RN Case Manager

RN Case Manager- TidalHealth Atlantic

Why work at TidalHealth?

Looking for a rewarding place to work? Choose TidalHealth, which now includes three hospitals – TidalHealth Peninsula Regional in Salisbury, Maryland; TidalHealth Nanticoke in Seaford, Delaware; and Atlantic General Hospital in Berlin, Maryland. All three hospitals are “A” rated by Leapfrog Hospital Safety Guide, and the facilities have received numerous other honors.

Located on the beautiful Delmarva Peninsula, close to the beach, becoming part of Team TidalHealth also offers an ideal opportunity for work-life balance. Take advantage of our tuition assistance and scholarship programs to grow both personally and professionally.

RN Case Manager- Position Summary

Assumes Care Coordination and Utilization Review functions for all patients. Facilitates the collaborative management of patients to prevent E.D. recidivism, unnecessary admissions and re-admissions. Initiates clinical review, denials / appeals and medical necessity for those being placed in a clinical bed to ensure “right patient / right level of care.”

RN Case Manager- Position Requirements

Required Education and Experience

• Graduation from an accredited RN nursing program.
• 2-5 years clinical experience.
• Prior utilization review experience preferred.
• Knowledge of MCG (Milliman) criteria preferred.
• Knowledge of community based resources.

Preferred Education and Experience

• Bachelor’s degree preferred
• Prior work experience should be directly related to core job functions.
• Two years’ experience in healthcare setting.
• Prior Case Management experience required.
• Ability to multi-task and perform functions in a fast-paced setting.
• Knowledge of insurance, and associated coordination of healthcare services.

Required Credentials (i.e. Licensure, Certification, etc.)

• Valid RN License is required within the state in which you live.

RN Case Manager- Benefits

• Benefits include medical, prescription, vision, dental, flexible spending accounts, disability insurance plans, life insurance, paid time off plans, retirement plans, tuition reimbursement and more!