Care Manager ( Registered Nurse / RN ) - Per Diem

Catholic Health; Bethpage (NY); On-site; USD 83,000 - 103,000; Full time

Job summary

Catholic Health in Bethpage, NY is seeking a skilled RN to educate staff, physicians, patients and families in case management, review admissions and determine DRG, length of stay and discharge planning. You will engage physicians to optimize DRG, stay length, and discharge timing, while coordinating with payors to support the certification and discharge process.

Collaborating with an interdisciplinary team, you will review records to avoid denials, participate in rounding, and help ensure safe,

Qualifications

• Graduate of an accredited School of Nursing.
• RN licensure in New York is required.
• BSN degree strongly preferred.
• Case management certification preferred.

Responsibilities

• Educate staff, physicians, patients, and families in case management.
• Review admissions and continued stay to meet criteria.
• Engage physicians for optimal DRG and discharge timing.
• Interface with third party payors to assist with certification and discharge planning.
• Review records and coordinate with the team to avoid denials.
• Participate in interdisciplinary rounding and identify improvements.
• Facilitate communication for safe, appropriate discharge plans.

Skills

Case Management

Interdisciplinary Collaboration

Communication

EMR Navigation

Time Management

Education

Graduate of an accredited School of Nursing

BSN degree preferred

Tools

EMR Systems

Insurance Portals

Care Coordination Platforms

Job description

Overview

At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence-based practice to improve outcomes – to every patient, every time.

Job Details

• Educate staff, physicians, patients, and families in the case management process.
• Review new admissions and continued stay patients to determine whether MCG criteria is met.
• Engage physicians to establish the optimal DRG, length of stay and expected date of discharge.
• Interface with representatives of third party payors to assist with the certification process and the discharge planning process, responding to requests for reviews in a timely fashion to avoid denials.
• Review records and collaborate with the interdisciplinary team to obtain information about all aspects of the patients, transmitting information to third party payors to avoid denials.
• Participate in interdisciplinary rounding and identify areas for improvement.
• Facilitate communication between patients, families, and social work to ensure safe and appropriate discharge plans.
• Collaborate effectively within an interdisciplinary team and engages patients and families with

What You'll Bring

• Passion for Case Management
• 3+ Years of diverse in-patient acute care RN experience
• Critical Care, Home Care, and/or Case Management experience
• Progressive leadership experience preferred
• Excellent written and verbal communication skills. Highly organized and detail oriented with strong critical thinking ability. Ability to assess, evaluate, plan, and coordinate complex patient placement and discharge activities.
• Strong time management skills with the ability to manage competing priorities in a fast-paced acute care environment. Exhibits flexibility and adaptability in response to changing patient needs, discharge plans, payer requirements, and operational demands.
• Proficiency in Microsoft Office applications required. Ability to quickly learn and effectively navigate multiple electronic medical record systems, insurance portals, and care coordination platforms.
• Knowledge of progression of care, medical necessity criteria, and post-acute authorization processes preferred.
• Education: Graduate of an accredited School of Nursing required
• Bachelors of Science in Nursing (BSN) degree strongly preferred
• Licensure: New York Registered Nurse (RN) License & Registration
• Certification: Case Management Certification preferred; PRI Certification preferred

Salary Range

USD $65.83 - USD $65.83 /Hr.

This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any differential pay or other forms of compensation that may be applicable to this job and it does not include the value of benefits.