Case Manager Registered Nurse
On-siteKansas City, Kansas, United States
Job Summary
Manage quality and resource management for all admitted patients across the continuum of care, ensuring cost containment and seamless provider integration. Perform holistic admission and concurrent reviews of medical records to verify medical necessity, service intensity, and severity of illness. Regularly assess care plans and outcomes to maintain compliance with insurance guidelines and healthcare regulations while utilizing analytics to improve processes and patient satisfaction. Establish communication channels between patients, providers, and work teams to deliver quality outcomes. Requires minimum five years of post-graduation nursing experience with a current state RN license.
Required Qualifications
- Minimum 5 years work experience post-graduation of an accredited school of nursing
- Current state Registered Nurse license
Desired Qualifications
- Five years acute care nursing experience
- At least one year experience in case management, discharge planning or nursing management
- Knowledge of Milliman Criteria and InterQual Criteria
- Behavioral Violence Prevention Training within 3 months of hires and maintain current
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