Organization: Rochester Regional Health
Posting Start: 2021-07-15
Location: Clifton Springs, NY
Job Title: Registered Nurse- Care Manager
Posting End: 2021-09-01
A Brief Job Description:
As a Registered Nurse – Care Manager, your excellent interpersonal, leadership and collaboration skills ensure the appropriate allocation of hospital resources while maintaining the quality of care.
STATUS: Full Time
LOCATION: Clifton Springs Hospital and Clinic
DEPARTMENT: In Patient Mental Health
- Three (3) years of acute hospital care, case management or utilization management experience preferred
- Excellent oral and written communication and interpersonal skills
- Good understanding of medical management techniques and processes
- Knowledge of federal and state regulations (DOH, Medicaid/Medicare)
- Strong organizational and problem-solving skills
- Knowledge of third party payor and/or managed care payment principles helpful
- Evaluation & Review. Evaluate hospital admissions to assure care is medically necessary and delivered at the most appropriate level; actively participate in the concurrent review process and communicate/intervene with third party payors to ensure reimbursement for services are provided while maintaining quality of care
- Patient Management. Collaborate with providers, patients and families to address concerns and identify safe, effective discharge plans; intervene to identify and facilitate early referral for discharge planning; facilitate the discharge process by working with the healthcare team to identify alternative solutions to minimize system delays while ensuring a safe discharge plan
- Recommendation. Coordinate and participate in the development, implementation and revisions of evidence based clinical pathways and guidelines; participate in driving clinical and administrative compliance with care guidelines and core measures; identify and recommend actions for improvement
•Bachelor’s degree in Nursing required for all team members hired on or after August 1st, 2013.
•AAS degree in Nursing required for all team members hired prior to August 1st, 2013.
•3 years of acute hospital care, Case Management or Utilization Management experience preferred.
•Excellent oral and written communication and interpersonal skills
•Good understanding of medical management techniques and processes
•Knowledge of federal and state regulations (DOH, Medicaid/Medicare)
•Strong organizational and problem solving skills
•Knowledge of third party payor and/or managed care payment principles helpful
•FOR ElderONE EMPLOYMENT: 1 year experience working with frail elderly population preferred.
Required Licensure/Certification Skills:
•Registered Nurse with current New York State License
•Case Management Certification Preferred.
Rochester General Health System is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran