Job Posting for RN Case Manager at VIR Healthway Inc.
Position Summary The RN Care Manager performs the initial comprehensive assessment on admission by the Care Management Department policy, screening all patients by utilizing established tools for high-risk indicators (i.e. AIMS, Geisinger, polypharmacy) to ensure high-risk patient populations receive the appropriate supportive services for discharge to prevent readmission and assess all populations for potential discharge planning needs. Provides ongoing reassessment of needs throughout the hospital course. Performs UR activity per department policy.
Essential Functions and Responsibilities Include the Following:
Understands and adheres to the WPH 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
#VIRHRNLPN
Job Types: Full-time, Part-time
Pay: $109,462.00 - $150,000.00 per year
Expected hours: 16 – 32 per week
Benefits:
401(k)
401(k) matching
Dental insurance
Health insurance
Life insurance
Paid time off
Retirement plan
Vision insurance
Schedule:
8 hour shift
Day shift
Monday to Friday
Weekends only
Work setting:
Inpatient
Experience:
Nursing: 1 year (Required)
Case management: 1 year (Required)
License/Certification:
RN (Required)
Ability to Commute:
White Plains, NY (Required)
Ability to Relocate:
White Plains, NY: Relocate before starting work (Required)
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