Nurse Case Manager
2 weeks ago
Under the general supervision of the Director, the Nurse Case Manager role provides clinically-based case management to support the delivery of effective and efficient patient care. The Nurse Case Manager will pace the case from physiological and economic perspectives, with overall accountability for the utilization management and transition management for patients within the assigned caseload.
Key Responsibilities- Determines medical necessity, appropriateness of admission, continuing stay and level of care using a combination of clinical information, clinical criteria, and third-party information.
- Validates admission and continuing stay criteria with third-party payers and primary care and attending physicians.
- Collaborates with the third-party payers to anticipate denial of payment and proactively addresses issues contributing to a potential denial.
- Supports the effective prevention and management of denials, including providing information as part of the appeal process.
- Assesses the patient and family for continuing care needs to develop, implement, and evaluate an effective discharge plan in collaboration with the multidisciplinary team.
- Collaborates and communicates with patients/families related to reimbursement issues and to create a discharge plan.
- Uses clinical knowledge and knowledge of anticipated response to treatment to assess patient progression towards anticipated outcomes.
- Must have strong interpersonal and communication skills.
- Ability to form positive, collaborative relationships with hospital staff, patients, and families.
- Ability to effectively negotiate with internal and external providers of patient care services.
- Must be able to work independently and prioritize work.
- Must be able to manage multiple priorities.
- Basic knowledge of computers and clinical applications.
- Ability to problem solve in a proactive, creative manner using sound judgment based on factual information and clinical knowledge.
- Preferred experience in Utilization Review/Management.
- Must have Associate's Degree or BSN preferred.
- Must have current RN license.
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Nurse Case Manager
2 weeks ago
Poughkeepsie, New York, United States Vassar Brothers Medical Center Full timeJob Title: Nurse Case ManagerVassar Brothers Medical Center is seeking a skilled Nurse Case Manager to join our team. As a key member of our Care Coordination department, you will play a vital role in ensuring the delivery of effective and efficient patient care.Job Summary:The Nurse Case Manager will provide clinically-based case management to support the...
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Nurse Case Manager
1 week ago
Poughkeepsie, New York, United States Vassar Brothers Medical Center Full timeJob Title: Nurse Case ManagerVassar Brothers Medical Center is seeking a skilled Nurse Case Manager to join our team. As a key member of our care coordination team, you will play a vital role in ensuring the delivery of effective and efficient patient care.Job Summary:The Nurse Case Manager will provide clinically-based case management to support the...
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Nurse Case Manager
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Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health is seeking a skilled Nurse Case Manager to join our team. As a key member of our care coordination team, you will play a vital role in ensuring the delivery of effective and efficient patient care.Key ResponsibilitiesProvide clinically-based case management to support the delivery of effective and efficient patient care.Utilize...
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Nurse Case Manager
5 days ago
Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health is seeking a skilled Nurse Case Manager to join our team. As a Nurse Case Manager, you will play a critical role in ensuring the delivery of effective and efficient patient care. You will work closely with patients, families, and healthcare teams to identify and address patient needs, develop and implement care plans, and coordinate...
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Nurse Case Manager
2 weeks ago
Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health is seeking a skilled Nurse Case Manager to join our team. As a key member of our care coordination team, you will play a vital role in ensuring the delivery of effective and efficient patient care.Key ResponsibilitiesProvide clinically-based case management to support the delivery of effective and efficient patient care.Utilize...
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Residential Nurse Case Manager
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Nurse Case Manager
2 weeks ago
Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health is seeking a skilled Nurse Case Manager to join our team. As a key member of our care coordination team, you will play a vital role in ensuring the delivery of effective and efficient patient care.Key ResponsibilitiesProvide clinically-based case management to support the delivery of effective and efficient patient care.Utilize...
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Nurse Case Manager
2 weeks ago
Poughkeepsie, New York, United States Vassar Brothers Medical Center Full timeJob SummaryUnder the general supervision of the Director, the Nurse Case Manager role provides clinically-based case management to support the delivery of effective and efficient patient care. The Nurse Case Manager will pace the case from physiological and economic perspectives, with overall accountability for the utilization management and transition...
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Residential Nurse Case Manager
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Residential Nurse Case Manager
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Case Manager
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Nurse Case Manager
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Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health is seeking a skilled Nurse Case Manager to join our team. As a key member of our care coordination team, you will play a vital role in ensuring the delivery of effective and efficient patient care.Key ResponsibilitiesProvide clinically-based case management to support the delivery of effective and efficient patient care.Pace cases...
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Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health seeks a skilled Nurse Case Manager to provide clinically-based case management and support the delivery of effective and efficient patient care.Key ResponsibilitiesCollaborate with healthcare teams to identify appropriate utilization of resources and ensure reimbursement.Utilize clinical criteria to confirm medical necessity for...
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Nurse Case Manager
3 weeks ago
Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health seeks a skilled Nurse Case Manager to provide clinically-based case management and support the delivery of effective and efficient patient care.Key ResponsibilitiesCollaborate with healthcare teams to identify appropriate utilization of resources and ensure reimbursement.Utilize clinical criteria to confirm medical necessity for...
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Nurse Case Manager
1 month ago
Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health is seeking a skilled Nurse Case Manager to join our team in providing high-quality patient care and ensuring efficient clinical operations.Key ResponsibilitiesCollaborate with healthcare teams to assess patient needs and develop effective discharge plans.Utilize clinical knowledge and criteria to determine medical necessity and...
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Nurse Case Manager
3 weeks ago
Poughkeepsie, New York, United States Vassar Brothers Medical Center Full timeJob SummaryVassar 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...
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Nurse Case Manager
3 weeks ago
Poughkeepsie, New York, United States Vassar Brothers Medical Center Full timeJob SummaryVassar 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...
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Nurse Case Manager
1 week ago
Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health is seeking a skilled Nurse Case Manager to join our team at Vassar Brothers Medical Center. As a key member of our Care Coordination department, you will play a vital role in ensuring the delivery of effective and efficient patient care.Key ResponsibilitiesProvide clinically-based case management to support the delivery of effective...
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Nurse Case Manager
3 weeks ago
Poughkeepsie, New York, United States Nuvance Health Full timeJob SummaryNuvance Health seeks a skilled Nurse Case Manager to provide clinically-based case management and support the delivery of effective and efficient patient care.Key ResponsibilitiesUtilize clinical knowledge and criteria to confirm medical necessity for admission and continued stay.Partner with Social Workers and collaborate with other healthcare...
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RN Case Manager
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