RN Case Manager

Overview

St. John's Riverside Hospital is a leader in providing the highest quality, compassionate health care utilizing the latest, state-of-the-art medical technology. Serving the Westchester community from Yonkers to the river town communities of Hastings-on-Hudson, Ardsley, Dobbs Ferry and Irvington, St. John's Riverside has been and continues to be a unique and comprehensive network of medical professionals dedicated to a tradition of service that spans generations.

St. John's has been an integral part of the community since the 1890's and its' commitment to provide the community with the most advanced medical services available continues to be the hospitals' vision, mission and value. St. John's Riverside Hospital built itself around an early foundation of nursing and community service. In 1894, the Cochran School of Nursing, the oldest hospital-based school of nursing in the metropolitan area, was founded, thus making the St.

John's Nursing Staff more than just the backbone of the hospital, but the heart and soul. St. John's dedicated nurses give superior attention to those who need it most with a strong emphasis on patient and family-focused nursing care.

St. John's Riverside Hospital staff is committed to making life better for all patients. The hospital continues to elevate the services provided with the goal of increasing the quality of life for all who entrust St. John's Riverside Hospital to their care.

St. John's Riverside Hospital is an equal opportunity employer. We maintain a policy of non-discrimination in providing equal employment to all qualified employees and candidates regardless of race, creed, color, national origin, sex, age, disability, marital status, or other legally protected classification in accordance with applicable federal, state, and local law.

Personalized care together with advanced technology is what it means to be Community Strong

Responsibilities

Assists in meeting the psychosocial needs of patients and families, through assessment ofinpatients based on assignment. Patients are screened for continuing care needs, including emotional support, community resource needs, home care, in patient care and health insurance issues. The Case Manager will assess patients and conduct medical insurance reviews for them. Educates, coordinates, and collaborates with nurses, physicians, Continuing Care Coordinators and interdisciplinary members of the Healthcare team, to assure an ongoing comprehensive discharge plan.

Ensures appropriate use of resources within an appropriate length of stay. Collaborates with the multidisciplinary team on the patient's treatment plan.

Reviews admissions and continued stays in accordance with established criteria. Conducts all adjunct procedures such as referrals to the Medical Director, keeps statistics, performs insurance reviews, and identifies quality of care issue.

ESSENTIAL FUNCTIONS/RESPONSIBILITIES

Under the immediate supervision of the Director of Case Management, and Vice President for Medical Affairs, a successful employee must demonstrate competency in the following areas:

Utilizes electronic Utilization Management platform for assigned units/patient's and assesses the patient's medical, social, financial, and psychological status within three days of patient's admission. A Case Manager is assigned to assess all patients in the Intensive Care Unit and manage their discharge plan until the patient transfers to another level of care. The CM, through assessment and reassessment, will manage the discharge planning needs of the patients assigned to them and review cases for quality of care and utilization management issues.

CM will consult CCC team member for the discharge planning needs of patients who are on palliative care, patient's that are substance abusers, homeless and uninsured, patients, victims of domestic violence, elder abuse, and child abuse, patients who need referrals for inpatient and outpatient terminal care, inpatient, outpatient psychiatric care, Subabcute and Acute Rehab placements, Home Visiting Nurse services and patients living in assisted living facilities, group homes and adult homes.

The dedicated CCC will be consulted for patients newly diagnosed with cancer for community support services. The CCC will be consulted for patients who require guardianship and the CCC will follow through on their discharge plan. A Case Manager is assigned to the Emergency Department and will consult the CCC for any social needs.

Counsels the patient and significant others in the admitting criteria and referral process to the below services. CM will follow through on these referrals to ensure a safe discharge plan. Case Manager is responsible for the completion of PRI's and Screen's, to issue the Important Message from Medicare during regular department hours as needed and to follow through with IPRO if the patient requests an appeal.

CM will refer cases to the CCC and assist as needed such as:

Visiting Nurse Services Inpatient Skilled Nursing Care…