RN Care Manager - Full Time (Days)

Job description

City/State:White Plains, New YorkDepartment:Care Management_2Work Shift:DayWork Days:MON-FRI, ALTERNATING WEEKENDS AND HOLIDAYSScheduled Hours:9 AM-5 PMHours Per Pay Period:75Pay Rate/Range:$ - $ For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.Job SummaryThe RN Care Manager performs the initial comprehensive assessment on admission in accordance with the Care Management Department policy, screening all patients by utilizing established tools for high risk indicators 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. Provides ongoing reassessment of needs throughout the hospital course. Performs UR activity per department policy.Essential FunctionsUnderstands and adheres to the WPH Performance Standards, Policies and BehaviorsCompletes a comprehensive initial assessment.Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care.Performs all transitional planning activities including but not limited to: patient/caregiver education; arrangement of after care; commercial payer involvement; high utilizer patient root causeCommunicates and collaborates all relevant patient information to appropriate health team members.Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized.Documents per department requirements.Participates in Performance Improvement activities as needed.Performs all UR activities per department policy: commercial payer reviews; disposition determination; retro/self audit; MC variance; admission clinical reviewThe RN Care Manager collaborates with all Health Care professionals to evaluate the needs and the safe discharge of all geriatric patients including but not limited to inpatients, emergency department and surgical outpatients.Performs all other related duties as assignedQualificationsBSN Required orMSN1-3 years 3 years Clinical experience-ED, Critical Care, or Medical Surgical nursing preferred Preferred1-3 years Previous Case Management experience preferred Preferred1-3 years Experience in the use of Milliman/InterQual criteria PreferredKnowledge of healthcare financial, regulatory, and payer issues preferred (Low proficiency)Knowledge of state, local, and federal programs strongly preferred (Low proficiency)Computer skills essential (Medium proficiency)Registered Nurse New York - New York State Board of Nursing Upon Hire RequiredPRI - Patient Review Instrument Cert - PHTC PRI Certification within 90 Days RequiredSCREEN - New York State Dept of Health PRI Screen Strongly preferred PreferredCCM - Certified Case Manager - Commission for Case Manager Certification A Care Management certification is preferred (i.e., CCM, CMC) CMC PreferredWhite Plains Hospital Medical Center is an equal employment opportunity employer. White Plains Hospital Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

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