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RN - Case Manager Utilization - Case Management

Department:  CASE MANAGEMENT

Job Details

Req Id    59068 
Department    CASE MANAGEMENT 
Shift   Days
Shift Hours Worked    7.50 
FTE    
Work Schedule    SEMC NYSNA 7.5 HR 
Employee Status    A1 - Full-Time 
Union  NYSNA

Job Summary

Reports to and is under direct supervision of Case Management Department. Provides ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. Promotes continuity of care and cost effectiveness through the integrating and functions of case management.

Core Job Responsibilities

  • Coordinates discharge planning to assure that the patient progresses through the continuum of care and is discharged to the least restrictive environment.
  • Coordinate the hospital activities concerned with case management and discharge planning. Ensure compliance with quality patient care and regulatory compliance.
  • Conduct concurrent medical record review using specific indicators and criteria as approved by medical staff, CMS, DNV and other stat agencies. (Blood screens, re-admission review, CHF and pneumonia education.)
  • Coordinate the integration of social services/case management functions into the patient care, discharge and home planning process with other hospital departments, external service organizations, agencies and healthcare facilities.
  • Mobilizes resources and interviews, as needed, to achieve expected goal to assist in achieving desired clinical outcome.
  • Assist physicians to maintain appropriate cost, case and desired patient outcome.

Education Requirements

Required: Minimum of two (2) years utilization review/case management experience or social work experience.
Preferred: Associate degree in healthcare related filed preferred. Bachelor’s degree is preferred. Licensed professional nurse may be considered. Bachelors or Masters Degree in related healthcare field (such as respiratory therapy or social work) may be considered.

Licensure/Certification Requirements

Required: Maintain current professional licensure in nursing or professional filed of certification.
Preferred: Appropriate certification in the case management preferred (e.g. Commission for Case Management Certification (CCMC) or Association of Rehabilitation Nurses).

EOE AA M/F/Vet/Disability

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.

Successful candidates might be required to undergo a background verification with an external vendor.


Nearest Major Market: Utica