Registered Nurse Case Manager - Contract

FlexStaff; New York (NY); On-site; USD 75,000 - 105,000; Full time

Job summary

FlexStaff seeks a Registered Nurse Case Manager to coordinate patient care from admission through discharge in a hospital setting. You will liaison with patients, families, physicians, and care teams to ensure a seamless care plan.

Responsibilities include concurrent utilization management, chart reviews, and collaboration with third-party payers for approvals, while maintaining compliance with state and federal regulations and accurate medical-record documentation.

Qualifications

• Graduate from an accredited School of Nursing.
• Bachelor’s Degree in Nursing preferred; must enroll in BSN within two years and obtain BSN within five years.
• Minimum 2 years relevant experience, required.
• Current License to practice as a Registered Nurse in New York State; additional certifications as needed.

Responsibilities

• Facilitates patient management throughout hospitalization and discharge planning.
• Collaborates with health care team to assess, plan, implement and evaluate patient care.
• Performs concurrent utilization management using evidence-based criteria.
• Documents the case management process in the medical record and coordinates discharge instructions.
• Interacts with third party payers to obtain approvals for hospital days and post-discharge eligibility.

Education

Bachelor’s Degree in Nursing

BSN enrollment within 2 years / BSN within 5 years

Job description

Registered Nurse Case Manager – FlexStaff

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.

Responsibilities:

• 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

Qualifications:

• 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
• Minimum 2 years relevant experience, required.
• Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.