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Prime Healthcare

Acquires and reorganizes underperforming hospitals

Registered Nurse - Case Manager

Medical, Clinical & VeterinaryPosted on Nov 10
Part-timeGarden Grove, CA, USA$49.82 - $62.22In-person

About the Job

Requirements

  • At least five years of work experience after graduating from an accredited school of nursing and a current state Registered Nurse license are required for the standard pathway.
  • For those grandfathered before April 1, 2015, at least five years after graduation from an accredited school of social work as a Licensed Clinical Social Worker is specified.
  • Five years of acute care nursing experience is preferred.
  • At least one year of experience in case management, discharge planning, or nursing management is preferred.
  • A current Basic Cardiac Life Support certificate from the American Heart Association is preferred.
  • Knowledge of Milliman Criteria and InterQual Criteria is preferred.
  • Basic to intermediate computer skills and knowledge are required.
  • Behavioral Violence Prevention Training must be completed within three months of hire and kept current.

Responsibilities

  • Manage the quality and resources of all patients admitted to the facility, beginning at admission and continuing across the health care management continuum.
  • Advocate on behalf of patients and promote cost containment.
  • Integrate health care providers to support seamless delivery of care.
  • Conduct holistic and comprehensive admission and concurrent medical-record reviews for medical necessity, intensity of service, and severity of illness.
  • Facilitate quality, clinical, and cost-effective outcomes.

Desired Qualifications

  • Five years of acute care nursing experience.
  • At least one year of experience in case management, discharge planning, or nursing management.
  • A current Basic Cardiac Life Support certificate from the American Heart Association.
  • Knowledge of Milliman Criteria and InterQual Criteria.

About the Company

Prime Healthcare

Acquires and reorganizes underperforming hospitals

Prime Healthcare operates a network of hospitals and outpatient centers across the United States, concentrating on turning around financially struggling facilities. It invests in infrastructure and technology, restructures operations, and negotiates payer terms (including pursuing higher out-of-network reimbursements) to improve financial performance, and it manages both for-profit hospitals and not-for-profit facilities through the Prime Healthcare Foundation. The company aims to raise clinical quality and patient safety while expanding access in hundreds of communities, though it has faced legal and regulatory scrutiny over billing practices and service-line decisions. Its goal is to stabilize and improve the financial and clinical performance of underperforming hospitals so they can continue serving their communities.

Company size
5,001-10,000
Company stage
Debt Financing
Total funding
$2.2B
Headquarters
Ontario, CA
Founded
2001

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