Overview
At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence-based practice to improve outcomes – to every patient, every time.
Responsibilities
Our Care Managers will:
- Educate staff, physicians, patients, and families in the case management process.
- Review new admissions and continued stay patients to determine whether MCG criteria is met.
- Engage physicians to establish the optimal DRG, length of stay and expected date of discharge.
- Interface with representatives of third party payors to assist with the certification process and the discharge planning process, responding to requests for reviews in a timely fashion to avoid denials.
- Review records and collaborate with the interdisciplinary team to obtain information about all aspects of the patients, transmitting information to third party payors to avoid denials.
- Participate in interdisciplinary rounding and identify areas for improvement.
- Facilitate communication between patients, families, and social work to ensure safe and appropriate discharge plans.
- Collaborate effectively within an interdisciplinary team and engages patients and families with
What you'll bring:
- Passion for Case Management
- 3+ Years of diverse in-patient acute care RN experience
- Critical Care, Home Care, and/or Case Management experience
- Progressive leadership experience preferred
- Excellent written and verbal communication skills. Highly organized and detail oriented with strong critical thinking ability. Ability to assess, evaluate, plan, and coordinate complex patient placement and discharge activities.
- Strong time management skills with the ability to manage competing priorities in a fast-paced acute care environment. Exhibits flexibility and adaptability in response to changing patient needs, discharge plans, payer requirements, and operational demands.
- Proficiency in Microsoft Office applications required. Ability to quickly learn and effectively navigate multiple electronic medical record systems, insurance portals, and care coordination platforms.
- Knowledge of progression of care, medical necessity criteria, and post-acute authorization processes preferred.
- Education: Graduate of an accredited School of Nursing required
- Bachelors of Science in Nursing (BSN) degree strongly preferred
- Licensure: New York Registered Nurse (RN) License & Registration
- Certification: Case Management Certification preferred; PRI Certification preferred
Pay Range
USD $65.83 - USD $65.83 /Hr.
Qualifications
This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any differential pay or other forms of compensation that may be applicable to this job and it does not include the value of benefits.
