Hospital Care Manager: Care Coordination Leader

Mount Sinai; New York (NY); On-site; USD 91,000 - 95,000; Full time

Job summary

Mount Sinai Queens is seeking a Care Manager in Care Management to coordinate patient care across the continuum, aiming for quality, clinical and cost outcomes. This full-time day shift role requires collaboration with interdisciplinary teams.

Ideal candidates are registered nurses in New York with 3–5 years acute care and PRI certification, experienced in managed care reviews and discharge planning to support complex care journeys.

Qualifications

• Registered professional nurse licensed to practice in New York.
• 3–5 years acute care experience.
• PRI Certification.

Responsibilities

• Review charts for appropriateness of admission/continued stays.
• Communicate with various departments when indicated to ensure tests that were ordered, are completed and followed up on.
• Follow up of abnormalities/delays: documentation, investigation, and treatment.
• Facilitate interdisciplinary rounds with house physician, social service, nursing and ancillary departments.
• Refer cases to Risk Management when appropriate.
• Concurrent and retrospective managed care reviews.
• Identify patient’s stability for Alternate Level of Care; obtain proper signatures and complete form after communication with attending.
• Enter appropriate ICD-9 codes and data entry codes for the Care Management worksheets.
• Complete any forms necessary in the discharge planning process including (but not limited to) PRI, M11Q, 485, and as requested by the Social Service Department.
• When managed care denies payment for days during concurrent review, contact the attending with this information. The attending can either evaluate for discharge or we will give telephone number and case number to facilitate attending contacting medical director for concurrent appeal of the denial

Education

Registered professional nurse licensed to practice in New York

Job description

Mount Sinai Queens is seeking a Care Manager in Care Management to coordinate patient care across the continuum, aiming for quality, clinical and cost outcomes. This full-time day shift role requires collaboration with interdisciplinary teams.

Ideal candidates are registered nurses in New York with 3–5 years acute care and PRI certification, experienced in managed care reviews and discharge planning to support complex care journeys.