Nurse Case Manager
4 weeks ago
Job Summary:
Prime Healthcare is seeking a skilled Nurse Case Manager to join our team. As a key member of our healthcare team, you will be responsible for ensuring the quality and resource management of all patients admitted to our facility.
Responsibilities:
- Conduct comprehensive admission and concurrent reviews of medical records to ensure medical necessity, intensity of service, and severity of illness.
- Develop and implement cost-effective care plans that promote seamless delivery of care.
- Collaborate with healthcare providers to integrate care and achieve quality, clinical, and cost-effective outcomes.
- Provide leadership and guidance to ensure the achievement of quality and resource management goals.
Qualifications:
- Minimum 5 years of work experience post-graduation from an accredited school of nursing and a current state Registered Nurse license.
- Knowledge of Milliman Criteria and InterQual Criteria preferred.
- Basic to intermediate computer skills required.
About Prime Healthcare:
Prime Healthcare is an award-winning health system headquartered in Ontario, California. We operate 45 hospitals and have over 300 outpatient locations in 14 states, providing over 2.6 million patient visits annually. We are committed to delivering high-quality, patient-centered care and are seeking talented professionals to join our team.
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