RN Care Manager
RN Care Manager
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Job Description
Job Opportunity : RN Care Manager
Location: White Plains NY
Department: Care Management
Position Type: FullTime
The RN Care Manager is responsible for conducting comprehensive initial assessments on patient admission utilizing established tools for highrisk indicators (e.g. AIMS Geisinger polypharmacy). This role ensures highrisk patient populations receive the appropriate supportive services and discharge planning to prevent readmission. The RN Care Manager will also perform ongoing reassessments throughout the hospital stay coordinate multidisciplinary care and oversee all transitional planning activities.
Essential Functions and Responsibilities:- Complete a comprehensive initial assessment upon patient admission.
- Perform multidisciplinary care coordination at both intrahospital and interhospital levels.
- Conduct all transitional planning activities including patient/caregiver education and arranging aftercare.
- Involve commercial payers and address root causes for high utilizer patients.
- Communicate and collaborate relevant patient information with the appropriate health team members.
- Work towards department goals of reducing length of stay (LOS) preventing readmissions reducing denials and improving patient satisfaction.
- Document patient care and activities in compliance with department requirements.
- Participate in Performance Improvement activities as needed.
- Perform Utilization Review (UR) activities including commercial payer reviews disposition determination retro/selfaudits MC variance and admission clinical review.
- Complete all other related duties as assigned.
- BSN or related Bachelors degree required.
- 5 years clinical experience in ED critical care or med/surg required.
- Previous case management experience preferred.
- Knowledge of healthcare financial regulatory and payer issues preferred.
- Familiarity with state local and federal programs strongly preferred.
- Experience in the use of Milliman/InterQual criteria preferred.
- Registered Nurse (RN) NYS license required.
- PRI/Screen certification strongly preferred.
- C.C.M. (Certified Case Manager) certification preferred.
- Computer skills essential.
- Strong communication skills both verbal and written with the ability to engage in twoway communication.
- Ability to delegate responsibilities appropriately.
- Capable of maintaining composure under stress while performing multiple tasks.
- Excellent problemsolving and prioritization skills.
- Must be physically able to walk stand or sit for extended periods.
- Ability to carry necessary equipment (e.g. iPad or laptop) on rounds.
- Must meet all regulatory requirements and demonstrate good manual dexterity.
- Ability to analyze complex problems and organize tasks accordingly.
- Must be able to effectively communicate in both written and verbal formats.
- Potential exposure to chemicals necessary to perform required tasks (hazardous chemicals listed in the hospitals SDS database).
Employment Type
Full Time
