RN Manager of Case Management

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 https://www.HealthcareRecruitmentPartners.com/Careers.

Feel free to share these contact details with anyone who might be interested in Case Management and Utilization Management opportunities.