Nurse Case Manager- $10k Sign On
: Job Details :

Nuvance Health has a network of convenient hospital and outpatient locations - Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations. Sign on - Bonus - $10,000! Summary: Under the general supervision of the Director, The Nurse Case Manager provides clinically-based case management to support the delivery of effective and efficient patient care. Paces the case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within the assigned caseload. Partners with Social Workers and collaborates with other health care team members to identify appropriate utilization of resources and to ensure reimbursement. Job Responsibilities: * Determines medical necessity, appropriateness of admission, continuing stay and level of care using a combination of clinical information, clinical criteria, and third party information. * Intervenes when determinations are not in alignment with clinical information, clinical criteria, computer system to resolve the situation. * Validates admission and continuing stay criteria with third party payers (including onsite and telephonic Case Managers) as well as Primary Care and Attending Physicians. * Supports the effective prevention and management of denials, including providing information as part of the appeal process. * Uses clinical knowledge and knowledge of anticipated response to treatment to assess patient progression towards anticipated outcomes. * Provides support and counseling to patients/families experiencing and/or anticipating issues to adjusting to illness, catastrophic diagnoses, changes in living situations and bereavement. * Consults, assesses, refers, coordinates interventions in cases of suspected or actual situations of child or adult abuse and neglect or other forms of domestic violence and/or sexual abuse. Job Requirements: * Minimum Requirement: 3 years experience in acute care. * Must have Associate's Degree or BSN preferred. Must have current RN license. * Preferred experience in Utilization Review/Management. Location: Vassar Brothers Medical Center Work Type: Full-Time Standard Hours: 40.00 Work Shift: Mon- Fri 8:00am-4:30pm; Every other weekend Salary Range: $39.2100 - $72.8300 Hourly. EOE, including disability/vets. We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-###-#### (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.