Inpatient Care Manager (RN)

The Execu|Search Group
Aug 13, 2017
Aug 14, 2017
Employer Type
Direct Employer
Employment Type
Full Time
Job Description:

About the Opportunity A healthcare organization in New York City is currently seeking a licensed Registered Nurse (RN) for a promising Inpatient Care Manager position with their growing medical staff. Under the direction of the Associate Director, the Inpatient Care Manager (RN) will be responsible for providing case management to members in accordance with the organization's Medical Management policies and procedures. Company Description Healthcare Organization Job Description The Inpatient Care Manager (RN): * Oversees the coordination and delivery of comprehensive, quality healthcare and services for the organization's members (as defined by eligibility), in a cost effective manner, and in concert with the member, PCP and all applicable resources * Performs global utilization, including: hospital admission certification; continued stay review; discharge planning; out-patient and ancillary service review, etc. by following established organization Utilization / Care Management policies, procedures and protocols * Interacts with and obtains relevant clinical information from the member's PCP and all other applicable providers, vendors or agencies * Informs member and provider of UM determinations and recommend treatment alternatives * Coordinates out-reach call to members and/or providers to facilitate and manage care more effectively * Performs all Utilization Management activities in compliance with all regulatory agency requirements * Maintains comprehensive case notes on all members in the medical management system, as well as other applicable files * Assists all of the organization's departments with the resolution of the member's issues related to utilization management * Conducts medical record reviews as appropriate to case management functions * Performs all other duties as required, requested or assigned Required Skills * 2+ years of Clinical experience in an Acute Care setting * Associate's Degree in Nursing * NYS Registered Nurse (RN) license * Solid documentation and clinical skills * Patient oriented * Great interpersonal skills * Excellent communication skills (written and verbal) * Strong attention to detail * Highly organized * Able to multitask efficiently and effectively Desired Skills * 2+ year of Case Management and/or Utilization Management experience * BSN * Medicare Managed Care experience