Registered Nurse (RN) - Case Management
Montefiore Wakefield Hospital
Bronx, NY
Days
$62/hourOverview
- Start DateASAP
- ShiftDays
Pay
Qualifications
Description
RN Case Manager
Coordinates the continuum of medical care services for patients to ensure optimum utilization of resources, delivery of quality patient care, and compliance with regulatory, accrediting and contractual requirements. Determines the appropriateness of patient care services, prepares clinical appeals for third party denials, and collects and interprets data for utilization, compliance, QI and other areas as assigned.
Requirements:
- BSN or a bachelor's degree in a related field required, Master's preferred
- NYS RN License required
- PRI assessor number required prior to end of 3-month probationary period
- 3-5 years recent acute care clinical experience preferred
- Experience in utilization management preferred
- Experience in a managed care organization preferred
- Certification in Utilization Review or Case Management preferred
- Analytical skills, problem-solving skills, conflict resolution and negotiation skills
- Demonstrated knowledge of federal, state and commercial/third-party regulations related to utilization management functions, discharge planning and associated processes
- Demonstrated knowledge of quality/performance improvement tools and techniques
- Demonstrated knowledge of utilization and case management principles
- Experience in the application of utilization management decision support criteria preferred
- Computer skills including data entry, word processing, and electronic messaging.
- Experience in the use of Windows-based software applications.
- Experience in the use of an electronic clinical information system preferred
- Excellent verbal, written and interpersonal communication skills, as well as a commitment to interdisciplinary teamwork
- Excellent organization skills, teamwork skills and time management skills
- Expert clinical knowledge of disease processes to identify care needs
- Understanding of the health care delivery system and its sites of care, delivery models, and the roles of various providers and health care professionals
- Experience in interpreting and applying benefit coverage rules and assessing coordination of benefits guidelines and managed care regulations required
Department: Utilization Management Bargaining Unit: 1199 RN Campus: WAKEFIELD Employment Status: Regular Full-Time Address: 600 East 233rd Street, BronxShift: Day Scheduled Hours: 9 AM-5 PM Req ID: 220528 Salary Range/Pay Rate: $61.68
For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.
To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.
Diversity, equity and inclusion are core values of Montefiore. We are committed to recruiting and creating an environment in which associates feel empowered to thrive and be their authentic selves through our inclusive culture. We welcome your interest and invite you to join us.
Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.
Employer
Montefiore Medical Center
About Bronx, NY
- The cost of living in the Bronx is higher than the national average.
- Wages may not fully match up with the higher cost of living.
- The average high temperature in summer is around 84°F, while the average low in winter is around 26°F.
- Short term rentals can be found in the Bronx, but availability may vary.
- It's recommended to start the search early.
- The Bronx is car-friendly, but public transportation, including buses and subways, is widely available.
- The Bronx is known for its diversity, with a wide range of ethnicities and age groups.
- Common health issues may include asthma and diabetes.
- There is a large population of healthcare professionals, including travel nurses.
- The Bronx offers a variety of activities including diverse restaurants, vibrant art scene, live music venues, sports events, and access to beautiful outdoor spaces like parks and botanical gardens.
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