Inpatient RN Case Manager - Utilization & Discharge Lead

IntelliResume; New York (NY); On-site; USD 130,000 - 145,000; Full time

Job summary

Mount Sinai Health System seeks a Case Manager (RN) to oversee case management for inpatients, ensuring appropriate admissions, continued stays, and care plan implementation. Collaboration with physicians and clinicians aims to accelerate diagnostics and treatment, while documenting reviews in Canopy.

The role requires an RN license in NYS with 3–5 years in acute care; CCM and PRI certifications are preferred.

Qualifications

• Bachelor’s Degree in Nursing.
• Master’s degree preferred.
• 3–5 years’ experience as a RN in an acute care setting preferred.
• Current NYS RN nursing license.
• CCM certification preferred.
• PRI Certification (to be obtained within 1 year).
• Experience in homecare, long-term care, or utilization review preferred.

Responsibilities

• Review new admissions to identify patients needing utilization review, discharge planning, and/or case management.
• Perform continued stay reviews to justify inpatient stays.
• Collaborate with physicians and clinicians to expedite diagnostic testing and treatment.
• Document all clinical reviews in Canopy.
• Assess patients' clinical, psychosocial, and functional status with the interdisciplinary team.
• Identify and document variances affecting length of stay and discharge planning.
• Conduct follow-ups on delays in treatment or reporting of results.
• Plan and develop specific goals with the physician and interdisciplinary team.
• Implement and coordinate activities and strategies to move patients through the continuum of care.
• Identify reasons for readmissions and collaborate on strategies to reduce readmission rates.

Skills

RN in acute care

Case management

Utilization review

CCM certification

PRI certification

Education

Bachelor’s Degree in Nursing

Master’s degree preferred

Tools

Canopy

Job description

Mount Sinai Health System seeks a Case Manager (RN) to oversee case management for inpatients, ensuring appropriate admissions, continued stays, and care plan implementation. Collaboration with physicians and clinicians aims to accelerate diagnostics and treatment, while documenting reviews in Canopy.

The role requires an RN license in NYS with 3–5 years in acute care; CCM and PRI certifications are preferred.