RN Manager of Case Management
Las Vegas, Nevada
The RN Manager of Case Management develops, implements, and maintains a system of outcome management. The RN Manager of Case Management ensures Coordination of Care across the continuum on a financial platform.
Qualifications :
- Registered Nurse required
- Basic Life Support (BLS) Certification required
- Bachelor’s degree in nursing required
- Leadership Management of Case Management in Acute Hospital Setting required
- Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred
Responsibilities :
- Care Management principle related to eligibility, authorizations, admission assessment, concurrent / retro-eligible review, denials and appeals
- InterQual and basic understanding of Milliman Care guidelines
- Supervisory principles and practices
- Nursing process (assessment, planning, implementation, and coordination of patient care) Standards of care
- Disease process of illnesses or injuries in variety of specialty areas
- Patient care plan development
- Patient evaluation and assessment techniques
- Nurse Practice Act
- Third party reimbursement regulations and rules
- Department and hospital safety practices and procedures
- Patient rights
- Department and hospital emergency response policies and procedures
- Working with patients in a variety of conditions
- Supervising the work of assigned staff
- Interpreting rules and regulations
- Interpreting and analyzing patient medical charts for Acute care criteria
- Communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds
- Establishing and maintaining effective working relationships
To apply for Case Management opportunities or to inquire further, interested individuals can directly contact Michelle Boeckmann at Michelle@HCRecruiter.
com or visit our Case Management website at
Feel free to share these contact details with anyone who might be interested in Case Management and Utilization Management opportunities.
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