RN Case Manager
3 weeks ago
SUNY Downstate Health Sciences University is seeking a highly skilled RN Case Manager to join our team. As a key member of our Department of Case Management, you will play a critical role in ensuring that patients receive the highest level of care.
Key Responsibilities:- Conduct thorough reviews of patient records to determine medical necessity for acute care treatment.
- Ensure that patients are in the appropriate level of care based on Milliman Care Guidelines (MCG).
- Perform clinical assessments and document findings in the EMR.
- Provide critical feedback to healthcare teams via participation in daily multidisciplinary rounds.
- Identify barriers to achieving patient goals and complete discharge plans.
- Conduct timely concurrent reviews and responses to third-party payor requests.
- Collaborate with ED Case Managers and Social Workers to facilitate discharge plans.
- Current New York State Registered Nurse Licensure.
- Bachelor's Degree in Nursing.
- PRI Certification.
- Graduate Degree in Healthcare.
- Case Management Certification.
Monday to Friday, 8:00am to 4:00pm (Full-Time)
Salary Grade/Rank:SL-5
Salary Range:Commensurate with experience and qualifications
Equal Employment Opportunity Statement:SUNY Downstate Health Sciences University is an affirmative action, equal opportunity employer and does not discriminate on the basis of race, color, national origin, religion, creed, age, disability, sex, gender identity or expression, sexual orientation, familial status, pregnancy, predisposing genetic characteristics, military status, domestic violence victim status, criminal conviction, and all other protected classes under federal or state laws.
Women, minorities, veterans, individuals with disabilities, and members of underrepresented groups are encouraged to apply.
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