Case Managers, RN / Various Units with current CM exp
Winthrop-University Hospital - Long Island, NY

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Job Summary: Coordinates and procures services necessary to meet the post-acute care needs of patients identified as requiring such services. Ensures a timely and smooth transition to the most appropriate post-acute care setting. Works collaboratively with interdisciplinary patient care staff both internal and external to the organization. Participates in quality improvement and evaluation processes related to the management of patient care. Ensures maximization of provider reimbursement of patient days through timely and accurate insurance reviews.
Reports to: Supervisor, Continuum of Care. Education: BSN preferred, Diploma or AAS Degree in Nursing. Licence/Certification: Current NYS licensed Registered Nurse. Certification from the NYS Department of Health as a Patient Review Instrument (PRI) Assessor preferred. Experience: Minimum five (5) years acute care clinical experience. Three (3) years Discharge Planning experience and/or three (3) years utilization management experience required. Skills: Excellent communication, interpersonal and organizational skills. Knowledge of clinical standards of practice for multiple patient populations. Knowledge of post-acute care referral process for the procurement of patient services. Computer literacy required, advanced skills preferred. Knowledge of hospital reimbursement process, insurance denials and appeals process preferred. Emergency Department/Case Management experience a plus.

Winthrop-University Hospital - 23 months ago - save job