RN Case Manager - Utilization Review Facility East Liverpool City Hospital Location US-OH-East Liverpool ID 2024-156006 Category Clinical Professional Position Type Full Time Shift Days Job Type Non-Exempt Overview Join an award-winning team of dedicated professionals committed to our core values of quality, compassion, and community! East Liverpool City Hospital, a member of the Prime Healthcare Foundation, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. East Liverpool City Hospital is an award-winning community hospital proudly serving residents of the tristate region since 1905. With 152 licensed beds and more than 500 employees, the hospital averages 31,000 Emergency Department visits annually. East Liverpool's medical staff is comprised of more than 160 physicians with an additional 21 resident physicians completing their training in Family Medicine and Internal Medicine. The hospital provides 24/7 emergency services, general surgery, medical stabilization for substance abuse, behavioral health for adults over the age of 55, and remains the ONLY cardiac rehabilitation program in Columbiana County. For more information, visit www.elch.org. We are an Equal Opportunity 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. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOCKnowYourRightsscreenreader10_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 Required qualifications: 1. Current and valid state license as a Registered Nurse, preferred. 2. BSW or other Bachelor degree in a related field. At least one year experience in case management, discharge planning or nursing management; 3. CCM or obtained within 6 months of hire. 4. Experience and knowledge in basic to intermediate computer skills. 5. Behavioral Violence Prevention Training within 3 months of hire and maintain current. Preferred qualifications: 1. Minimum 5 years of acute care experience preferred. 2. At least one-year experience in case management, discharge planning or management, preferred. 3. Current BCLS (AHA) certificate preferred. 4. Knowledge of Milliman Criteria and InterQual Criteria preferred. #LI-WM1 Connect With Us! Not ready to apply? Connect with us for general consideration. We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, sexual orientation, gender, gender identity, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources: hr-prime@primehealthcare.com