Care Manager-RN at Rochester Regional Health – ROCHESTER, New York

SUMMARY

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: Rochester General Hospital

DEPARTMENT: RGH CARE MANAGEMENT

SCHEDULE: M-F, 8:00am-4:30pm

ATTRIBUTES

• 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

RESPONSIBILITIES

• 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

REQUIRED QUALIFICATIONS

• Requires an Associate’s Degree in Nursing (ASN)
• AAS degree in Nursing required for all Care Managers hired prior to August 1st, 2013.

PREFERRED QUALIFICAITONS

• Bachelors in Nursing (BSN) preferred
• 3 years of acute hospital care, Nursing, Case Management, or Utilization Management experience preferred

PHYSICAL REQUIREMENTS: M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.

LICENSES/CERTIFICATIONS:

• RN - Registered Nurse - New York State Education Department (NYSED)New York State Education Department (NYSED)
• BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA)

PAY RANGE: $82,742.00 - $113,568.00

The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, clinical licensure date, relevant qualifications, specialty, internal equity, location, and contracts.