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Poughkeepsie, New York, United States Vassar Brothers Medical Center Full timeJob Title: Nurse Case ManagerJoin our team at Vassar Brothers Medical Center as a Nurse Case Manager, where you will play a crucial role in ensuring the delivery of effective and efficient patient care.Job Summary:Under the general supervision of the Director, the Nurse Case Manager will provide clinically-based case management to support the delivery of...
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Nurse Case Manager
2 months ago
Vassar Brothers Medical Center seeks a skilled Nurse Case Manager to provide clinically-based case management and support the delivery of effective and efficient patient care. This role requires strong interpersonal and communication skills, with the ability to form positive, collaborative relationships with hospital staff, patients, and families.
Key Responsibilities- Determine medical necessity, appropriateness of admission, continuing stay, and level of care using clinical information, clinical criteria, and third-party information.
- Validate admission and continuing stay criteria with third-party payers and primary care and attending physicians.
- Collaborate with the third-party payers to anticipate denial of payment and proactively address issues contributing to a potential denial.
- Support the effective prevention and management of denials, including providing information as part of the appeal process.
- Assess the patient and family for continuing care needs to develop, implement, and evaluate an effective discharge plan in collaboration with the multidisciplinary team.
- Collaborate and communicate with patients/families related to reimbursement issues and to create a discharge plan.
- Provide support and counseling to patients/families experiencing and/or anticipating issues to adjusting to illness, catastrophic diagnoses, changes in living situations, and bereavement.
- Minimum 3 years of experience in acute care.
- Associate's Degree or BSN preferred.
- Current RN license.
- Preferred experience in Utilization Review/Management.
Vassar Brothers Medical Center offers a competitive salary range of $72.83 hourly and a comprehensive benefits package.
