Care Manager RN

Job Description

Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal.
 
 
The Care Manager is responsible for a group of inpatients, ED patients and Observation 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 in a timely basis, and identify the expected length of stay and problem solves care transitions accordingly within the interdisciplinary health care team. 
 
Roles & Responsibilities:
 
Responsibilities include, but are not limited to:
Review and advice for appropriate level of care using criteria sets (refer to designated site software), cases referred or who have Observation diagnosis, or other high risk diagnosis as well as readmissions.
 
Review all patients in the Observation unit ensure they  meet criteria, assist with discharge or admit to next level care of  with-in unit specified timeframes.

Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve optimal patient outcomes and appropriate reimbursement for the organization.
Performs continued stay reviews utilizing standardized criteria to justify continued inpatient stay.
 
Oversee clinical throughput of patient, ensuring medical treatment plan, e.g., timely tests, consults.
 
Collaborates with Physicians and other clinicians to expedite diagnostic testing, treatment and consultations.
 
Identifies reasons for readmissions and collaborates with interdisciplinary team on strategies to reduce readmission rate.
 
Documents all clinical reviews in using designated site software program.
Complete any forms necessary in the discharge planning process including (but not limited to) PRI, M11Q, 485.
 
Interacts with patient/family to discuss plan of care and coordination of services based on clinical needs and available resources
 
 
Requirements:
 
Education Requirements:

Bachelor’s Degree in Nursing required
Experience Requirements: 
Previous experience in case management, utilization review or discharge planner preferred or a minimum of 4 years’ experience as a RN in an acute care setting. 
Basic knowledge of DRGs. 
Ability to work independently and collaboratively with the interdisciplinary team, patient/family, and others as appropriate. Ability to coordinate, prioritize and allocate resources.
Case management and or Utilization certification preferred. 
PRI Certification
Licensing and Certification Requirements: 
Current NYS RN nursing license.
 
Strength Through Diversity
 
The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize medicine together.
 
We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care.
 
Explore more about this opportunity and how you can help us write a new chapter in our story!
 
Who We Are
 
Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
 
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
 
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.
 
EOE Minorities/Women/Disabled/Veterans
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