RN Case Manager: Care Coordination Lead

One Brooklyn Health System Inc.; New York (NY); Sur place; USD 85 000 - 105 000; Plein temps

Résumé du poste

One Brooklyn Health System seeks a Case Manager to assess medical necessity for patient admissions and continued stays, coordinating care with a multidisciplinary team across hospital services. The role emphasizes safe discharge planning and adherence to Milliman Care Guidelines and CMS guidelines.

The ideal candidate has a BSN, NY RN licensure, BLS, and PRI certification, with at least three years of relevant clinical experience in acute or home-care settings.

Qualifications

• Bachelor's degree in Nursing (BSN), required.
• Minimum three years of clinical experience in acute care, medical-surgical, ICU, ED, or community/home care.
• RN license valid in New York; Basic Life Support (BLS) certification; PRI certification required; PALS/CCM/ACLS preferred.

Responsabilités

• Perform face-to-face patient assessments to identify barriers to self-care and coordinate referrals to social work.
• Review daily EHR to assess medical necessity and service intensity during rounds.
• Collaborate with social workers on social determinants affecting health outcomes.
• Communicate with attending physicians and care team to ensure admission guidelines and plan of care are followed.
• Document activities in EPIC and coordinate with insurance providers and home care agencies.

Connaissances

Interdisciplinary collaboration

Clinical assessment

EHR documentation

Communication

Formation

Bachelor's degree in Nursing (BSN)

Description du poste

One Brooklyn Health System seeks a Case Manager to assess medical necessity for patient admissions and continued stays, coordinating care with a multidisciplinary team across hospital services. The role emphasizes safe discharge planning and adherence to Milliman Care Guidelines and CMS guidelines.

The ideal candidate has a BSN, NY RN licensure, BLS, and PRI certification, with at least three years of relevant clinical experience in acute or home-care settings.