Case Manager Nurse

Overview

Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine. CMH includes Central Maine Medical Center (CMMC) in Lewiston, Bridgton Hospital, and Rumford Hospital.

Responsibilities

• Responsible for the quality and resource management of all patients admitted to the facility.
• Works on behalf of the advocate, promoting cost containment and demonstrating leadership to integrate health care providers to achieve a seamless delivery of care.
• Facilitates and ensures the achievement of quality, clinical, and cost-effective outcomes through a holistic and comprehensive admission and concurrent review of the medical record for medical necessity, intensity of service, and severity of illness.

Qualifications

• Education: Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license. Grandfathered prior to April 1, 2015.
• Experience: Minimum 5 years post-graduate of an accredited school of social work for Licensed Clinical Social Worker. Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning, or nursing management, preferred.
• Knowledge: Knowledge of Milliman Criteria and InterQual Criteria preferred. Experience and knowledge in basic to intermediate computer skills.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

The 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.