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Job Summary:
We are seeking a dedicated Registered Nurse Case Manager to join our healthcare team. The ideal candidate will provide high-quality patient care by coordinating with healthcare providers, patients, and their families to ensure effective treatment plans and positive outcomes.
Registered Nurse RN Care Management
Full Time
Day
M-F 9A-5P with a weekend rotation ( Sat & Sun)
Position Summary
The RN Care Manager performs 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. Provides ongoing reassessment of needs throughout the hospital course. Performs UR activity per department policy.
Essential Functions and Responsibilities Includes the Following:
Understands and adheres to the WPH Performance Standards, Policies and Behaviors
Completes a comprehensive initial assessment.
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
High utilizer patient root cause
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.
Documents per department requirements.
Participates in Performance Improvement activities as needed.
Performs all UR activities per department policy:
Commercial payer reviews
Disposition determination,
Retro/self-audit
MC variance
Admission clinical review.
Performs all other related duties as assigned
Education & Experience Requirements
BSN or related Bachelor's degree required
5 years clinical ED, critical care or med/surg experience required
Previous case management experience preferred
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
Registered Nurse (RN) NYS license required
PRI/Screen certification strongly preferred.
C.C.M. (Certified Case Manager) certification preferred
Computer skills essential
Core Competencies
Demonstrates ability to establish two-way communication by clearly defining expectations, communicating utilizing a variety of methods, actively listening to ideas and concerns and responding in an appropriate manner.
Demonstrates ability to delegate responsibilities appropriately.
Demonstrates ability to retain composure under stress and perform multitasking functions.
Job Type: Full-time
Pay: $101,821.00 - $120,431.00 per year
Medical specialties:
Schedule:
Work setting:
Experience:
License/Certification:
Work Location: In person
Full Time
$99k-119k (estimate)
06/08/2024
06/10/2024
The job skills required for Registered Nurse (RN) Case Manager include Case Management, Patient Care, Coordination, Planning, Care Management, Discharge Planning, etc. Having related job skills and expertise will give you an advantage when applying to be a Registered Nurse (RN) Case Manager. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Registered Nurse (RN) Case Manager. Select any job title you are interested in and start to search job requirements.
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