RN Care Manager

TEEMA Group; New York (NY); On-site; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization in New York is seeking a Clinical Coordinator/RN Care Manager responsible for conducting comprehensive assessments upon patient admission. The role involves coordinating care, facilitating discharge planning to prevent readmissions, and collaborating with healthcare professionals. Candidates must hold a BSN and an active RN license in New York, with preferred experience in critical care or emergency department settings. Join a dynamic team committed to patient care and quality improvement.

Qualifications

• BSN required for the Clinical Coordinator role.
• Registered Nurse (RN) licensed in New York State is essential.
• Experience in use of Milliman/InterQual criteria preferred.

Responsibilities

• Perform comprehensive assessments on patient admission.
• Facilitate care coordination within and between hospitals.
• Participate in Performance Improvement activities.

Skills

Patient/caregiver education

Multidisciplinary care coordination

Collaboration with healthcare professionals

Education

BSN

Registered Nurse (RN) licensed in New York State

PRI Certification

Screen certification

3 years clinical experience

Job description

The Clinical Coordinator / 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

• 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.
• Participates in Performance Improvement activities as needed:
  • Commercial payer reviews
  • 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.
• Registered Nurse (RN) licensed in New York State.
• PRI Certification (must be obtained within 3 months of initial employment).
• Screen certification (strongly preferred).
• 3 years clinical ED, critical care, or med/surg 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.

If you're interested, please reply to this advertisement or directly email your resume to me at [e-mail] or by calling/texting [phone].

I strive to reply within 48 hours. Looking forward to connecting with you soon. Thank you!