Case Manager - AOMC

Cayuga Medical Center

26d•$84,365 - $104,104•Onsite

About The Position

The Case Manager coordinates and manages care for complex patients, collaborating with interdisciplinary teams to support quality outcomes, effective resource utilization, and successful discharge planning. The role reviews patient care for utilization management, facilitates access to appropriate services, and supports continuous quality improvement while maintaining a caseload of approximately 15–25 patients. The position is onsite with Arnot Health and works days. The standard pay range is $84,364.80–$104,104 per year, plus benefits.

Requirements

Graduate of an approved registered nursing program.
Current license as a registered nurse or eligibility for licensure in New York State.
Basic Life Support (BLS) required within 90 days of hire.
Must be able to remain at a workstation and move around the workspace as needed to complete job tasks, with or without reasonable accommodation.

Nice To Haves

BSN or Case Management Certification.
Three to five years of clinical nursing experience in an acute care hospital setting.
Case management experience.

Responsibilities

Review patient admissions and continued stays for medical necessity and appropriate level of care using established InterQual criteria and payer guidelines.
Identify patients who would benefit from Case Management services and develop individualized care plans to support quality outcomes and efficient resource utilization.
Collaborate with physicians, patients, families, payers, and interdisciplinary care teams to coordinate services, resolve barriers, and facilitate effective care transitions.
Manage discharge planning and post-acute care arrangements, including home health services, durable medical equipment (DME), rehabilitation placements, and community resources.
Prepare and communicate Medicare and non-Medicare notices of non-coverage and maintain compliance with regulatory and payer requirements.
Monitor patient progression throughout the continuum of care, address delays, reduce unnecessary length of stay, and promote timely discharge.
Track and analyze utilization management metrics, including length of stay, readmissions, denials, resource utilization, and patient satisfaction outcomes.
Lead and participate in care coordination meetings, daily interdisciplinary rounds, and complex case reviews to support optimal patient care and continuity of services.