Registered Nurse Case Manager

$119,829 - $182,853/Yr

Northwell Health - New Hyde Park, NY

Full-time

New Hyde Park, NY

Ambulatory Health Care Services

About the position

The Registered Nurse Case Manager serves as a vital link between patients and healthcare facilities, ensuring quality patient care throughout hospitalization and facilitating smooth discharge processes. This role involves assessing, planning, overseeing, and evaluating patient care to maintain a continuum of quality services during their stay.

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 patient, family, admitting, primary care physician, healthcare team, 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.
• Performs related duties as required.

Requirements

• Graduate from an accredited School of Nursing.
• Bachelor's Degree in Nursing preferred.
• Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date.
• Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.
• 3-5 years+ of RN experience, highly preferred.
• Case Management experience, preferred.

Benefits

• Comprehensive benefits package including health insurance, retirement plans, and paid time off.