We are an acute care medical center and a proud member of a neighboring large academic Health System looking for a Care Management Nurse to join our growing Care Management team. As the Care Management Nurse you will perform the initial comprehensive assessment on admission in accordance with the Care Management Department policy, screening all patients by utilizing established tools for high risk indicators (i.e. AIMS, Geisinger, polypharmacy) to ensure high risk patient populations receive the appropriate supportive services for discharge to prevent readmission and assess all populations for potential discharge planning needs.

Position: RN Care Manager

Location: White Plains, NY

Hours: 8 am - 4 pm or 9 am -5 pm

Salary: $120,000 - $140,000

Responsibilities:

• Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care. Performs all transitional planning activities including but not limited to: Patient/caregiver education, Arrangement of all aftercare, Commercial payer involvement and Communicates and collaborates all relevant patient information to appropriate health team members
• Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized
• Participates in Performance Improvement activities as needed
• Performs all UR activities per department policy: Commercial payer reviews, disposition determination, Retro/self-audit and Admission clinical review.

Requirements

• Bachelor’s Degree in Nursing with RN License required, CCM certification preferred, and PRI/Screen certification preferred
• Previous case management experience needed with 3-5 years clinical med/surg experience required
• Knowledge of healthcare financial, regulatory, and payer issues preferred
• Knowledge of state, local, and federal programs strongly preferred
• Experience in use of Milliman/InterQual criteria

Job Types: Full-time, Permanent

Pay: $120,000.00 - $140,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Medical specialties:

• Medical-Surgical

Physical setting:

• Acute care

Standard shift:

• Day shift

Supplemental pay types:

• Signing bonus

Weekly schedule:

• Monday to Friday

Work Location: In person