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RN Case Manager

unlimited holidays - extra parental leave

Remote:

Hybrid

Salary:

120 - 154K yearly

Experience:

Senior (5-10 years)

Work from:

White Plains (US)

Offer summary

Qualifications:

BSN or related Bachelor's degree, 5 years clinical ED experience, Previous case management preferred, Registered Nurse (RN) NYS license, Computer skills essential.

Key responsabilities:

Perform initial comprehensive assessments
Coordinate care activities and discharge planning
Communicate relevant patient information
Participate in Performance Improvement activities
Complete UR activities per department policy

Intellisoft Technologies SME https://www.intellisofttech.com/

51 - 200 Employees

See more Intellisoft Technologies offers

Job description

RN Case Manager

Care Management

Full Time

Day

Mon-Fri, 8:30a-4:30p or 9a-5p; monthly weekend rotation(Saturday & Sunday

Sign On Bonus : $5,000

Salary Range: $119,970.24 - $153,900.24

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.

Physical/Mental Demands/Requirements & Work Environment

May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital's SDS (Safety Data Sheet) data base and may be accessed through the hospital's Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc.
Must be physically able to walk, stand and/or sit for extended periods of time, with the ability to carry necessary equipment (i.e., IPad or laptop) on rounds. Must be able to perform difficult manipulative, arm-hand steadiness and hand-eye coordination skills. Must be able to meet all regulatory requirements. Demonstrates ability to follow written and oral instructions required for the position.
Demonstrates ability to analyze multidimensional problems into component parts and sort out tasks in priority order to solve the problem.
Must be able to see object closely and far away, hear normal sounds with some background noise. Communicates effectively verbally and in writing.