Registered Nurse Care Manager

1 month ago


Yonkers, United States MLee Healthcare Staffing and Recruiting, Inc Full time
Registered Nurse Care Manager
  • Up to $2,500 Sign On Bonus
Shift Type: Day Shifts, Sunday, Thursday & Fridays

Employment Type: Part Time, PT

Position Summary: MLee Healthcare is seeking a passionate RN Care Manager. The RN Care Manager conducts initial comprehensive assessments upon patient admission according to Care Management Department policies. This involves using established tools (e.g., AIMS, Geisinger, polypharmacy) to identify high-risk indicators, ensuring that high-risk patients receive appropriate supportive services for discharge and preventing readmission. The RN Care Manager continuously reassesses patient needs throughout their hospital stay and performs Utilization Review (UR) activities as per department policy.

Essential Functions and Responsibilities:
  • Understands and adheres to Performance Standards, Policies, and Behaviors.
  • Completes a thorough initial assessment of patients.
  • Manages multidisciplinary care coordination within and between hospitals.
  • Handles all aspects of transitional planning, including patient/caregiver education, arranging aftercare, engaging commercial payers, and addressing root causes for high-utilizer patients.
  • Shares relevant patient information with appropriate healthcare team members.
  • Works towards achieving departmental goals related to length of stay (LOS) reduction, readmission prevention, denial reduction, and improvement in patient satisfaction.
  • Documents patient information and activities as required by department policies.
  • Participates in Performance Improvement activities as needed.
  • Performs all Utilization Review activities, including commercial payer reviews, disposition determination, retro/self-audit, MC variance, and admission clinical reviews.
  • Executes other related duties as assigned.
Education & Experience Requirements:
  • Bachelor of Science in Nursing (BSN) or related Bachelor's degree required.
  • Minimum of 5 years of clinical experience in ED, critical care, or med/surg. Previous case management experience is preferred.
  • Familiarity with healthcare financial, regulatory, and payer issues preferred. Knowledge of state, local, and federal programs is strongly preferred. Experience with Milliman/InterQual criteria is beneficial.
  • Registered Nurse (RN) license in New York State required.
  • PRI/Screen certification strongly preferred. Certified Case Manager (CCM) certification preferred.
  • Strong computer skills are essential.


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