Registered Nurse, Care Manager (Utilization Management), Per Diem

NYU Langone Health; New York (NY); On-site; USD 60,000 - 80,000; Part time

Job summary

An established industry player is seeking a dedicated Registered Nurse, Care Manager to join their dynamic team. This per diem role focuses on utilization management, requiring a blend of clinical expertise and strong interpersonal skills. You will review clinical indicators, manage patient care plans, and collaborate with interdisciplinary teams to ensure quality care. If you are passionate about patient advocacy and have a knack for effective communication, this opportunity offers a competitive hourly rate and a chance to make a real difference in patient outcomes. Join a team committed to excellence in healthcare and professional development.

Qualifications

• Licensed Registered Nurse in New York State with current registration.
• 3-5 years of clinical experience, preferably in acute medical-surgical settings.

Responsibilities

• Manage patient care using multidisciplinary teams to develop realistic goals.
• Conduct chart reviews, manage care authorizations, and communicate with payors.
• Educate staff, patients, and families about care management roles and resources.

Skills

Interpersonal Skills

Communication Skills

Negotiation Skills

Leadership Skills

Clinical Assessment

Patient Advocacy

Education

Bachelor of Science in Nursing (BSN)

Registered Nurse License - NYS

Tools

Microsoft Office

Eclipsys Sunrise Manager

Canopy

ECIN

Job description

Registered Nurse, Care Manager (Utilization Management), Per Diem

Join to apply for the Registered Nurse, Care Manager (Utilization Management), Per Diem role at NYU Langone Health

Position Summary

We have an exciting opportunity to join our team as a Registered Nurse, Care Manager (Utilization Management). The role involves reviewing clinical indicators and criteria, identifying care trends, referring cases for peer review, participating in quality improvement initiatives, collaborating with interdisciplinary teams, and managing patient care plans effectively.

Responsibilities

1. Apply protocols, pathways, evidence-based processes, and manage patient care using multidisciplinary teams to develop realistic goals and adapt plans as needed.
2. Support hospital standards and policies, contribute to departmental goals, and promote cost-effective care initiatives.
3. Conduct chart reviews, manage care authorizations, and communicate with payors and healthcare teams regarding approval and authorization statuses.
4. Advocate for patients, collaborate on maintaining appropriate care levels, and identify delays or barriers to treatment.
5. Participate in hospital and departmental committees, providing feedback and reports on care management issues.
6. Assess patient documentation for medical necessity, appropriateness of admission, and discharge planning.
7. Perform comprehensive patient assessments, considering cultural, religious, and individual factors, and develop individualized care plans.
8. Coordinate with physicians and healthcare teams to develop and implement patient-centered, efficient care plans.
9. Document all assessments, interventions, and outcomes accurately in care management systems and medical records.
10. Develop strategies for transitional planning, care coordination, and quality improvement using current literature and data analysis.
11. Participate in interdisciplinary rounds, facilitate communication, and coordinate discharge planning and follow-up.
12. Ensure timely and effective communication regarding clinical and administrative issues, including potential denials and discharge appeals.
13. Educate staff, patients, and families about care management roles, resources, and clinical criteria.
14. Maintain current clinical knowledge, licensure, and certifications, and pursue ongoing professional development.
15. Evaluate the appropriateness of care levels, anticipate discharge barriers, and facilitate effective resource utilization.
16. Report safety, quality, and risk issues to the appropriate departments and maintain confidentiality.
17. Serve as a resource for education and support within the healthcare team and promote best practices in care management.

Minimum Qualifications

Licensed Registered Nurse in New York State with current registration. BSN required or equivalent with a related healthcare degree. 3-5 years of clinical experience, preferably in acute medical-surgical settings or similar populations. Demonstrated interpersonal, communication, negotiation, and leadership skills. Proficiency in Microsoft Office and care management software such as Eclipsys Sunrise Manager, Canopy, and ECIN.

Licenses and Certifications

Registered Nurse License-NYS, Basic Life Support Certification.

Additional Information

NYU Langone Health is committed to diversity and inclusion and encourages all qualified individuals to apply. The role offers a salary of $75.00 per hour, with actual compensation based on experience and qualifications. Applications are to be completed online.