RN Case Manager

3 weeks ago


Lake Success, United States FlexStaff Careers Full time
Job Title: RN Case Manager - Queens Peds/Adults Full and Part-time Contracts

FlexStaff Careers is seeking a skilled Registered Nurse Case Manager to join our team in Queens. As a RN Case Manager, you will serve as a liaison between patients and healthcare facilities, ensuring a continuum of quality patient care throughout hospitalization.

Responsibilities:
  • Facilitate patient management throughout hospitalization
  • Perform concurrent utilization management using evidence-based medical necessity criteria
  • Submit data to management regarding case management and/or quality initiatives
  • Serve as an in-patient liaison - planning, assessing, implementing, and evaluating patient care in collaboration with the healthcare team
  • Conduct chart reviews for appropriateness of admission and continued length of stay; facilitate throughput
  • Conduct clinical reviews and interact with third-party payers to obtain approval of hospital days, pre-certification, and post-discharge eligibility in relation to clinical course
  • Ensure compliance with current state, federal, and third-party payer regulations
  • Document the case management process in the medical record; complete and document a care coordination assessment on the patient
  • Serve as a liaison to patients, family, admitting, primary care physician, healthcare team, and hospital departments
  • Complete applicable areas of the patient's discharge instruction sheet and the patient transfer sheet; ensure case management documentation is current and accurate
  • Perform related duties as required
Qualifications:
  • Graduate from an accredited School of Nursing
  • Bachelor's Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date
  • Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed

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