RN - Care Coordinator, Utiliz Mgmt - F/T - Days
4 weeks ago
Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The Care Coordinator, Care Management is a member of the healthcare team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment and discharge plan. Accountable for a designated patient caseload; assesses, plans, and facilitates with patients, families and the multidisciplinary team to meet treatment goals, expected length of stay, and arrange for the appropriate next level of care. Oversees interfacility transitions and handoff between acute and post-acute services.
Responsibilities:
A day in the life of a Care Coordinator,Utilization Management at Hackensack Meridian Health includes:
Follows departmental workflows for utilization review activities including admission reviews, admission denials, continued stay reviews, continued sray denials, termination of benefits, communication of information to insurance company, billing certifications, concurrent managed care denial appeals and retrospective medical record utilization reviews.
Obtains and evaluates medical records for inpatient admissions to determine if required documentation is present
Obtains appropriate records as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions
Performs chart reviews for appropriateness of admission and continued hospital stay applying appropriate clinical criteria.
Performs admission review within 24 hours or the first business day
Refers cases not meeting criteria to the physician advisor or designated vendor for determination and action
Participates actively on appropriate committees, workgroups, and or meetings
Identifies and refers quality issues for review to the Quality Management Program
Participates in multidisciplinary rounds, specific to assigned unit, brings forth issues which impact discharge and length of stay in a timely manner
Performs appropriate reassessments and evaluates progress against care goals and the plan of care and revises plans, as needed
Collaborates with all members of the multidisciplinary team to support length of stay reduction and observation management goals
Provides appropriate CMS documents to the patient and family/support person as per regulatory guidelines (ie., Important Message 4 to 48 hours prior to discharge, appeal and HINN notices)
Maintains annual competencies and completes training and continuing education in applicable platforms. (Epic, Xsolis Cortex, Enterprise Analytics, Google Suites)
Qualifications:
Education, Knowledge, Skills and Abilities Required:
BSN or BSN in progress and/or willing to acquire within 3 years of hire or transfer into the position.
Effective decision-making skills, demonstration of creativity in problem-solving, and influential leadership skills.
Excellent verbal, written and presentation skills
Moderate to expert computer skills
Familiar with hospital resources, community resources, and utilization management
Licenses and Certifications Required:
NJ State Professional Registered Nurse License
AHA Basic Health Care Life Support HCP Certification
Care Management certification by a nationally recognized organization within 1 year.
-
Registered Nurse
1 week ago
Manahawkin, United States Hackensack Meridian Health Full timeOverview: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one...
-
Patient Care Technician
1 day ago
Manahawkin, United States Hackensack Meridian Health Full timeOverview: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one...
-
Production Coordinator
7 days ago
New York, United States EXCALIBUR GARMENTS INC Full timeProduction Coordinator. NYC. Develop, direct, oversee & coordinate all aspects of pre-production, production & logistics for fashion manufacturing business; analyze customer needs & create cost charts; manage factory communications for timely deliveries; monitor logistic performance & schedules; generate sales analysis reports for strategic decision-making &...
-
Cosmetic Sales Associate
4 weeks ago
New York, United States C.O. Bigelow NY Full timeJob DescriptionJob DescriptionWe are expanding our team and seeking a F/T Cosmetic Sales Associate! You will be responsible for building relationships with customers and selling luxury skincare, makeup, hair care, hair accessories, fragrance, and bath & body products in a retail setting. Experience is a MUST. Applicants without prior beauty experience will...
-
Sr Associate, Equity Investment Mgmt. Support
4 weeks ago
New York, New York, United States ORIX USA LP. Full timeINVESTMENTORIX USA LP. NY, NY, Sr Associate, Equity Investment Mgmt. Support evaluation, structuring, negotiation, & financing transactions. Perform credit investment research, financial analy-sis valuation & modeling industry analysis & diligence. $155,000 - $180,000/year. Apply online at working-at-orix/ Req # R T Jobs , Location:New York, NY
-
Registered Nurse
1 week ago
Manahawkin, United States Hackensack Meridian Health Full timeOverview: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one...
-
New Jersey, United States CI&T Full timeNew Jersey / Boston, MA / Chicago, IL / Houston, TX / Miami, FL / Pennsylvania, PA / Philadelphia, PA / San Antonio, TX / United StatesNorth America – Future Ready Growth /Full Time /HybridWe partner with the world’s most valuable brands to build digital solutions that transform businesses. As a digital native, we bring a 29-year track record of...
-
Patient Observer
4 weeks ago
Manahawkin, United States Hackensack Meridian Health Full timeOur team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another...
