RN Care Manager (Full-Time)

Montefiore Health System; City of White Plains (NY); On-site; USD 88,000 - 112,000; Full time

Job summary

Montefiore Health System in White Plains, NY is seeking an RN Care Manager for a full-time day shift. The role performs initial admissions assessments, coordinates multidisciplinary care, and develops discharge plans to minimize readmissions.

Qualified candidates hold a BSN or MSN, NY RN license, and have 1–3 years of relevant experience (case management preferred). Certification in CCM/CMC or PRI screens is a plus.

Qualifications

• BSN or MSN required.
• 1–3 years clinical experience in ED/ICU/Med-Surg preferred.
• 1–3 years case management experience preferred.
• 1–3 years experience with Milliman/InterQual criteria preferred.
• Knowledge of healthcare financial, regulatory, and payer issues preferred.
• Knowledge of state, local, and federal programs preferred.
• Computer skills essential.
• RN license NYS required on hire.
• PRI certification within 90 days required.
• PRI Screen preferred.
• CCM/CMC certification preferred.

Responsibilities

• Performs the initial comprehensive assessment on admission.
• Coordinates multidisciplinary care at intra- and inter-hospital levels.
• Conducts discharge planning and aftercare arrangements.
• Communicates patient information to relevant health team members.
• Supports LOS reduction and readmission prevention goals.
• Documents per department requirements.
• Participates in performance improvement activities.
• Performs UR activities per department policy.

Skills

Care Coordination

Computer Skills

Registered Nurse NY

PRI Certification

PRI Screen

CCM/CMC Certification

Milliman/InterQual

Payer/Regulatory knowledge

Education

BSN

MSN

Tools

Milliman/InterQual criteria

Job description

RN Care Manager (Full-Time)### RN Care Manager (Full-Time)Apply: 41 East Post Road: Full time: Posted Today: JR235537**City/State:**White Plains, New York**Department:**Care Management\\_2**Work Shift:**Day**Work Days:**MON-FRI, ALTERNATING WEEKENDS AND HOLIDAYS**Scheduled Hours:**9 AM-5 PM**Hours Per Pay Period:**75**Pay Rate/Range:**$63.6719 - $81.0719For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors. **Job 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*** 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 after care; 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 **Qualifications*** BSN Required or* MSN* 1-3 years 3 years Clinical experience-ED, Critical Care, or Medical Surgical nursing preferred Preferred* 1-3 years Previous Case Management experience preferred Preferred* 1-3 years Experience in the use of Milliman/InterQual criteria Preferred* Knowledge of healthcare financial, regulatory, and payer issues preferred (Low proficiency)* Knowledge of state, local, and federal programs strongly preferred (Low proficiency)* Computer skills essential (Medium proficiency)* Registered Nurse New York - New York State Board of Nursing Upon Hire Required* PRI - Patient Review Instrument Cert - PHTC PRI Certification within 90 Days Required* SCREEN - New York State Dept of Health PRI Screen Strongly preferred Preferred* CCM - Certified Case Manager - Commission for Case Manager Certification A Care Management certification is preferred (i.e., CCM, CMC) CMC Preferred White Plains Hospital Medical Center is an equal employment opportunity employer. White Plains Hospital Medical Center will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.