Registered Nurse, (RN), Case Manager,Utilization Review-Full-Time, Nights (8hr)

Location: 
SMMC-SMMC Hospital
Schedule: 
Full Time
Shift: 
Day Job
Job Listing: 
SAD002048
Case Management - Utilization

Position Summary:The Registered Nurse (RN) Case Manager collaborates with other professional disciplines/unit leaders to ensure safe and effective patient care delivery and the achievement of desired patient outcomes. She / he will be collaborating closely with ED and Admitting Physicians to ensure approprate admission status and supportive documentation.

Qualifications: 

Experience:

  • Three to five years of acute hospital experience in clinical areas and specifically in area of specialization, with working knowledge of utilization review, discharge planning activities, government and managed care regulations, quality improvement principles and risk management.
  • Computers, Internet, order entry and word processing experience preferred.
  • Ability to perform accurate chart review, analysis and data collection.
  • Clinical experience with for the ability to assess for the delivery of appropriate, evidence based medical care focused on quality and patient safety.
  • Collaborative interaction and effective education skills to facilitate discussions with medical staff, coders, and other healthcare team members.
  • Milliman Care Guideline and ED expertise is desireable.
Education/License/Certification:
  • Bachelor degree or higher in Nursing or a healthcare related field is preferred.
  • RN License required.
  • Current BLS for Healthcare Providers Certification.
  • Case Management Certificate or Certification preferred
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