RN Care Manager

White Plains Hospital Center•White Plains, NY

51d

About The Position

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 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.

Requirements

BSN required for all RNs hired after 1/1/18
All RNs hired before 1/1/18 will be required to have their BSN (or MSN) by 12/31/21.
Registered Nurse (RN) NYS license required
PRI Certification (PRI certification to be obtained within 3 months of initial employment)
3 years clinical ED, critical care or med/surg experience preferred
Computer skills essential
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.
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.

Nice To Haves

Screen certification strongly preferred
A Care Management certification preferred (i.e. CMC, CCM etc.)
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
A Care Management certification preferred (i.e. CMC, CCM etc.)

Responsibilities

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.
The RN Care Manager collaborates with all Health Care professionals to evaluate the needs and the safe discharge of all geriatric patients including but not limited to inpatients, emergency department and surgical outpatients.
Performs all other related duties as assigned