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RN - Case Manager Nurse

2 weeks ago

Brooklyn, NY, United States Integrated Resources Full time
Job Title: RN - Case Manager
Location: Brooklyn, NY 11213
Duration: 01/06/2026 - 04/04/2026
Schedule: Monday-Friday, 5 days per week, 8 hours per day, 40 hours per week
Shift: Day Shift
Pay Range: $75-$70/hr.

Required Skills & Experience
  • Minimum of three (3) years' experience in one or more of the following:
    • Acute Care
    • Medical-Surgical
    • Intensive Care
    • Emergency Department
    • Community Nursing (Home Care)
  • PRI certified
  • Strong clinical background with ability to assess physical, mental, and emotional barriers to self-care
  • Knowledge of Milliman Care Guidelines
  • Knowledge of CMS guidelines for post-acute placements
  • Proficiency in EPIC documentation
  • Experience reviewing admissions for medical necessity (severity of illness and intensity of service)
  • Ability to collaborate with interdisciplinary care teams, physicians, and social work
  • Knowledge of discharge planning, appeal process, and community resource coordination
Education Requirements
  • Bachelor's degree in Nursing
Required Certifications & Licensure
  • Current New York State RN License
  • Basic Life Support (BLS)
  • Advanced Cardiovascular Life Support (ACLS)
Preferred Certifications
  • Pediatric Advanced Life Support (PALS)
  • Case Manager Certification (CCM)
Job Summary
  • Advocates for safe, timely execution of patient plans of care and adherence to medical necessity guidelines.
  • Performs face-to-face patient assessments addressing physical, mental, and emotional barriers to care.
  • Conducts daily EHR reviews to evaluate severity of illness and intensity of service.
  • Collaborates with physicians, physician advisors, social workers, and interdisciplinary teams.
  • Reviews HMO and inpatient admissions for medical necessity within required timeframes.
  • Completes utilization reviews and clinical documentation for insurance submissions.
  • Coordinates discharge planning, post-acute placements, and home care services.
  • Documents all case management activities in EPIC and Careport.
  • Serves as patient and family advocate to ensure access to appropriate community resources.