The RN Case Manager utilizes a collaborative process to plan and evaluate healthcare options using Interqual and Milliman Care Guidelines
Job Summary
The RN Case Manager utilizes a collaborative process to plan and evaluate healthcare options using Interqual and Milliman Care Guidelines.
This role focuses on facilitating quality patient care, cost-effective utilization, and efficient movement of patients through appropriate levels of care.
Candidates must be familiar with various community resources and charitable organizations to ensure timely and cost-effective resource usage.
Matching Summary
The RN Case Manager utilizes a collaborative process to plan and evaluate healthcare options using Interqual and Milliman Care Guidelines.
Skills & Requirements
Must-have
Interqual and Milliman Care Guidelines expertise
Discharge planning and case management experience
Electronic medical records navigation skills
Nice-to-have
Bilingual communication capabilities
CCM certification preference
Experience with community resources
Key Requirements
Current Texas RN license required
Associate degree in nursing required; BSN preferred
At least three years of case management or utilization review experience
Basic Life Support (BLS) certification within 30 days