-
Construction Logistics Coordinator
3 weeks ago
New Albany, United States LEAD Staffing Full timeJob DescriptionJob DescriptionGrow with us!We are seeking a Construction Coordinator to lead all site logistics on a commercial jobsite!Benefits OverviewCompetitive salary with overtime opportunitiesComprehensive benefits package including medical, dental, vision, short- and long-term disability, life insurancePaid time off, paid sick leave, paid...
-
New Patient Care Coordinator Position
1 week ago
New York, United States Tribeca Physical Therapy Full timeTribeca Physical Therapy is hiring an experienced, part-time employee to serve as a Front Office Patient Care Coordinator for the company's growing team. Our Patient Care Coordinators are responsible for contributing to the team's efforts by providing amazing customer support from the initial phone call to the final visit and beyondJust a little heads up.We...
-
Care Coordinator, Care Management Per Diem
35 minutes ago
Manahawkin, United States Hackensack Meridian Health Full timeOverview: Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. Its also about how we support one...
-
Field Care Coordinator
1 day ago
New York, United States Premier Home Health Care Services, Inc. Full timePremier Home Health Care Services, Inc. is a leading established Home Health Care Agency. We currently have opportunities for Field Care Coordinators supporting our Healthfirst Care Management team. The Field Care Coordinator (FCC) is responsible for conducting local home visits for Healthfirst members. **Minimum Qualifications**: - High school diploma or...
-
Care Coordinator, Care Management Per Diem
3 days ago
Manahawkin, United States Hackensack Meridian Health Full timeOverview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one...
-
Adult Day Care Program Director
4 days ago
New York, United States Centers Adult Day Care Full timeCenters Adult Day Care - Adult Day Care Program Director Amsterdam Adult Day Care is seeking a Program Director for our Adult Day Care in the heart of NYC. The Ideal candidate will have a background in ADC and be extremely organized. Competitive Compensation & comprehensive benefits package. DUTIES: Perform/direct all marketing/outreach activities...
-
RN- Care Manager
4 days ago
New York, United States Village Care Full timeJob DescriptionJob DescriptionRN - Care ManagerMLTC/MAP/DSNP*Fully Remote*Join our team at Village Care as a Full Time RN- Care Manager! This exciting position offers the opportunity to work remotely, providing care and support to our members in the greater NYC area. As an integral part of our team, you will have the chance to showcase your nursing expertise...
-
Registered Nurse
1 month ago
Edison, New Jersey, 08899, Middlesex County, NJ, United States Hackensack Meridian Health Full timeDescription: The Registered Nurse functions as a caregiver for a specific patient population in order to achieve desired outcomes. This position focuses on expanding knowledge and skills, provides effective direct care as part of the interdisciplinary team to a variety of complex patients. This position directs and oversees the care provided by other...
-
Travel Nurse RN
5 days ago
Manahawkin, United States Ardor Health Solutions Full timeJob DescriptionArdor Health Solutions is seeking a travel nurse RN Med Surg for a travel nursing job in Manahawkin, New Jersey.Job Description & RequirementsSpecialty: Med SurgDiscipline: RNStart Date: 06/03/2024Duration: 13 weeks36 hours per weekShift: 12 hours, daysEmployment Type: Travel\tLocation: Manahawkin, NJ\tSetting: Hospital\t\tEmployment Type:...
-
New Patient Care Coordinator Position
4 weeks ago
New York, United States Tribeca Physical Therapy Full timeJob DescriptionJob DescriptionTribeca Physical Therapy is hiring an experienced, part-time employee to serve as a Front Office Patient Care Coordinator for the companys growing team. Our Patient Care Coordinators are responsible for contributing to the team's efforts by providing amazing customer support from the initial phone call to the final visit and...
-
P/T HR Generalist-Sourcing Coordinator
1 week ago
New York, United States Experis Full timeOur client is in need of a P/T Recruitment Coordinator-Sourcer to assist with increased hiring needs their client group. The ideal candidate will have some recruitment experience, manage scheduling interviews, reviewing applications, reference checks, and junior level searches, and other duties as required. P/T Recruitment Coordinator-Sourcer Pay $35-40hr ...
-
Scheduling Coordinator
3 days ago
New City, United States Ultimate Care NY Full timeJob DescriptionJob DescriptionUltimate Care NY is seeking a dedicated and detail-oriented Scheduling Coordinator to join our team in New City, NY!As a Scheduling Coordinator, you will play a critical role in ensuring efficient and effective scheduling of our home health care staff to meet the needs of our clients. Ultimate Care NY has been providing...