RN -Case Management

Job Description

BSN; NYS License; PRI Certification (PRI certification to be obtained within 3 months of initial employment); Screen certification strongly preferred; A Care Management certification preferred (i.e. CMC, CCM etc.); 3 years clinical ED, critical care or med/surg experience preferred; Previous case management experience preferred; Knowledge of healthcare financial, regulatory, and payer issues preferred; Knowledge of state, local, and federal programs strongly preferred; Experience in use of Milliman/InterQual criteria; Computer skills essential; 3 years experience required; Additional Information: Position Description: Position Summary The RN Care Manager performs the initial comprehensive assessment on admission in accordance with the Care Management Department policy, screening all patients by utilizing established tools for high risk indicators to ensure high risk patient populations receive the appropriate supportive services for discharge to prevent readmission and assess all populations for potential discharge planning needs. Provides ongoing reassessment of needs throughout the hospital course. Performs UR activity per department policy. Essential Functions and Responsibilities Includes the Following: Understands and adheres to the WPH Performance Standards, Policies and BehaviorsCompletes a comprehensive initial assessment.Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care.Performs all transitional planning activities including but not limited to:Patient/caregiver educationArrangement of all aftercareCommercial payer involvementHigh utilizer patient root causeCommunicates and collaborates all relevant patient information to appropriate health team members.Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized.Documents per department requirements.Participates in Performance Improvement activities as needed.Performs all UR activities per department policy:Commercial payer reviewsDisposition determination,Retro/self-auditMC varianceAdmission clinical review.The RN Care Manager collaborates with all Health Care professionals to evaluate the needs and the safe discharge of all geriatric patients including but not limited to inpatients, emergency department and surgical outpatients.Performs all other related duties as assigned Education & Experience Requirements BSN required for all RNs hired after 1/1/18All RNs hired before 1/1/18 will be required to have their BSN (or MSN) by 12/31/21.Registered Nurse (RN) NYS license requiredPRI Certification (PRI certification to be obtained within 3 months of initial employment)Screen certification strongly preferredA Care Management certification preferred (i.e. CMC, CCM etc.)3 years clinical ED, critical care or med/surg experience preferredPrevious case management experience preferredKnowledge of healthcare financial, regulatory, and payer issues preferredKnowledge of state, local, and federal programs strongly preferredExperience in use of Milliman/InterQual criteria A Care Management certification preferred (i.e. CMC, CCM etc.)Computer skills essentialIf you are not familiar with the facility, please take time to look it up and see the great things they have happening there. White Plains wins many awards for being a great place to work; this does not happen by accident. They thoroughly review their applicants and make sure they are a fit both clinically and behaviorally. The HR team reviews the candidate before deciding to send it to the unit managers. This can take some time so please allow 72 hours before following up. They want to see longevity in their work history; if they have been traveling, they will want to know why they are looking to stop traveling, if they have been at a perm job for a while they are going to ask why they are wanting to leave. If they don t live close, they will want to know if they are planning to commute or move there. Now that we have had some time to get more familiar with what the Clients expectations are with submittals, here are some points to consider when submitting your candidates to the Direct Hire Jobs @ White Plains. Please note that these are direct hire (permanent) jobs that they are applying to so resumes need to be clean, clear and professional. Please take the time to do this for your candidate to increase their chances of being considered as the Client is highly detail-oriented when reviewing submittals. We have gotten a lot of feedback that resumes are very messy and unprofessional, if they cannot take the time to send a professional looking resume then they are not a fit for us . This is the 1st impression of your candidates so let s help them by taking time to present professional and clear profiles ?? Any candidates that have been submitted to a Direct Hire need through another agency or applied directly to White Plains Hospital within the past 6 months will not be considered. They DO NOT ALLOW anyone that has been submitted in that time frame to be resubmitted with another agency. Please confirm this with candidates before they are submitted or will be redirected. Submittals must include the following items or will be declined and noted as More information needed and a note will be added as to what updates are needed for resubmittal: Having all of this on submittal will help expedite your submittal!Resumes must be clean and professional looking and include the following information:Name of Facility (along with city, state), -not name of travel agency/company they worked through if was a travel positionWas job perm, travel or PRNUnit Size,Hospital Size,Trauma Level,Duties for each facility listed on resume.Education in mm/yy,Licensure and Certifications.Any gaps greater than 30 days accounted for on the resumeVerifications from state sight of all certifications required for job if it is a state issued certificationVerification from state sight for all license/s required for jobCopies of all Certification BLS, ACLS etceteraMust list availability for interviews in submittal- please list this in the Interview Availability .Must list in Affiliate Provider Comments section:Salary request/expectations in submittal; please list in the Affiliate provider comments If they have been at a perm job, why they are wanting to leave.If they don t live close, they will want to know if they are planning to commute or move there."If they have been traveling long term and now wanting to go perm -why (relocation, time off from travel, etc)Comments: Direct Hire RN Care Manager req# 27784Per DiemDayVaried Shifts, 9A-5P, weekend availability, minimum 2 shifts per monthsalary low - 60.63 salary high - 76.96full suite of benefits and retirement plan Name of Position Requirements - BSN - NYS License - PRI Certification (PRI certification to be obtained within 3 months of initial employment) - Screen certification strongly preferred - A Care Management certification preferred (i.e. CMC, CCM etc.) - 3 years clinical ED, critical care or med/surg experience preferred - Previous case management experience preferred - Knowledge of healthcare financial, regulatory, and payer issues preferred - Knowledge of state, local, and federal programs strongly preferred - Experience in use of Milliman/InterQual criteria - Computer skills essential - 3 years experience required Specialty: Case Management Unit: Case Management Shift: Days