Care Management - Manager
Apply NowCompany: White Plains Hospital - WH
Location: White Plains, NY 10605
Description:
Details
Client Name
White Plains Hospital - WH
Job Type
Permanent
Offering
Nursing
Profession
RN
Specialty
Case Manager
Job ID
30821863
Job Title
Care Management - Manager
Shift Details
Shift
Day - 8x5 - 08AM
Scheduled Hours
40
Job Order Details
Start Date
03/12/2025
Job Description
Shift: Sun, Monday & Friday; 8-4:30pm
Description:
The RN Care Manager performs comprehensive initial assessments on admission in line with Care Management Department policy. They screen all patients using established tools for high-risk indicators (e.g., AIMS, Geisinger, polypharmacy) to ensure that high-risk populations receive the necessary supportive services for discharge, preventing readmission. The RN Care Manager also evaluates all patient populations for discharge planning needs and provides ongoing reassessment throughout the hospital stay. They perform Utilization Review (UR) activities per department policy.
Essential Functions and Responsibilities Include the Following:
Understands and adheres to client Performance Standards, Policies, and Behaviors.
Completes a comprehensive initial assessment on admission.
Performs multidisciplinary care coordination at both intra-hospital and inter-hospital levels of care.
Conducts all transitional planning activities, including:Patient/caregiver education.
Arrangement of all aftercare services.
Commercial payer involvement.
Root cause analysis for high utilizer patients.
Communicates and collaborates relevant patient information with appropriate healthcare team members.
Works to achieve department goals including:Length of Stay (LOS) reduction.
Readmission prevention.
Denial reduction.
Improvement in patient satisfaction.
Documents patient care and activities according to department requirements.
Participates in Performance Improvement activities as needed.
Conducts UR activities per department policy, including:Commercial payer reviews.
Disposition determination.
Retrospective/self-audits.
MC variance.
Admission clinical review.
Performs other related duties as assigned.
Education & Experience Requirements:
BSN or related Bachelor's degree required.
5 years of clinical experience in ED, critical care, or medical/surgical settings required.
Previous case management experience is preferred.
Knowledge of healthcare financial, regulatory, and payer issues is preferred.
Familiarity with state, local, and federal programs is strongly preferred.
Experience with Milliman/InterQual criteria is required.
Registered Nurse (RN) NYS license required.
PRI/Screen certification is strongly preferred.
C.C.M. (Certified Case Manager) certification preferred.
Computer proficiency is essential.
Client Details
Address
41 E Post Rd
City
White Plains
State
NY
Zip Code
10601
Job Board Disclaimer
By applying for jobs on this website, you consent to receive daily messages from CYNET about assignments that match your profile. Email or text HELP for more info, or STOP to unsubscribe.
Your mobile info will not be shared with third parties for marketing. Standard messaging and data rates may apply.
Client Name
White Plains Hospital - WH
Job Type
Permanent
Offering
Nursing
Profession
RN
Specialty
Case Manager
Job ID
30821863
Job Title
Care Management - Manager
Shift Details
Shift
Day - 8x5 - 08AM
Scheduled Hours
40
Job Order Details
Start Date
03/12/2025
Job Description
Shift: Sun, Monday & Friday; 8-4:30pm
Description:
The RN Care Manager performs comprehensive initial assessments on admission in line with Care Management Department policy. They screen all patients using established tools for high-risk indicators (e.g., AIMS, Geisinger, polypharmacy) to ensure that high-risk populations receive the necessary supportive services for discharge, preventing readmission. The RN Care Manager also evaluates all patient populations for discharge planning needs and provides ongoing reassessment throughout the hospital stay. They perform Utilization Review (UR) activities per department policy.
Essential Functions and Responsibilities Include the Following:
Understands and adheres to client Performance Standards, Policies, and Behaviors.
Completes a comprehensive initial assessment on admission.
Performs multidisciplinary care coordination at both intra-hospital and inter-hospital levels of care.
Conducts all transitional planning activities, including:Patient/caregiver education.
Arrangement of all aftercare services.
Commercial payer involvement.
Root cause analysis for high utilizer patients.
Communicates and collaborates relevant patient information with appropriate healthcare team members.
Works to achieve department goals including:Length of Stay (LOS) reduction.
Readmission prevention.
Denial reduction.
Improvement in patient satisfaction.
Documents patient care and activities according to department requirements.
Participates in Performance Improvement activities as needed.
Conducts UR activities per department policy, including:Commercial payer reviews.
Disposition determination.
Retrospective/self-audits.
MC variance.
Admission clinical review.
Performs other related duties as assigned.
Education & Experience Requirements:
BSN or related Bachelor's degree required.
5 years of clinical experience in ED, critical care, or medical/surgical settings required.
Previous case management experience is preferred.
Knowledge of healthcare financial, regulatory, and payer issues is preferred.
Familiarity with state, local, and federal programs is strongly preferred.
Experience with Milliman/InterQual criteria is required.
Registered Nurse (RN) NYS license required.
PRI/Screen certification is strongly preferred.
C.C.M. (Certified Case Manager) certification preferred.
Computer proficiency is essential.
Client Details
Address
41 E Post Rd
City
White Plains
State
NY
Zip Code
10601
Job Board Disclaimer
By applying for jobs on this website, you consent to receive daily messages from CYNET about assignments that match your profile. Email or text HELP for more info, or STOP to unsubscribe.
Your mobile info will not be shared with third parties for marketing. Standard messaging and data rates may apply.