge of Milliman Criteria and InterQual Criteria is preferred.
• Basic to intermediate computer skills.