Care Manager ( Registered Nurse / RN ) - Per Diem

Catholic Health • Bethpage, NY

13d • Onsite

About The Position

Our Care Managers will educate staff, physicians, patients, and families in the case management process. They will review new admissions and continued stay patients to determine whether MCG criteria is met. They will engage physicians to establish the optimal DRG, length of stay and expected date of discharge. They will interface with representatives of third party payors to assist with the certification process and the discharge planning process, responding to requests for reviews in a timely fashion to avoid denials. They will review records and collaborate with the interdisciplinary team to obtain information about all aspects of the patients, transmitting information to third party payors to avoid denials. They will participate in interdisciplinary rounding and identify areas for improvement. They will facilitate communication between patients, families, and social work to ensure safe and appropriate discharge plans. They will collaborate effectively within an interdisciplinary team and engages patients and families.

Requirements

• 3+ Years of diverse in-patient acute care RN experience
• Critical Care, Home Care, and/or Case Management experience
• Excellent written and verbal communication skills.
• Highly organized and detail oriented with strong critical thinking ability.
• Ability to assess, evaluate, plan, and coordinate complex patient placement and discharge activities.
• Strong time management skills with the ability to manage competing priorities in a fast-paced acute care environment.
• Exhibits flexibility and adaptability in response to changing patient needs, discharge plans, payer requirements, and operational demands.
• Proficiency in Microsoft Office applications required.
• Ability to quickly learn and effectively navigate multiple electronic medical record systems, insurance portals, and care coordination platforms.
• Graduate of an accredited School of Nursing required
• New York Registered Nurse (RN) License & Registration

Nice To Haves

• Passion for Case Management
• Progressive leadership experience preferred
• Knowledge of progression of care, medical necessity criteria, and post-acute authorization processes preferred.
• Bachelors of Science in Nursing (BSN) degree strongly preferred
• Case Management Certification preferred
• PRI Certification preferred

Responsibilities

• Educate staff, physicians, patients, and families in the case management process.
• Review new admissions and continued stay patients to determine whether MCG criteria is met.
• Engage physicians to establish the optimal DRG, length of stay and expected date of discharge.
• Interface with representatives of third party payors to assist with the certification process and the discharge planning process, responding to requests for reviews in a timely fashion to avoid denials.
• Review records and collaborate with the interdisciplinary team to obtain information about all aspects of the patients, transmitting information to third party payors to avoid denials.
• Participate in interdisciplinary rounding and identify areas for improvement.
• Facilitate communication between patients, families, and social work to ensure safe and appropriate discharge plans.
• Collaborate effectively within an interdisciplinary team and engages patients and families.

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree