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Clinical Case Manager

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. This role is based in Bronx, New York, and requires a Bachelor's degree in a relevant field, along with a valid NYS RN License and 3-5 years of experience in acute care settings.

  • Specialty: Case Management
  • Discipline: 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 third-party service denials
  • Gather and analyze data for compliance and utilization
  • Facilitate the continuum of healthcare services

Qualifications:

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

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 diversity, equity, and inclusion within our workforce. Montefiore is an equal opportunity employer.