Clinical Case Manager RN

4 weeks ago


Salisbury, Maryland, United States TidalHealth Full time

About the Role

TidalHealth is seeking a skilled Utilization Review Registered Nurse to join our team. As a key member of our interdisciplinary team, you will be responsible for facilitating appropriate lengths of stay and reimbursement for all hospital admissions. Your expertise will help us promote quality of care and improve patient outcomes.

Key Responsibilities

  • Collaborate with the interdisciplinary team to develop organization-wide approaches to problem-solving.
  • Analyze current systems and variances to identify opportunities for improvement.
  • Work with the leadership team to align goals and visions.
  • Develop and implement evidence-based clinical practice guidelines.

Requirements

  • Current and valid license to practice as a RN.
  • BSN preferred.
  • Accreditation preferred.
  • 3 or more years of strong clinical experience.
  • Interqual or Milliman criteria preferred.
  • Excellent interpersonal communication and negotiation skills.
  • Strong analytical, data management, and PC skills.
  • Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.

What We Offer

  • A competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • A collaborative and supportive work environment.


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