Registered Nurse Case Manager Utilization Management

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion, and community! Knapp Medical Center, 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.

Knapp Medical Center is an award-winning, not-for-profit hospital in Weslaco, Texas. With 227 beds, the community hospital specializes in emergency care, orthopedics, obstetrics and gynecology, wound care, surgery, cardiology, gastroenterology, critical care, and interventional radiology. Knapp serves as the only acute care hospital in the Mid-Valley area, as well as Weslaco's only Level III Trauma Center, Advanced Primary Stroke Center, and Level II Newborn Nursery. Knapp has been providing quality and compassionate healthcare to Mid-Valley residents for 60 years.  More than 300 physicians serve on the hospital's medical staff. Knapp also serves as one of the largest employers in the Mid-Valley, employing more than 450 people.  For more information, please call 956-968-8567 or visit www.KnappMed.org

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_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. BSW or other Bachelor degree in a related field. At least one year experience in case management, discharge planning or nursing management;2. CCM or obtained within 6 months of hire.3. Experience and knowledge in basic to intermediate computer skills.4. 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.