Registered Nurse Case Manager

Northwell Health; Town of Hempstead (NY); On-site; USD 90,000 - 115,000; Full time

Job summary

Northwell Health in New York is seeking a Hospital-based RN Case Manager to coordinate patient care across hospitalization and into discharge. You will collaborate with physicians, nurses, social workers, and care coordinators to ensure a seamless continuum of care.

The role requires NY RN licensure (BSN preferred) and experience in case management or utilization review. You will participate in quality initiatives and work with multidisciplinary teams to optimize outcomes and hospital throughput.

Qualifications

• RN license in New York required or pending licensure.
• BSN preferred; BSN enrollment within 2 years and degree within 5 years of hire.
• HomeCare or Case Management/Utilization experience preferred.

Responsibilities

• Facilitates patient management and discharge planning in collaboration with the health care team.
• Performs concurrent utilization management using evidence-based medical necessity criteria.
• Submits data to management on case management and quality initiatives.
• Acts as an in-patient liaison for patients, families, and care teams.
• Reviews charts for admission appropriateness and length of stay; supports throughput.
• Conducts clinical reviews and liaises with third-party payers for approvals.
• Ensures compliance with state, federal, and payer regulations.
• Documents the case management process in the medical record and care coordination assessments.
• Communicates with patients, families, admitting physicians, and hospital departments.
• Completes discharge instructions and transfer documentation accurately.
• Performs other related essential duties as required.

Skills

Care coordination

Clinical assessment

Interdisciplinary collaboration

Education

Bachelor of Science in Nursing (BSN)

Job description

Job Description

Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient care throughout hospitalization and oversees provisions for patient's discharge. Assesses, plans, oversees and evaluates the appropriateness of care throughout admission and hospitalization of the patient.

Job Responsibility

• Facilitates patient management throughout hospitalization.
• Performs concurrent utilization management using evidence based medical necessity criteria.
• Submits data to management regarding case management and/or quality initiatives.
• Serves as an in-patient liaison - planning, assessing, implementing and evaluating patient in collaboration with the health care team.
• Conducts chart review for appropriateness of admission and continued length of stay; Facilitates throughput.
• Conducts clinical reviews and interacts with third party payers to obtain approval of hospital days, pre-certification and post-discharge eligibility in relation to clinical course.
• Ensures compliance with current state, federal, and third party payer regulations.
• Documents the case management process in the medical record; completes and documents a care coordination assessment on the patient.
• Serves as a liaison to patient, family, admitting, primary care physician, health care team, and hospital departments.
• Completes applicable areas of the patients discharge instruction sheet and the patient transfer sheet; ensures case management documentation is current and accurate.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Graduate from an accredited School of Nursing. Bachelor’s Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date.
• Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.
• HomeCare or Case Management / Utilization experience, preferred.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).