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Care Manager-PD

Care Manager-PD Facility: St Joseph Hospital Location: Bethpage, NY Department: Util Rev/Care Mgmt/Qlty Assur Category: Nursing / Nursing Leadership Schedule: Per Diem Shift: Weekend Hours: 8a-4p ReqNum: 6017518
Participates in the development of department and continues updating the department's goals and objectives.
Educates staff, physicians, patients and families in the case management process.
Reviews new admissions and continued stay patients to determine whether InterQual criteria is met.
Interfaces with representatives of third party payors to assist with the certification process and the discharge planning process. Responds to requests for reviews in a timely fashion to avoid denials.
Reviews records and interacts with staff and physicians to obtain information about all aspects of patients. Transmits information to third party payors to avoid denials.
Participates in rounds with members of other disciplines and identifies areas for improvement.
Facilitates communication between patients, families and social workers.
Interacts with social workers to affect safe discharge plans.
Identifies variances between actual and expected outcomes and assists in problem solving.
EXPERIENCE, EDUCATION AND TRAINING:
Registered Nurse, NYS license
BS in a health related field preferred
In-hospital case management and discharge planning experience preferred
Excellent written, verbal, statistical and interpersonal skills
Certification in case management preferred
PRI assessor


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