New York Presbyterian Hospital

Case Manager - RN - Inpatient Units - Brooklyn Methodist Day Shift Including 1 Weekend Every 4 Weeks and Assigned Holidays

New York Presbyterian Hospital • $122K — $161K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Current NYS RN license required
  • Bachelor's degree in Nursing (BSN) mandatory
  • 3-5 years of Acute Care RN nursing experience needed
  • PRI certification required within one year
  • Master's degree and CCM certification preferred
  • Previous experience in inpatient case management or discharge planning is advantageous

Responsibilities

  • Manage discharge planning and utilization review for assigned patients
  • Conduct clinical reviews for managed care, Medicare, and Medicaid admissions
  • Communicate with medical staff regarding inpatient stay criteria
  • Coordinate appeals for inpatient service denials with physicians and insurers
  • Ensure appropriate utilization of organization resources
  • Conduct patient assessments within 24 hours of admission
  • Coordinate post-acute care plans effectively

Benefits

  • Full-time position with standard Monday to Friday schedule
  • On-site resources, including a home care agency and authorization center
  • Opportunities for personal and professional growth
  • Dynamic work environment that values every individual
  • Occasional weekend and holiday shifts are part of the role
Full Job Description
Location
Brooklyn, New York
Shift:
Day (United States of America)
Description:

Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days

Located in Park Slope, Brooklyn, this acute-care teaching hospital has been providing outstanding medical care to the surrounding communities for over 135 years.

The Case Manager is responsible for all aspects of discharge planning and utilization management/review for an assigned group of patients to determine the appropriateness of the admission and continued stay, assist in the development of the plan of care; ensure that the plan is implemented timely and identify the expected length of stay (ELOS). The Case Manager works collaboratively with physicians, social workers, clinical nurses, home care services, and other members of the interdisciplinary team. The Case Manager actively participates in specific clinical initiatives focused on reducing the length of stay (LOS), improving efficiency and quality, and ensuring resource utilization is appropriate.

Case manager/utilization manager: Responsible for an average of 60-70 medical/surgical daily admissions that requires risk identification and clinical reviews. A utilization nurse completes no less than 20 initial clinical reviews daily.

Responsibilities also includes:
• Completing 100% clinical reviews for managed care, Medicare and Medicaid admissions
• Completing concurrent and retrospective reviews
• Communicating with physicians and the inpatient case management teams on patients who do not meet initial inpatient criteria or continued inpatient stay
• Coordinating expedited appeals for inpatient denials with attending physicians and insurance providers
• Ensuring organization resources are being utilized appropriately
• Completing patient assessments within 24 hours
• Coordinating safe and appropriate post-acute care plans
• Obtains authorizations from managed care companies for post-discharge services.

There is an onsite home care agency and a transfer and authorization center that can facilitate the referral process.

This is a full time Monday - Friday position 8:30am -5:00pm

Position requires working 1 weekend every 4 weeks and assigned holidays.

Preferred Criteria
  • Master's degree
  • CCM certification
  • Previous experience in inpatient acute care case manager/discharge planning, certified home health care (CHHA), Case Management experience, utilization experience, or managed care organization.


Required Criteria
  • Current NYS RN license
  • Bachelor's degree in Nursing (BSN)
  • 3-5 yrs Acute Care RN nursing experience
  • PRI certification (to be obtained within 1 year)

Please note that all roles require on-site presence (variable by role). Therefore, all employees should live within a commutable distance to NYP.

NYP will not reimburse for travel expenses.

Salary Range:

$122,859-$161,605/Annual

It all begins with you. Our amazing compensation packages start with competitive base pay and include recognition for your experience, education, and licensure. Then we add our amazing benefits, countless opportunities for personal and professional growth and a dynamic environment that embraces every person. Join our team and discover where amazing works.

About New York Presbyterian Hospital

NewYork-Presbyterian Hospital is a nonprofit academic medical center located in New York City. The hospital is affiliated with two Ivy League medical schools, Columbia University's College of Physicians and Surgeons and Weill Cornell Medical College. NewYork-Presbyterian Hospital provides a wide range of medical services, including cancer care, cardiology, neurology, orthopedics, and pediatrics. The hospital was formed in 1998 with the merger of two hospitals, New York Hospital and Presbyterian Hospital. Today, NewYork-Presbyterian Hospital is one of the largest hospitals in the United States and is consistently ranked as one of the best hospitals in the country.
Learn more about New York Presbyterian Hospital
Size
20,000 employees
Industry
Founded
1998

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