RN Case Manager, Inpatient
About The Position
About Us: The people of Memorial Sloan Kettering Cancer Center (MSK) are united by a singular mission: ending cancer for life. Our specialized care teams provide personalized, compassionate, expert care to patients of all ages. Informed by basic research done at our Sloan Kettering Institute, scientists across MSK collaborate to conduct innovative translational and clinical research that is driving a revolution in our understanding of cancer as a disease and improving the ability to prevent, diagnose, and treat it. MSK is dedicated to training the next generation of scientists and clinicians, who go on to pursue our mission at MSK and around the globe. Exciting Opportunity at MSK: Are you passionate about using your Case Management experience to support Oncology Patients? The MSK Case Management Department is made up of Registered Nurses (RNs), Licensed Practical Nurses (LPNs) and support staff. In this role, you will be responsible for evaluating and responding to clinical and administrative denials referred to Case Management Department for appeal. You will participate in the daily management of the denial through resolution after the appeal is filed. You will perform special chart reviews to support strategic planning initiatives, while working with multidisciplinary team and acts as a liaison to insurance carriers and staff. Role Overview: Provide case management for a caseload of Oncology patients Assess discharge planning needs at the patient’s admission Perform regular concurrent review on all patients and coordinate all needed services including home care to facilitate the safe and timely transition to the next level of care and to follow selected patients in the outpatient setting Act as part of a multidisciplinary team to provide continuity of care throughout various stages of treatment and follow-up Connect with physicians and clinical nursing staff regarding ongoing patient care Work with insurance carriers and MSKCC billing departments to initiate appeals and acquire authorizations for treatment
Requirements
- Current NYS Registered Nurse License/Registration and BSN preferred
- At least 2-3 years of clinical hospital nursing experience
- Managed care/UR/CM experience strongly preferred
- Knowledge of state and federal regulations that govern health insurance coverage
- Knowledge of Microsoft: Outlook, Word, Excel, and PowerPoint
- Excellent interpersonal, decision-making, and communication skills
- Strong decision-making and negotiation skills
Responsibilities
- Provide case management for a caseload of Oncology patients
- Assess discharge planning needs at the patient’s admission
- Perform regular concurrent review on all patients and coordinate all needed services including home care to facilitate the safe and timely transition to the next level of care and to follow selected patients in the outpatient setting
- Act as part of a multidisciplinary team to provide continuity of care throughout various stages of treatment and follow-up
- Connect with physicians and clinical nursing staff regarding ongoing patient care
- Work with insurance carriers and MSKCC billing departments to initiate appeals and acquire authorizations for treatment
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
