RN Inpatient Case Manager - Part Time - Care Coordination

Presbyterian Healthcare Services•New York, NY

1d•Onsite

About The Position

Presbyterian Hospital is seeking an experienced RN Case Manager to join their team and support high quality, patient-centered care. This role involves providing clinically based case management, integrating utilization management, care coordination, and transition planning. The RN Case Manager will manage a designated caseload, ensuring patients receive appropriate care, managing length of stay, optimizing resource utilization, and supporting smooth transitions across the continuum of care. Collaboration with an interdisciplinary team is key to facilitating care, improving patient outcomes, enhancing satisfaction, and ensuring timely, accurate communication with payers.

Requirements

Associates Degree in nursing required.
BSN within 5 years of hire date.
Current State of New Mexico Registered Nurse licensure required.
2 years clinical nursing experience in relevant clinical practice area.

Nice To Haves

Utilization review or case management experience desirable
National Case Management certification preferred

Responsibilities

Interviews and assesses each patient, family or other designated person(s) within 48 hours of admission in order to obtain financial, emotional, physical, social, functional and health care needs in order to define and recommend potential discharge plans, manage patient and family expectations, identify readmission risk and target interventions to reduce risk for readmission, and identify, adjust and manage barriers to discharge.
Applies approved clinical criteria to monitor appropriateness of admissions and continued stays to ensure a clear status determination.
Refers cases and issues to Case Management Medical Director based on departmental standards.
Demonstrates skill in communicating with physicians the necessary documentation required to demonstrate medical necessity.
Elevates to Supervisor and/or Medical Director all patients not meeting criteria after discussion with physician.
Demonstrates skill in educating patient, family and interdisciplinary team regarding post-acute care options, status determination, and other care coordination services.
Develops implements, coordinates, monitors and evaluates preliminary and final discharge plans with the interdisciplinary team, patient and family.
Arranges and/or facilitates identified discharge needs and services of patients and ensures timely intervention to prevent delays in service and transition of care.
Ensures all elements of the plan of care have been communicated to the patient/family and members of the healthcare team to assure continuity of care.
Participates and facilitates care progression in daily multidisciplinary rounds and addresses target length of stay with health care providers to achieve complete delivery of services within prescribed timeframe.
Monitors length of stay and takes action to mitigate overutilization and elevates to medical director as needed.
Presents and actively participates in complex rounds, discharge planning huddles, process improvement teams, department specific initiatives and department meetings.
Identifies patients and families with complex psychosocial issues and refers them to the Social Worker as appropriate.
Demonstrates skill and success in collaboration with Social Work partner.
Facilitates and leads patient/family and provider care conferences as needed.
Documents results of assessments, status assignment, and interventions and discharge planning in the medical record according to departmental policies and procedures.
Ensures safe care to patients adhering to policies, procedures, and standards within budgetary specifications, including time management, supply management, productivity and accuracy of practice.
Promotes individual professional growth and development by meeting requirements for continuing education, skills competency, supports departmental based goals which contribute to the success of the organization.

Benefits

Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
Malpractice liability insurance
Loan forgiveness through the New Mexico Higher Education Department
EPIC electronic charting system
Sign-On Bonus and Relocation available for qualified candidates
Free on-site and community-based gyms
Nutrition coaching and classes
Mindfulness and meditation resources
Wellness challenges and more