Full Time Case Manager Nurse jobs in White Plains New York | 1 Total Nurse Allied Jobs

A Westchester County-based healthcare network is currently seeking an experienced, licensed Registered Nurse (RN) to join their team in White Plains as a Care Manager. In this role, the Care Manager (RN) will be responsible for performing the initial comprehensive assessment on admission 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.

Responsibilities:

The Care Manager (RN) will:

• Complete a comprehensive initial assessment
• Perform all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care
• Perform all transitional planning activities including: patient / caregiver education; arrangement of all aftercare; commercial payer involvement; high utilizer patient root cause; etc.
• Communicate and collaborate all relevant patient information to appropriate health team members
• Ensure department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized
• Document per department requirements
• Participate in Performance Improvement activities, as needed
• Perform all UR activities per department policy, including: commercial payer reviews; disposition determination; retro / self-audit; MC variance; and, admission clinical review
• Perform all other related duties, as assigned

• 5+ years of experience in a Clinical Emergency Department, Critical Care, and/or Medical-Surgical role/setting
• BSN or related Bachelor's degree required
• NYS Registered Nurse (RN) license
• Experience in use of Milliman / InterQual criteria
• Computer savvy
• Solid assessment, clinical, and documentation skills
• Patient oriented
• Great interpersonal skills
• Excellent communication skills (written and verbal)
• Strong attention to detail
• Highly organized

• Certified Case Manager (CCM)
• PRI/Screen certification
• Previous experience in Case Management
• Knowledge of Healthcare Financial, Regulatory, and Payer issues
• Knowledge of State, Local, and Federal programs