Case Manager

1 day ago


Brooklyn, New York, United States NewYork-Presbyterian Hospital Full time
Job Title: Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days

Located in Park Slope, Brooklyn, this acute-care teaching hospital has been providing outstanding medical care to the surrounding communities for over 135 years.

Job Summary:

The Case Manager is responsible for all aspects of discharge planning and utilization management/review for an assigned group of patients to determine the appropriateness of the admission and continued stay, assist in the development of the plan of care; ensure that the plan is implemented timely and identify the expected length of stay (ELOS). The Case Manager works collaboratively with physicians, social workers, clinical nurses, home care services, and other members of the interdisciplinary team.

Responsibilities:
  • Completing 100% clinical reviews for managed care, Medicare and Medicaid admissions
  • Completing concurrent and retrospective reviews
  • Communicating with physicians and the inpatient case management teams on patients who do not meet initial inpatient criteria or continued inpatient stay
  • Coordinating expedited appeals for inpatient denials with attending physicians and insurance providers
  • Ensuring organization resources are being utilized appropriately
  • Completing patient assessments within 24 hours
  • Coordinating safe and appropriate post-acute care plans
  • Obtains authorizations from managed care companies for post-discharge services
Requirements:
  • Current NYS RN license
  • Bachelor's degree in Nursing (BSN)
  • 3-5 yrs Acute Care RN nursing experience
  • Previous experience in inpatient acute care case manager/discharge planning, certified home health care (CHHA), Case Management experience, utilization experience, or managed care organization experience required
  • PRI certification & BCLS
  • Ability to work independently and collaboratively within an interdisciplinary team
About NewYork-Presbyterian Hospital:

NewYork-Presbyterian Hospital is an equal opportunity employer. We foster a culture of respect, diversity, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life.

Our amazing compensation packages start with competitive base pay and include recognition for your experience, education, and licensure. Then we add our amazing benefits, countless opportunities for personal and professional growth and a dynamic environment that embraces every person.

Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, diversity, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life.

Salary Range: $112,508-$149,911/Annual


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