Inpatient Case Manager RN

Req #:
2297

Job ID:
13817

Job Location:
Milbrook, NY

Zip Code:
12545

Category:
Managed Care Nursing

Agency:
Elderplan

Status:
Regular Full-Time

Office:
Office-based

Salary:
$90,000.00 - $110,000.00 per year

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Why work for MJHS?:

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No? You will here! You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals. You take care of our patients, residents and health plan members, and we will take care of the rest!

Benefits include:

• Sign-on Bonuses OR Student Loan Assistance for clinical staff
• FREE Online RN to BSN and MSN degree programs!
• Tuition Reimbursement for all full and part-time staff
• Dependent Tuition Reimbursement for clinical staff!
• Generous paid time off
• Affordable medical, dental and vision coverage for employee and family members
• Two retirement plans ! 403(b) AND Employer Paid Pension
• Flexible spending
• And MORE!

MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)

Responsibilities:

Provide quality cost-effective care to all members by evaluating the need for and pre-authorizing requests for inpatient, outpatient, specialty care, home care, DME, and transportation services, from network and out of network providers, in accordance with departmental criteria and guidelines. managed care nurse, managed care rn, nursing, rn, nurse, care management

Qualifications:

Graduate of an accredited nursing program; Bachelor's degree preferred. Minimum of three (3) years experience in medical/surgical nursing Working knowledge of utilization management processes. Knowledge of Federal and State managed care regulations. Prior managed care experience preferred. Working knowledge of Windows, Word, Excel. Licensed to practice as a registered nurse in the state of New York with current registration. CCM preferred. Knowledge of current standards of medical practice. Ability to solve problems through the application of nursing theory and processes. Excellent written and oral communication skills. Knowledge of current standards of the healthcare delivery system. Ability to set priorities. Ability to work independently while recognizing issues having departmental or organizational impact Ability to work as a team member and facilitate communication among the member, healthcare providers, community and medical management staff. Elderplan in order to meet the healthcare needs of the member.