Registered Nurse (RN) Case Manager - Care Management (Acute Care)

Salary Range
The expected base rate for this Glens Falls, New York, United States-based position is $40.83 to $60.74 per hour. (Exact rate is determined on a case-by-case basis commensurate with experience level, as well as education and certifications pertaining to each position which may be above the listed job requirements.)

The Impact You Can Make

The Case Manager (Acute Care) role must optimize and integrate the interface between clinical and financial systems supporting positive health outcomes. The Case Manager uses nursing and case management knowledge to promote appropriate allocation of hospital and other resources, while striving to provide high quality care to each patient in a cost effective and timely manner. Support services provided by the Case Manager include, but are not limited to, utilization review, case management, weekend and holiday case management, care transition, collaboration with physicians and social workers for care coordination and discharge planning.

How You Will Fulfill Your Potential (Responsibilities)

• Ensures order in chart/EMR coincides with the InterQual review or CMS rules and regulations for appropriate Level of Care and status on all patients through collaboration with Utilization Review RN.
• Assesses the patient’s plan of care as soon as possible on admission and re-evaluates.
• Contacts the attending physician for additional information if the patient does not meet the appropriate guidelines.
• Collaborates and makes referrals to physician advisor when unable to resolve issues with attending physician.
• Meets with patient and/or family/personal representative as soon as possible, but not greater than 48 hours of admission, to assess, evaluate, and identify discharge needs. Provides support and information, as needed.
Will facilitate safe transitional care practices to reduce readmissions and to ensure safe transition from the acute care setting to the post-acute care setting.

What You Bring (Qualifications)

Education/Experience:

• Bachelors of Nursing (BSN) is preferred at hire, and is required within 5 years of hire. Exceptions may be made for Associate’s degree RN with relevant experience and obtains certification in case management (CCM or ACM) within 1 year.
• Minimum of two years of experience in a hospital environment strongly preferred

• Home care, payer, or other experience will be considered
  

• Ability to function autonomously maintaining a high level of clinical and professional accountability

• Demonstrates skill in creative problem solving, facilitation, collaboration, coordination and critical thinking

• Embraces change and continuously identifies opportunities for improvement by demonstrating a commitment to creativity and innovation

• Committed to promoting excellence in Customer Service; functions as a team player

• Computer literacy and data analysis skills are required

• Maintains professional image by demonstrating strong verbal and written communication skills

• Demonstrates ability in self-starting, self-directing and clear decision making behaviors