Nurse Case Manager

5 days ago


Fort Lee, New Jersey, United States Montefiore Medical Center Full time
Job Summary

Montefiore Medical Center is seeking a skilled Nurse Case Manager to join our team. As a key member of our healthcare team, you will play a vital role in coordinating the continuum of medical care services for patients to ensure optimum utilization of resources, delivery of quality patient care, and compliance with regulatory, accrediting, and contractual requirements.

Key Responsibilities
  • Coordinate Patient Care: Determine the appropriateness of patient care services, prepare clinical appeals for third-party denials, and collect and interpret data for utilization, compliance, quality improvement, and other areas as assigned.
  • Develop and Implement Care Plans: Collaborate with healthcare professionals to develop and implement individualized care plans that meet the unique needs of each patient.
  • Monitor and Evaluate Patient Progress: Regularly monitor and evaluate patient progress, making adjustments to care plans as needed to ensure optimal outcomes.
  • Communicate Effectively: Communicate effectively with patients, families, healthcare professionals, and other stakeholders to ensure seamless coordination of care.
  • Stay Up-to-Date with Industry Developments: Stay current with industry developments, best practices, and regulatory requirements to ensure compliance and optimal patient care.
Requirements
  • Education and Experience: BSN or a bachelor's degree in a related field required, Master's preferred. 3-5 years recent acute care clinical experience preferred.
  • Certifications and Licenses: NYS RN License required. PRI assessor number required prior to end of 3-month probationary period.
  • Skills and Abilities: Analytical skills, problem-solving skills, conflict resolution and negotiation skills. Demonstrated knowledge of federal, state, and commercial/third-party regulations related to utilization management functions, discharge planning, and associated processes.
What We Offer
  • Competitive Salary: $61.68 per hour.
  • Opportunities for Growth and Development: Montefiore Medical Center is committed to the growth and development of our employees, offering opportunities for professional growth and advancement.
  • Diverse and Inclusive Work Environment: Montefiore Medical Center is an equal employment opportunity employer, committed to creating a diverse and inclusive work environment that values and respects the contributions of all employees.

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