Discover Where Amazing Works Case Manager - RN - Inpatient Units- Brooklyn Methodist - Days Located in Park Slope, Brooklyn, this acute-care teaching hospital has been providing outstanding medical care to the surrounding communities for over 135 years. The Case Manager is responsible for all aspects of discharge planning and utilization management / review for an assigned group of patients to determine the appropriateness of the admission and continued stay, assist in the development of the plan of care; ensure that the plan is implemented timely and identify the expected length of stay (ELOS). The Case Manager works collaboratively with physicians, social workers, clinical nurses, home care services, and other members of the interdisciplinary team. The Case Manager actively participates in specific clinical initiatives focused on reducing the length of stay (LOS), improving efficiency and quality, and ensuring resource utilization is appropriate. Case manager / utilization manager : Responsible for an average of 60-70 medical / surgical daily admissions that requires risk identification and clinical reviews. A utilization nurse completes no less than 20 initial clinical reviews daily. Responsibilities also includes : - Completing 100% clinical reviews for managed care, Medicare and Medicaid admissions - Completing concurrent and retrospective reviews - Communicating with physicians and the inpatient case management teams on patients who do not meet initial inpatient criteria or continued inpatient stay - Coordinating expedited appeals for inpatient denials with attending physicians and insurance providers - Ensuring organization resources are being utilized appropriately - Completing patient assessments within 24 hours - Coordinating safe and appropriate post-acute care plans - Obtains authorizations from managed care companies for post-discharge services. There is an onsite home care agency and a transfer and authorization center that can facilitate the referral process. This is a full time Monday - Friday position 8 : 30am -5 : 00pm Position requires weekend rotation and holidays. Preferred Criteria
Inpatient Case Manager • Brooklyn, NY, United States