Job Location : Brooklyn,NY, USA
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Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days
Located in Park Slope, Brooklyn, this acute-care teaching hospital has been providing outstanding medical care to the surrounding communities for over 135 years.
The Case Manager is responsible for all aspects of discharge planning and utilization management/review for an assigned group of patients to determine the appropriateness of the admission and continued stay, assist in the development of the plan of care; ensure that the plan is implemented timely and identify the expected length of stay (ELOS). The Case Manager works collaboratively with physicians, social workers, clinical nurses, home care services, and other members of the interdisciplinary team. The Case Manager actively participates in specific clinical initiatives focused on reducing the length of stay (LOS), improving efficiency and quality, and ensuring resource utilization is appropriate.
Case manager/utilization manager: Responsible for an average of 60-70 medical/surgical daily admissions that requires risk identification and clinical reviews. A utilization nurse completes no less than 20 initial clinical reviews daily. Responsibilities also includes:
• Completing 100% clinical reviews for managed care, Medicare and Medicaid admissions • Completing concurrent and retrospective reviews• Communicating with physicians and the inpatient case management teams on patients who do not meet initial inpatient criteria or continued inpatient stay• Coordinating expedited appeals for inpatient denials with attending physicians and insurance providers • Ensuring organization resources are being utilized appropriately• Completing patient assessments within 24 hours• Coordinating safe and appropriate post-acute care plans• Obtains authorizations from managed care companies for post-discharge services.
This is a full time Monday – Friday position 8:30am -5:00pm
Position requires weekend rotation and volunteer for holidays
Preferred Criteria
Master's degree
CCM certification
Required Criteria
Current NYS RN license
Bachelor's degree in Nursing (BSN)
3-5 yrs Acute Care RN nursing experience
Previous experience in inpatient acute care case manager/discharge planning, certified home health care (CHHA), Case Management experience, utilization experience, or managed care organization experience required
PRI certification within one year of hire.
Ability to work independently and collaboratively within an interdisciplinary team
Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, diversity, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life. Start your life-changing journey today.__________________
NewYork-Presbyterian Hospital is an equal opportunity employer.
Salary Range:
$112,508-$149,911/Annual
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