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Registered Nurse Care Management Utilization Review MHB 1

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Location: Buffalo, NY, United States

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Job Description

Facility: Mercy Hospital of Buffalo

Shift: Shift 1

Status: Per Diem FTE: 0.100000

Bargaining Unit: CWA Local 1133

Exempt from Overtime: Exempt: No

Work Schedule: Days and Evenings with Weekend and Holiday Rotation

Hours:
Primary 8:00-4:00pm

Summary:

The 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/EXPERIENCE
  • 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 six (6) months
  • National Certification in Case Management preferred
  • Two (2) years RN Case Management experience required

If no applicants have two (2) years RN Case Management experience, the applicants meeting the following criteria will be considered next:
EDUCATION/EXPERIENCE
  • 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 six (6) months
  • National Certification in Case Management preferred
  • Two (2) years acute care RN experience required
  • 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
  • Variable schedule which may include weekends and holidays

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

VACCINE REQUIREMENTS

  • Effective January 1st 2022, you must be fully vaccinated with an FDA COVID-19 vaccination and provide proof of your vaccination status as part of your new employee pre-boarding. Exceptions to the COVID-19 vaccination requirement may be granted for medical reasons.
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