RN Case Manager: Drive Care Continuum & Discharge

Mount Sinai; United States; On-site; USD 75,000 - 107,000; Full time

Job summary

Mount Sinai West is seeking a dedicated RN/Case Manager to oversee inpatient case management across units. You will determine admission appropriateness, assist in care planning, and ensure timely implementation of the plan of care with an emphasis on reducing length of stay.

You will collaborate with physicians, social workers, and nurses, perform utilization review, and manage discharge planning and post-discharge authorizations. NYS RN license required; CCM/PRI certifications preferred.

Qualifications

• RN with current New York State license and active clinical practice.
• Experience in homecare, long-term care or utilization review preferred.
• CCM certification preferred; PRI certification to be obtained within 1 year.

Responsibilities

• Review new admissions to identify utilization review, discharge planning and case management needs.
• Perform continued stay reviews using standardized criteria to justify inpatient stay.
• Collaborate with physicians and clinicians to expedite testing and consultations.
• Document all clinical reviews in the patient record and Canopy system.
• Lead discharge planning and obtain authorizations for post-discharge services.
• Coordinate with finance for insurance coverage and participate in appeals when needed.
• Develop goals with the team and patient/family and monitor plan of care progress.

Skills

Utilization review

Discharge planning

Case management

Interdisciplinary collaboration

Documentation

Education

Bachelor's Degree in Nursing

NYS RN license

CCM certification preferred

PRI Certification (to be obtained within 1 year)

Masters degree preferred

Job description

Mount Sinai West is seeking a dedicated RN/Case Manager to oversee inpatient case management across units. You will determine admission appropriateness, assist in care planning, and ensure timely implementation of the plan of care with an emphasis on reducing length of stay.

You will collaborate with physicians, social workers, and nurses, perform utilization review, and manage discharge planning and post-discharge authorizations. NYS RN license required; CCM/PRI certifications preferred.