Care Manager (RN) - Days

$132,214 - $161,896/Yr

NYU Langone Health - Mineola, NY

Full-time - Mid Level

Mineola, NY

501-1,000 employees

Hospitals

About the position

The Care Manager (RN) - Days at NYU Langone Hospital-Long Island is responsible for coordinating and procuring services necessary to meet the post-acute care needs of patients. This role ensures a smooth transition to appropriate post-acute care settings, collaborates with interdisciplinary teams, and participates in quality improvement processes related to patient care management. The position requires effective communication and documentation skills to maximize provider reimbursement and ensure compliance with insurance requirements.

Responsibilities

• Coordinates and procures services for post-acute care needs of patients.
• Ensures timely transition to appropriate post-acute care settings.
• Collaborates with interdisciplinary patient care staff.
• Participates in quality improvement and evaluation processes.
• Performs initial utilization reviews of patients for appropriateness of setting.
• Collaborates with attending physicians and physician advisors for patient reviews.
• Conducts continued stay and extended stay reviews as needed.
• Provides clinical reviews to payers for certification of patient days.
• Screens inpatients for potential post-acute care needs.
• Develops and implements discharge plans in collaboration with patients and care teams.
• Completes necessary documentation utilizing Allscripts.
• Tracks avoidable days to identify opportunities for improvement.
• Facilitates communication among interdisciplinary healthcare team members.

Requirements

• Bachelor's degree in Nursing (required for employees hired after 9/1/2020).
• Current and valid New York State Registered Nurse License.
• 3-5 years of clinical acute care experience.
• Excellent communication skills (oral and written).
• Strong interpersonal and organizational skills.
• Knowledge of clinical standards of practice for multiple patient populations.
• Computer skills.

Nice-to-haves

• Bachelor's Degree in Nursing (preferred).
• New York State Department of Health Patient Review Instrument (PRI) Assessor certification.
• 3-5 years of discharge planning and/or utilization management experience.
• Knowledge of post-acute care referral processes.
• Understanding of hospital reimbursement processes, insurance denials, and appeals.

Benefits

• Competitive salary range of $132,213.80 - $161,895.85 annually.
• Opportunities for professional development and continuing education.
• Supportive work environment that values diversity and inclusion.