Senior Health Care Manager

4 weeks ago


Philadelphia, Pennsylvania, United States Prime Healthcare Management Inc Full time
Prime Healthcare Management Inc is an award-winning health system headquartered in Ontario, California. With over 45 hospitals and more than 300 outpatient locations in 14 states, the company provides more than 2.6 million patient visits annually. As one of the nation's leading health systems, Prime Healthcare employs nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity.

**Equal Employment Opportunity Employer**

Prime Healthcare Management Inc is an equal employment opportunity employer. The 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.

**Responsibilities**

As a Senior Health Care Manager, you will be responsible for the quality and resource management of all patients admitted to our facilities from the point of admission and across the continuum of health care management. You will work on behalf of the advocate, promoting cost containment and demonstrating leadership to integrate health care providers to achieve a seamless delivery of care. The methodology is designed to facilitate and ensure 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 medical necessity, intensity of service, and severity of illness.

**Qualifications**

EDUCATION, EXPERIENCE, TRAINING

To be eligible for this role, you must have:

1. A minimum of 5 years of work experience post-graduation from an accredited school of nursing and a current state Registered Nurse license.

2. Grandfathered prior to April 1, 2015, with a minimum of 5 years post-graduation from an accredited school of Social Work for Licensed Clinical Social Worker. However, RN Case Manager is preferred.

3. Five years of acute care nursing experience preferred. At least one year of experience in case management, discharge planning, or nursing management is preferred.

4. Current BCLS certificate is preferred.

5. Knowledge of Milliman Criteria and InterQual Criteria is preferred.

6. Experience and knowledge in basic to intermediate computer skills.

**Estimated Salary: $95,000 - $120,000 per year**

Note: The estimated salary range is based on industry standards and may vary based on location, experience, and other factors.

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