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CASE MANAGER (RN) - UTILIZATION MANAGEMENT in Reno, NV at Prime Healthcare Services Inc

Date Posted: 6/6/2019

Job Snapshot

Job Description

Responsibilities

Department: Utilization Management

Status: Full Time

Shift: Days

 

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

  1. Two (2) years clinical experience in an acute care setting within the last 5 years.
  2. Current licensure as a Registered Nurse in the State of Nevada.
  3. Must be able to communicate in English (Speak, Write)
  4. Demonstrates: - excellent communication skills both verbal and written - ability to facilitate and collaborate with an interdisciplinary team - flexibility to manage multiple complex cases simultaneously - attention to detail and follow-up - critical thinking and problem-solving skills.
  5. Current BLS (AHA) certificate
  6. Case Management Certification (CCM) preferred.
  7. Utilization review/appeals experience preferred

Employees must be in their current position for a minimum of six calendar months and not received any disciplinary action within the last six months to apply and be considered for a transfer.

 

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law: http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf