Case Manager (RN) - Utilization Management

Founded in 1973, Montclair Hospital, a 106-bed acute care, not-for-profit community hospital, received the “100 Top Hospital” in the nation award from IBM Watson Health, the Patient Safety Excellence award from Healthgrades®, and the Women's Choice Award® for America's Best Emergency Care. The methodology is designed to facilitate and ensure 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.

Overview:

At Montclair Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of the Prime Healthcare Foundation, Montclair Hospital Medical Center is actively seeking new members to join its award-winning team!
 
Founded in 1973, Montclair Hospital, a 106-bed acute care, not-for-profit community hospital, received the “100 Top Hospital” in the nation award from IBM Watson Health, the Patient Safety Excellence award from Healthgrades®, and the Women's Choice Award® for America's Best Emergency Care. For more information visit Montclair-hospital.org

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 ensure 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, EXPERIENCE, TRAINING

Required Qualifications:

1.  Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
2. At least one year experience in case management, discharge planning or nursing management
3. Experience and knowledge in basic to intermediate computer skills.

Preferred Qualifications:

1. Five years of acute care nursing experience.  preferred
2. CCM or obtained within 1year
3. Knowledge of Milliman Criteria and InterQual Criteria preferred.
4. Current BCLS certificate, preferred

Pay Transparency:

Montclair Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $43.25 to $58.21 The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status: Full Time Shift: Days Equal Employment Opportunity: Privacy Notice:

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