RN Care Manager (Full-Time)

Montefiore Health System; Nevada; On-site; USD 88,000 - 112,000; Full time

Job summary

White Plains Hospital Medical Center seeks an RN Care Manager to perform comprehensive admission assessments, coordinate multidisciplinary care, and lead discharge planning to prevent readmissions. You will collaborate with a wide health team to ensure smooth transitions for patients across departments.

The role requires a BSN or MSN and 1–3 years of relevant clinical experience; case management certification is preferred.

Qualifications

• Current RN license in New York or eligibility for New York state license.
• BSN required or MSN; 1–3 years clinical experience in ED, Critical Care, or Med-Surg preferred.
• Prior case management experience preferred; CCM/CMC certification desirable.
• Knowledge of Milliman/InterQual criteria and payer rules.
• Strong computer and data skills; ability to use hospital information systems.

Responsibilities

• Perform initial comprehensive admission assessment using established tools.
• Coordinate multidisciplinary care intra- and inter-hospital; plan discharge and aftercare.
• Engage in case management activities to reduce LOS and prevent readmissions.
• Communicate patient information with health team and respond to department policies.

Skills

RN licensure

Case management

Milliman/InterQual

Nursing certifications

Healthcare payer knowledge

Computer skills

NY RN license

Education

BSN

MSN

Tools

Milliman/InterQual criteria

Job description

Location & Schedule

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 - $81.0719 For 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.

White Plains Hospital is a proud member of the Montefiore Health System, serving as its tertiary hub of advanced care in the Hudson Valley. The Hospital is a 292-bed not-for-profit health care organization with the primary mission of providing exceptional acute and preventive medical care to all people who live in, work in or visit Westchester County and its surrounding areas. White Plains Hospital has outpatient medical facilities across Westchester, including multispecialty practices in Armonk, Hawthorne, Larchmont, New Rochelle, Rye Brook, Scarsdale, Somers, Yonkers and Yorktown Heights; and Scarsdale Medical Group locations in Harrison and Scarsdale. The Hospital is fully accredited by the Joint Commission, and in 2025 received another 5-star rating from the Centers for Medicare & Medicaid Services (CMS) — the highest distinction offered by the federal agency – for the fourth consecutive year. In addition, the Hospital received its third Magnet® designation from the American Nurses Credentialing Center (ANCC), a distinction held by only two percent of hospitals in the country. White Plains Hospital has consistently received the Outstanding Patient Experience Award from Healthgrades®, and in 2025 was awarded an “A” Safety Grade from the Leapfrog Group for the 14th consecutive time.