Winthrop Hospital is a world-class 591-bed university-affiliated medical center and a major regional healthcare resource with a deep commitment to medical education and research. We continue to offer an incredibly positive workplace that truly nurtures, develops & engages our staff creating a unique harmony among all disciplines.
We currently seek Case Managers for various units with currnent CM experience. In this role, you will coordinate and procure services necessary to meet the post-acute care needs of patients identified as requiring such services. In addition, you will ensure a timely and smooth transition to the most appropriate post-acute care setting, work collaboratively with interdisciplinary patient care staff both internal and external to the organization, and participate in quality improvement and evaluation processes related to the management of patient care. You will also ensure maximization of provider reimbursement of patient days through timely and accurate insurance reviews.
- Diploma or AAS Degree in Nursing, BSN preferred.
- Current NYS licensed Registered Nurse, Certification from the NYS Department of Health as a Patient Review Instrument (PRI) Assessor preferred.
- Minimum five (5) years acute care clinical experience, three (3) years Discharge Planning experience and/or three (3) years utilization management experience.
- Must have excellent communication, interpersonal and organizational skills, knowledge of clinical standards of practice for multiple patient populations and post-acute care referral process for the procurement of patient services. Computer literacy required, advanced skills preferred. Knowledge of hospital reimbursement process, insurance denials and appeals process preferred. Emergency Department/Case Management experience a plus.
An EOE m/f/d/v.