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Clinical Case Manager Position

2 months ago

Bronx, New York, United States Montefiore Medical Center Full time
Opportunity at Montefiore Medical Center

We are seeking a Case Manager to oversee the coordination of healthcare services for our patients. The ideal candidate will possess a Bachelor's degree in a relevant discipline, hold a valid NYS RN License, and have 3-5 years of experience in acute care settings.

  • Specialty: Case Management
  • Field: Healthcare Services
  • Duration: Ongoing
  • Shift: Daytime
  • Employment Type: Staff Position

Key Responsibilities:

  • Optimize resource utilization to ensure high-quality patient care
  • Prepare clinical appeals for denied claims by third parties
  • Gather and analyze data for compliance and utilization
  • Facilitate the continuum of care for patients

Qualifications:

  • BSN or a related Bachelor's degree is mandatory; a Master's degree is preferred
  • Experience in utilization management and managed care is advantageous
  • Familiarity with federal, state, and commercial healthcare regulations
  • Strong analytical, problem-solving, and communication abilities
  • In-depth clinical knowledge and understanding of the healthcare delivery system

About Montefiore Medical Center:

Montefiore is a premier academic medical institution committed to delivering exceptional care and advancing healthcare research. We are dedicated to fostering a culture of diversity, equity, and inclusion. Montefiore is an equal opportunity employer.