RN Clinical Coordinator

TEEMA; City of White Plains (NY); On-site; USD 85,000 - 105,000; Full time

Job summary

TEEMA is seeking a Clinical Coordinator / RN Care Manager to perform initial comprehensive assessments on admission, screen high-risk patients, and coordinate discharge planning to prevent readmission. This role ensures ongoing reassessment and UR activities per department policy within the hospital setting.

The RN Care Manager collaborates with all health care professionals to evaluate needs, coordinate aftercare, educate patients and caregivers, and support LOS reduction and patient

Qualifications

• BSN required.
• Registered Nurse (RN) NYS license required.
• PRI Certification (must be obtained within 3 months of initial employment).
• Screen certification (strongly preferred).
• Clinical Experience: 3 years clinical ED, critical care, or med/surg experience preferred.
• Technical Knowledge: 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.

Responsibilities

• Performs initial comprehensive assessment on admission.
• Performs multidisciplinary care coordination at intra- and inter-hospital levels of care.
• Performs transitional planning: patient/caregiver education, arrangement of all aftercare, commercial payer involvement.
• Collaborates with health care professionals to evaluate needs and safe discharge of geriatric patients.
• Ensures LOS reduction, readmission prevention, denial reduction, and satisfaction improvement.

Skills

RN Care Coordination

Discharge planning

Interdisciplinary collaboration

Regulatory knowledge

Education

BSN

Tools

Milliman/InterQual criteria

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

Licensure: Registered Nurse (RN) NYS license required.

Certifications:

PRI Certification (must be obtained within 3 months of initial employment).

Screen certification (strongly preferred).

Clinical Experience: 3 years clinical ED, critical care, or med/surg experience preferred.

Technical Knowledge: * 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.