Details
Client Name
White Plains Hospital - WH
Job Type
Permanent
Offering
Nursing
Profession
RN
Specialty
Case Manager
Job ID
29563051
Job Title
Care Management - Manager
Shift Details
Shift
Day - 8x5 - 09AM
Scheduled Hours
40
Job Order Details
Start Date
12/02/2024
Job Description
Shift: 09:00 AM - 05:00 PM
Description:
Understands and adheres to the facility Performance Standards, Policies and Behaviors
Completes a comprehensive initial assessment.
Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care.
Performs all transitional planning activities including but not limited to:
Patient/caregiver education
Arrangement of all aftercare
Commercial payer involvement
High utilizer patient root cause
Communicates and collaborates all relevant patient information to appropriate health team members.
Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized.
Documents per department requirements.
Participates in Performance Improvement activities as needed.
Performs all UR activities per department policy:
Commercial payer reviews
Disposition determination,
Retro/self-audit
MC variance
Admission clinical review.
Performs all other related duties as assigned
Education & Experience Requirements:
BSN or related Bachelor's degree required
5 years clinical ED, critical care or med/surg experience required
Previous case management experience preferred
Knowledge of healthcare financial, regulatory, and payer issues preferred
Knowledge of state, local, and federal programs strongly preferred
Experience in use of Milliman/InterQual criteria
Registered Nurse (RN) NYS license required
PRI/Screen certification strongly preferred.
C.C.M. (Certified Case Manager) certification preferred
Computer skills essential
Requirements & Work Environment:
May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital's SDS (Safety Data Sheet) data base and may be accessed through the hospital's Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc.
Must be physically able to walk, stand and/or sit for extended periods of time, with the ability to carry necessary equipment (i.e., IPad or laptop) on rounds. Must be able to perform difficult manipulative, arm-hand steadiness and hand-eye coordination skills.
Must be able to meet all regulatory requirements. Demonstrates ability to follow written and oral instructions required for the position.
Demonstrates ability to analyze multidimensional problems into component parts and sort out tasks in priority order to solve the problem.
Must be able to see object closely and far away, hear normal sounds with some background noise. Communicates effectively verbally and in writing.
Client Details
Address
41 E Post Rd
City
White Plains
State
NY
Zip Code
10601
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