What are the responsibilities and job description for the Case Management Nurse position at Pride Health?
RN Case Manager / Utilization Review (Inpatient)
Location: Brooklyn, NY 11212
Shift: Days, Monday–Friday 8:00 AM–4:00 PM; every other Saturday required (8:00 AM–4:00 PM)
Guaranteed Hours: 40/week
Contract Length: ~13 weeks
Position Summary:
RN Case Manager responsible for coordinating inpatient care, utilization management, and discharge planning. The role focuses on concurrent review, high-risk patient identification, collaboration with physicians and interdisciplinary teams, and communication with third-party payers to ensure appropriate level of care and timely discharge.
Key Responsibilities:
- Perform concurrent utilization and continued-stay reviews
- Identify high-risk patients and develop discharge plans for uncomplicated cases
- Coordinate with physicians to establish and update time-oriented plans of care
- Communicate clinical information to third-party payers and complete retro reviews
- Monitor delays, duplication of services, and appropriateness of care
- Collaborate with social work and interdisciplinary teams to facilitate discharge
- Ensure accurate documentation and participation in quality and performance improvement activities
Requirements:
- Active New York State RN license
- BSN required
- Minimum 3 years of direct patient care experience
- BLS and ACLS required
- Strong utilization review, discharge planning, and interdisciplinary collaboration skills
Preferred:
- MSN
- CCM (Certified Case Manager)
- PALS
Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts.
Best Regards,
Tabish Ahmad
Salary : $65 - $78