RN Care Manager

Veracity Software Inc; City of White Plains (NY); On-site; USD 100,000 - 160,000; Full time

Job summary

Join Veracity Software Inc as an RN Care Manager in White Plains, NY, where you will lead patient assessments and coordinate care to prevent hospital readmissions. This full-time position requires a RN license and at least 3 years of clinical experience. Enjoy a supportive work environment and contribute to improving patient outcomes through effective care management.

Qualifications

• 3+ years of clinical experience in ED, critical care, or med/surg preferred.
• Experience in case management highly regarded.

Responsibilities

• Perform initial assessments and discharge planning for high-risk patients.
• Coordinate multidisciplinary care and ensure effective communication.

Skills

Communication

Multitasking

Delegation

Education

BSN required

Registered Nurse (RN) NYS license

PRI Certification

Care Management certification

Job description

3 weeks ago Be among the first 25 applicants

White Plains, NY

Nursing

Full Time

Department/Location: Care Management

Day: M-F 9A-5P with a weekend rotation ( Sat & Sun)

Position Summary

The RN Care Manager performs the initial comprehensive assessment on admission in accordance with the Care Management Department policy, screening all patients by utilizing established tools for high risk indicators to ensure high risk patient populations receive the appropriate supportive services for discharge to prevent readmission and assess all populations for potential discharge planning needs. Provides ongoing reassessment of needs throughout the hospital course. Performs UR activity per department policy.

Essential Functions and Responsibilities Includes the Following:

• Understands and adheres to the WPH Performance Standards, Policies and Behaviors
• Completes a comprehensive initial assessment.
• Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care.
• Performs all transitional planning activities including but not limited to:
• Patient/caregiver education
• Arrangement of all aftercare
• Commercial payer involvement
• High utilizer patient root cause
• Communicates and collaborates all relevant patient information to appropriate health team members.
• Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized.
• Documents per department requirements.
• Participates in Performance Improvement activities as needed.
• Performs all UR activities per department policy:
• Commercial payer reviews
• Disposition determination,
• Retro/self-audit
• MC variance
• Admission clinical review.
• The RN Care Manager collaborates with all Health Care professionals to evaluate the needs and the safe discharge of all geriatric patients including but not limited to inpatients, emergency department and surgical outpatients.
• Performs all other related duties as assigned
  
  

Education & Experience Requirements

• BSN required for all RNs hired after 1/1/18
• All RNs hired before 1/1/18 will be required to have their BSN (or MSN) by 12/31/21.
• Registered Nurse (RN) NYS license required
• PRI Certification (PRI certification to be obtained within 3 months of initial employment)
• Screen certification strongly preferred
• A Care Management certification preferred (i.e. CMC, CCM etc.)
• 3 years clinical ED, critical care or med/surg experience preferred
• Previous case management experience preferred
• Knowledge of healthcare financial, regulatory, and payer issues preferred
• Knowledge of state, local, and federal programs strongly preferred
• Experience in use of Milliman/InterQual criteria
  
  

A Care Management certification preferred (i.e. CMC, CCM etc.)

Computer Skills Essential

Core Competencies

Demonstrates ability to establish two-way communication by clearly defining expectations, communicating utilizing a variety of methods, actively listening to ideas and concerns and responding in an appropriate manner.

Demonstrates ability to delegate responsibilities appropriately.

Demonstrates ability to retain composure under stress and perform multitasking functions.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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