Registered Nurse Case Manager

$119,829 - $182,853/Yr

Northwell Health - New Hyde Park, NY

Full-time - Mid Level

New Hyde Park, NY

1,001-5,000 employees

Ambulatory Health Care Services

About the position

The Registered Nurse Case Manager serves as a crucial liaison between patients and healthcare facilities, ensuring a seamless continuum of quality patient care throughout hospitalization. This role involves assessing, planning, overseeing, and evaluating the appropriateness of care during a patient's admission and hospitalization, as well as facilitating their discharge process.

Responsibilities

• Facilitates patient management throughout hospitalization.
• Performs concurrent utilization management using evidence-based medical necessity criteria.
• Submits data to management regarding case management and/or quality initiatives.
• Serves as an in-patient liaison, planning, assessing, implementing, and evaluating patient care in collaboration with the healthcare team.
• Conducts chart reviews for appropriateness of admission and continued length of stay; facilitates throughput.
• Conducts clinical reviews and interacts with third-party payers to obtain approval of hospital days, pre-certification, and post-discharge eligibility in relation to clinical course.
• Ensures compliance with current state, federal, and third-party payer regulations.
• Documents the case management process in the medical record; completes and documents a care coordination assessment on the patient.
• Serves as a liaison to patients, families, admitting, primary care physicians, healthcare teams, and hospital departments.
• Completes applicable areas of the patient's discharge instruction sheet and the patient transfer sheet; ensures case management documentation is current and accurate.

Requirements

• Graduate from an accredited School of Nursing.
• Current License to practice as a Registered Professional Nurse in New York State required.
• 3-5 years+ of RN experience, highly preferred.
• Case Management experience, preferred.
• Bachelor's Degree in Nursing, preferred; must be enrolled in an accredited BSN program within two years and obtain a BSN Degree within five years of job entry date.

Benefits

• Competitive hourly pay ranging from $57.61 to $87.91.
• Full-time employment with potential for career advancement.