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Registered Nurse Care Manager Utilization Review KMH

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Location: Kenmore, NY, United States

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Job Description

Facility: Kenmore Mercy Hospital

Shift: Shift 1

Status: Full Time FTE: 1.000000

Bargaining Unit: ACE Associates

Exempt from Overtime: Exempt: Yes

Work Schedule: Days and Evenings with Weekend and Holiday Rotation

Hours: 8:00am to 4:00pm

Summary:

The Registered Nurse (RN) Care Manager-Utilization Review, as an active member of the Care Management and interdisciplinary care team, provides comprehensive Utilization Review and discharge services to patients and families in the hospital setting. Utilizing foundational nursing clinical skills and discharge planning principles, the RN Care Manager, Utilization Review collaborates with the interdisciplinary team to maintain appropriate levels of care and to facilitate movement of the patient through the continuum. The RN Care Manager identifies and removes barriers for delays of treatment.

Responsibilities:

EDUCATION
  • BSN degree or RN with BSW, BS Education, or BS in Health related field
  • Registered Nurse, licensed (unrestricted) in New York State
  • New York State PRI & Screen certification hospital and community or obtained within 6 months
  • National Certification in Case Management preferred

EXPERIENCE
  • Two (2) years medical surgical nursing and/or job related experience
  • Preferred prior insurance /managed care/utilization review experience in the role of a Case Manager or Disease Manager, Population Health, Discharge Planning or Chronic Care Manager
KNOWLEDGE, SKILL AND ABILITY
  • Strong clinical assessment skills and ability to articulate findings in a fast paced environment. Possess the ability to make independent decisions within the professional scope of practice
  • Possess ability to educate, inform, advocate, promote and facilitate health care options, and demonstrate the willingness to work harmoniously with a team approach
  • Possesses ability to effectively and efficiently utilize technology within daily work with the care team and ability to quickly learn and adapt to new technology tools and software

WORKING CONDITIONS
  • Willingness to work beyond normal working hours, and in other positions temporarily, and/or at other locations when necessary
  • Variable schedule which may include weekends and holidays
  • May be requested to travel to multiple hospital and community sites

ENVIRONMENT
  • Normal heat, light space, and safe working environment; typical of most office jobs
  • Occasional exposure to one or more mildly unpleasant physical conditions
  • Minimum physical effort required, typical of most office work
  • Significant amount of walking within the acute care facility
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