RN Case Manager

3 weeks ago


Lake Success NY, United States FlexStaff Careers Full time
Job Summary:

As a RN Case Manager, you will serve as a liaison between patients and healthcare facilities/physicians, ensuring a continuum of quality patient care throughout hospitalization. You will oversee provisions for patient discharge, assess, plan, and evaluate the appropriateness of care throughout admission and hospitalization. Additionally, you will perform concurrent utilization management using evidence-based medical necessity criteria, submit data to management regarding case management and/or quality initiatives, and serve as an in-patient liaison. Your responsibilities will include conducting clinical reviews, interacting with third-party payers, and documenting the case management process in the medical record. A Bachelor's Degree in Nursing is preferred, and you must be a graduate from an accredited School of Nursing.

Key Responsibilities:
  • Serve as liaison between patients and healthcare facilities/physicians
  • Oversee provisions for patient discharge
  • Assess, plan, and evaluate the appropriateness of care throughout admission and hospitalization
  • Perform concurrent utilization management using evidence-based medical necessity criteria
  • Submit data to management regarding case management and/or quality initiatives
  • Conduct clinical reviews and interact with third-party payers
  • Document the case management process in the medical record

Requirements:
  • Graduate from an accredited School of Nursing
  • Bachelor's Degree in Nursing, preferred


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