BHMC - RN Case Manager

Location: New York

BHMC - RN Case Manager

Meta Sense Inc.

Job location:

New York, NY.

Base Pay Range

$23.52/hr - $23.52/hr

Job Summary

Coordinates and ensures delivery of care; collects utilization management and quality assessment data; regularly interacts with physicians to clarify plans of care; and reviews patients for high-risk criteria for discharge planning needs.

Required Skills & Experience

• Minimum three (3) years’ experience in direct patient care.

Required Education

• Bachelor’s Degree in Nursing (BSN) required.

Preferred Education

• Master's Degree in Nursing, preferred.

Required Certifications & Licensure

• Current NY State RN License required.
• Basic Life Support (BLS) required.
• Advanced Cardiovascular Life Support (ACLS) required.

Preferred Certifications & Licensure

• Pediatric Advanced Life Support (PALS) preferred.
• Case Manager Certification (CCM) preferred.

Responsibilities

• Monitors patients and determines needs for a timely discharge.
• Confers with 3rd party payers within 24 hours past notification.
• Conducts initial case review no later than 72 hours after admission.
• Screens patient to determine if he/she meets high-risk criteria for discharge planning needs.
• Develops discharge plan for uncomplicated cases.
• Makes referral to Social Worker for assessment and discharge planning as indicated.
• Collaborates with other members of the health care team to facilitate the progress of care.
• Ensures that a plan of care is developed expeditiously by the attending physician.
• Ensures that a plan of care is time oriented and has clearly defined objectives.
• Negotiates, if needed, with physician and other health care practitioners to develop a more effective care plan.
• Monitors duplication of tests, delays in diagnostic, treatment and/or scheduling.
• Ensures documentation of patient progress toward identified clinical outcomes by health care practitioners.
• Conducts concurrent review.
• Participates in the collection of data related to performance improvement.
• Reviews cases for continued stay appropriateness.
• Collaborates with physician regarding issues. If unsuccessful, refers to physician advisor.
• Accurately a document review findings and provides clinical information to 3rd party payers.
• Performs retro reviews as requested by 3rd party payers.
• Maintains current knowledge of developments in the field.
• Review professional literature to seek out and recommends improvements.
• Maintains competency by participating in in-service and continuing educational programs.
• Maintains membership in professional organizations, attends lectures, reads journals and articles.
• Develops and maintains a high level of patient and staff satisfaction.
• Displays courtesy, tact, and diplomacy when dealing with staff, colleagues, superiors, patients, hospital visitors, and vendors, representatives of other institutions, and government and regulatory agencies.
• Offers to assist those mentioned above in attaining their goals or completing their tasks whenever possible, or if unable, obtain appropriate assistance.
• Performs other related duties assigned by manager/supervisor. In an emergency, performs other duties necessary for the welfare of patients or the efficient operations of the institution.

Seniority Level

Associate

Employment Type

Contract

Job Function

Health Care Provider

Industry

Hospitals and Health Care

Location & Salary

New York, NY – $95,000.00–$

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