Case Manager Registered Nurse - Social Work Services - Case Management

Case Manager Registered Nurse - Social Work Services

Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Mission Regional Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Mission Regional Medical Center is a 297-bed, non-profit hospital that provides inpatient and outpatient hospital services to the people of the Rio Grande Valley. Rated one of the top hospitals in the country for clinical excellence in many services including maternity and orthopedic care, Mission Regional Medical Center has been offering quality healthcare, close to home, for over 60 years. For more information visit www.missionrmc.org. Company is an equal employment opportunity employer. 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. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure 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 the medical necessity, intensity of service and severity of illness. Qualifications Education and Work Experience Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred. Current BCLS (AHA) certificate upon hire and maintain current;. Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic to intermediate computer skills. Behavioral Violence Prevention Training within 3 months of hires and maintain current.