Case Management Nurse

Pride Health; New York (NY); On-site; USD 70,000 - 100,000; Full time

Job summary

An innovative healthcare provider is looking for a dedicated Registered Nurse (RN) specializing in Case Management. In this vital role, you will support patients through the healthcare continuum, ensuring optimal resource utilization and care outcomes. With a focus on collaboration with healthcare teams, you will conduct utilization reviews and manage patient transitions effectively. If you have a passion for improving patient care and possess the necessary qualifications, this is an exciting opportunity to make a significant impact in a non-clinical setting.

Qualifications

• Minimum two years of experience in case/resource management.
• Active RN License in New York State required.

Responsibilities

• Perform case and resource management for efficient care coordination.
• Conduct utilization reviews to assess medical service necessity.

Skills

Case Management

Utilization Management

Patient Coordination

Electronic Medical Records (EPIC)

BLS Certification

Education

Active New York State RN License

AHA Basic Life Support Certification

Tools

EPIC Electronic Health Records

Job description

Job Description: Registered Nurse (RN) - Case Management

We are seeking a qualified Registered Nurse (RN) with a minimum of two years of experience in case/resource management and utilization management. This non-clinical role focuses on supporting patients through the healthcare continuum, ensuring appropriate utilization of resources, and promoting optimal care outcomes.

Key Responsibilities:

1. Perform case and resource management to ensure efficient and appropriate care coordination.
2. Conduct utilization reviews to assess the necessity and appropriateness of medical services.
3. Collaborate with healthcare teams to coordinate care and manage patient transitions.
4. Utilize electronic medical records systems such as EPIC for documentation and reporting.
5. Apply knowledge of PRI (Patient Review Instrument) and SCREEN processes as applicable.

Required Qualifications:

• Active New York State RN License.
• Minimum two (2) years of experience in case/resource management and utilization management.
• AHA Basic Life Support (BLS) certification.
• Primary Source Verification of credentials.

Preferred Qualifications:

• Three to five (3–5) years of experience in care management.
• Experience with EPIC electronic health records.
• Certification or experience in PRI and SCREEN assessments.

Note: The description contains extraneous information about other jobs and company benefits, which should be omitted for clarity and focus on the role.