Registered Nurse Care Manager

Registered Nurse Care Manager

The role of the RN Care Manager is integral to our patient care strategy. This position involves performing initial comprehensive assessments upon admission, ongoing reassessments, and effective discharge planning to prevent readmissions. The RN Care Manager ensure coordination of care through intra-hospital and inter-hospital levels, documenting activities and participating in performance improvement initiatives aimed at departmental goals including reduction of length of stay, readmission prevention, and denial reduction.

Salary: DOE per year

Essential Duties and Responsibilities:

• Complete a comprehensive initial assessment on admission according to department policy.
• Identify high risk patients using established tools and coordinate appropriate supportive services.
• Engage in all multidisciplinary care coordination activities both intra-hospital and inter-hospital.
• Manage transitional planning activities including patient/caregiver education, arrangement of aftercare, and involvement of commercial payers.
• Communicate and collaborate effectively with all relevant health team members.
• Document activities as per department requirements and perform utilization review activities per department policy.
• Contribute to department goals of reducing length of stay, preventing readmissions, reducing denials, and improving patient satisfaction.
• Collaborate with healthcare professionals to evaluate needs and ensure safe discharge of geriatric patients across various departments including inpatient, emergency, and surgical outpatient settings.
• Perform all other related duties as assigned.

Minimum Position Qualifications:

• BSN required or in progress for those hired after 1/1/18.
• Active Registered Nurse (RN) license in NYS.
• PRI Certification or obtained within 3 months of employment.
• Ability to perform comprehensive assessments and thorough documentation.
• Capable of multitasking and retaining composure under stress.

Preferred Qualifications:

• Care Management Certification (e.g., CMC, CCM).
• 3+ years of clinical experience in ED, critical care, or med/surg settings.
• Previous case management and discharge planning experience.
• Knowledge of healthcare finance, regulatory issues, and payer systems.
• Experience with state, local, and federal programs and Milliman/InterQual criteria.
• Strong organizational and communication skills.

Skills:

• Excellent communication and interpersonal skills for effective interaction with all levels of hospital staff and patients.
• Strong ability to delegate responsibilities and authority effectively.
• Proven capability in handling high-stress situations while maintaining attention to detail.
• Competent in using healthcare IT systems and basic computer applications.
• Capable of analytical and critical thinking necessary for effective case management.