Travel Nurse RN - Case Manager in White Plains, NY

Registered Nurse (RN) | Case Manager Location : White Plains, NY Agency : Cynet Health Pay : Competitive weekly pay (inquire for details) Shift Information : Days - 5 days x 8 hours Start Date : ASAP About the Position Job Title : RN Care Manager Profession : Nursing Specialty : Care Management Duration : Full-time Shift : 9-5, weekend commitment; minimum of 2 shifts per month Experience : 3 years clinical experience in emergency department, critical care, or med / surg; previous case management experience preferred License : Registered Nurse (RN) license required Certifications : BSN required for RNs hired after specified date; PRI Certification to be obtained within 3 months of initial employment; screen certification strongly preferred; Care Management certification preferred Must-Have : Computer skills essential; 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 Description : The RN Care Manager performs the initial comprehensive assessment on admission in accordance with department policy. Screens all patients by utilizing established tools for high-risk indicators. Ensures high-risk patient populations receive appropriate supportive services for discharge to prevent readmission. Assesses all populations for potential discharge planning needs. Provides ongoing reassessment of needs throughout the hospital course. Performs Utilization Review (UR) activity per department policy. Understands and adheres to department performance standards and policies. Completes a comprehensive initial assessment. Performs multidisciplinary care coordination activities at intra-hospital and inter-hospital levels of care. Conducts transitional planning activities including patient / caregiver education, arrangement of aftercare, and communication with payers. Identifies high utilizers and conducts root cause analysis. Communicates and collaborates all relevant patient information to appropriate health team members. Ensures department goals of length of stay (LOS) reduction, readmission prevention, denial reduction, and satisfaction improvement are achieved. Documents per department requirements. Participates in performance improvement activities as needed. Performs all UR activities per department policy including commercial payer reviews and clinical reviews. Collaborates with healthcare professionals to evaluate the needs and ensure safe discharge for all patients including geriatric inpatients, emergency department, and surgical outpatients. Performs all other related duties as assigned. Requirements Required for Onboarding BLS Pharmacology Skills Checklist Specialty Exam