Travel Nurse RN - Clinical Document Improvement Specialist
White Plains, NY
Tact Staff
3x12 hrs

**MINIMUM $1.25 AN HOUR FOR PARKING**
COVID VACCINE REQUIRED
DISCHARGE EXPERIENCE REQUIRED
? ? Registered Nurse (RN) NYS license required
? 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
? A Care Management certification preferred (i.e. CMC, CCM etc.)
? Computer skills essential
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:
1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors
2. Completes a comprehensive initial assessment.
3. Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital
level of care.
4. Performs all transitional planning activities including but not limited to:
? Patient/caregiver education
? Arrangement of all aftercare
? Commercial payer involvement
? High utilizer patient root cause
5. Communicates and collaborates all relevant patient information to appropriate health team members.
6. Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction
improvement are realized.
7. Documents per department requirements.
8. Participates in Performance Improvement activities as needed.
9. Performs all UR activities per department policy:
? Commercial payer reviews
? Disposition determination,
? Retro/self-audit
? MC variance
? Admission clinical review.
10. 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.
11. Performs all other related duties as assigned