Children's Care Manager RN
1 week ago
At NYC Health + Hospitals, we are committed to providing the highest quality healthcare services to our community. We are seeking a highly skilled and compassionate Children's Care Manager Registered Nurse to join our team.
Job SummaryThe Children's Care Manager Registered Nurse will be responsible for coordinating the care of medically fragile children and their families. This includes reviewing and approving plans of care, conducting assessments, and authorizing services. The successful candidate will have excellent communication and interpersonal skills, as well as the ability to work effectively with healthcare providers, families, and community agencies.
Key Responsibilities- Coordinate with Health Home Coordinators and LDSS/VFCA Care Managers to ensure that patient comprehensive treatment needs are met.
- Coordinate member's service needs with community agencies.
- Provide education and coaching to members' family.
- Conducts follow up quarterly assessment calls to Health Home Coordinators.
- Provide clinical guidance and support to assist member in achieving their goals.
- Have extensive knowledge of community resources/services.
- Prepares for and participates in all clinical rounds.
- Interacts with physicians and other members of the Providers' Clinical Teams for discharge planning and required DME.
- Performs telephonic care review and authorization determinations for pre-admission and continuing care with hospitals, clinics and at home services.
- Determines appropriate level of care.
- Consults with Clinical Peer Reviewers when requests for services do not meet medical necessity criteria.
- Interacts with Clinical Peer Reviewers to discuss clinical/authorization questions, alternative treatment options and concerns regarding specific cases.
- Provides information to members' families, Health Home coordinators, LDSS/VFCA, clinical and HCBS providers regarding medical benefits.
- Provides telephone triage and crisis intervention to callers and, when necessary, assists with ensuring members have access to local services and resources.
- Recognizes quality of care issues and reports them appropriately through internal and external processes.
- Bachelor's Degree required
- A minimum of two year's clinical experience in an acute care setting
- Experience using Interqual Guidelines required.
- Knowledge of medical care and HCBS services needed by medically fragile children.
- A valid NYS RN license
- Professional Competencies: Integrity and Trust, Customer Focus, Functional/Technical skills, Written/Oral Communication, Clinical skills and subject matter knowledge.
We offer a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and compassionate individual who is passionate about providing high-quality care to children and families, we encourage you to apply for this exciting opportunity.
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