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NewYork-Presbyterian·New York, NY

Case Manager - RN - Inpatient Units - Brooklyn Methodist Day Shift Including 1 Weekend Every 4 Weeks and Assigned Holidays

Social Work / Case ManagementFull timeMon–Fri · DaysPosted Oct 1Job 00880549
✓Requirements
Licensure
✓Current NYS RN license
Certifications
✓PRI certification (to be obtained within 1 year)
CCM certification preferred
Previous experience in inpatient acute care case manager/discharge planning, certified home health care (CHHA), Case Management experience, utilization experience, or managed care organization. preferred
Education
✓Bachelor’s degree in Nursing (BSN)
Master’s degree preferred
Qualifications
✓3-5 yrs Acute Care RN nursing experience
Pay for this position
Employer-posted
$123k – $162k/yr
Apply to NewYork-Presbyterian ↗
Questions about pay or the unit? Ask a Waypoint recruiter.
✓You’ll need
Licensure
✓Current NYS RN license
Certifications
✓PRI certification (to be obtained within 1 year)
CCM certification preferred
Previous experience in inpatient acute care case manager/discharge planning, certified home health care (CHHA), Case Management experience, utilization experience, or managed care organization. preferred
Education
✓Bachelor’s degree in Nursing (BSN)
Master’s degree preferred
Qualifications
✓3-5 yrs Acute Care RN nursing experience

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About the role

What you’ll do
Completing 100% clinical reviewsCompleting 100% clinical reviews for managed care, Medicare and Medicaid admissions
Completing concurrent and retrospectiveCompleting concurrent and retrospective reviews
Communicating with physicians andCommunicating with physicians and the inpatient case management teams on patients who do not meet initial inpatient criteria or continued inpatient stay
Coordinating expedited appeals forCoordinating expedited appeals for inpatient denials with attending physicians and insurance providers
Ensuring organization resources areEnsuring organization resources are being utilized appropriately