Healthcare Quality Manager

1 week ago


Philadelphia, Pennsylvania, United States Roxborough Memorial Hospital Full time
About Roxborough Memorial Hospital

Roxborough Memorial Hospital is a 131-bed community hospital serving the medical and health care needs of the Roxborough, Manayunk, East Falls and northwest section of Philadelphia communities for over a century.

Job Summary

We are seeking a skilled Registered Nurse to join our team as a Case Manager. The successful candidate will be responsible for the quality and resource management of all patients admitted to the facility, promoting cost containment and demonstrating leadership to integrate healthcare providers for a seamless delivery of care.

Responsibilities
  • Conduct comprehensive admission and concurrent review of medical records for medical necessity, intensity of service, and severity of illness.
  • Develop and implement care plans to achieve quality, clinical, and cost-effective outcomes.
  • Collaborate with healthcare providers to ensure a coordinated and efficient delivery of care.
  • Monitor and report on patient outcomes and quality metrics.
Qualifications
  • Minimum 5 years of work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license.
  • Experience in case management, discharge planning, or nursing management preferred.
  • Knowledge of Milliman Criteria and InterQual Criteria preferred.
  • Basic to intermediate computer skills required.
What We Offer

Roxborough Memorial Hospital offers a dynamic and supportive work environment, opportunities for professional growth and development, and a competitive compensation package.



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