Care Manager-RN

Job Title: RN Care Manager
Department: Greater Rochester Independent Practice Association (GRIPA)
Location: 100 Kings Highway South, Rochester, NY
Hours Per Week: 40 hours
Schedule: Full-time, Days

GRIPA was founded in 1996 as a unique collaboration between hospitals and physicians, for the purpose of simultaneously improving the quality and efficiency of health care. This position will not be employed by Rochester Regional Health (RRH).

As a Registered Nurse – Care Manager, your excellent interpersonal, leadership and collaboration skills ensure the appropriate allocation of hospital resources while maintaining the quality of care. Actively participates in the utilization management process using standards of care to determine the most appropriate level of care, participating in the development of plans for care, managing the care across the continuum to ensure a safe discharge in a timely manner.

• Evaluation & Review. Evaluate hospital admissions to assure care is medically necessary and delivered at the most appropriate level; actively participate in the concurrent review process and communicate/intervene with third party payors to ensure reimbursement for services are provided while maintaining quality of care
• Patient Management. Collaborate with providers, patients and families to address concerns and identify safe, effective discharge plans; intervene to identify and facilitate early referral for discharge planning; facilitate the discharge process by working with the healthcare team to identify alternative solutions to minimize system delays while ensuring a safe discharge plan
• Recommendation. Coordinate and participate in the development, implementation and revisions of evidence based clinical pathways and guidelines; participate in driving clinical and administrative compliance with care guidelines and core measures; identify and recommend actions for improvement

• Associate’s Degree in Nursing (ASN)
• Registered Nurse with current New York State License
• AHA BLS

• Bachelors in Nursing (BSN)
• Three (3) years of acute hospital care, case management or utilization management experience
• Case Management Certification
• Excellent oral and written communication and interpersonal skills
• Good understanding of medical management techniques and processes
• Knowledge of federal and state regulations (DOH, Medicaid/Medicare)
• Strong organizational and problem‑solving skills
• Knowledge of third party payor and/or managed care payment principles helpful

M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects;
Requires frequent walking, standing or squatting.

• BLS - Basic Life Support - American Heart Association (AHA)
  American Heart Association (AHA)
• RN - Registered Nurse - New York State Education Department (NYSED)
  New York State Education Department (NYSED)

$80,750.00 - $