RN Case Manager
Brooklyn, NY
Soloh Partners
5x8 hrs
Referral Bonus

Description:

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.
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.

Skills:
Required Skills & Experience:
-Minimum three (3) years’ experience in direct patient care.
Preferred Skills & Experience:
N/A