RN Care Manager - Full Time (Days)

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.