Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations.

Sign On - Bonus - $10,000!

Summary: Under the general supervision of the Director, The Nurse Case Manager role provide clinically-based case management to support the delivery of effective and efficient patient care. With the patient, family and health care team, creates a discharge plan appropriate to the patient’s needs and resources.

Job Responsibilities:

• Determines medical necessity, appropriateness of admission, continuing stay and level of care using a combination of clinical information, clinical criteria, and third party information. 
• Validates admission and continuing stay criteria with third party payers (including onsite and telephonic Case Managers) as well as Primary Care and Attending Physicians.
• Collaborates with the third party payers to anticipate denial of payment and proactively addresses issues contributing to a potential denial. 
• Supports the effective prevention and management of denials, including providing information as part of the appeal process.
• Assesses the patient and family for continuing care needs to develop, implement and evaluate an effective discharge plan in collaboration with the multidisciplinary team.
• Completes the interventions necessary for discharges to home with self-care, home with services and short term skilled nursing facility placement. 
• Consults, assesses, refers, coordinates interventions in cases of suspected or actual situations of child or adult abuse and neglect or other forms of domestic violence and/or sexual abuse.

 Job Requirements:

• Minimum Requirement: 3 years experience in acute care.
• Must have Associate's Degree or BSN preferred.
• Must have current RN license.
• Preferred experience in Utilization Review/Management.

Location: Vassar Brothers Medical Center

Work Type: Full-Time

Standard Hours: 40.00

Work Shift: 7:00-3:30/8:30-5, Every other weekend requirement.

Salary: $39.00 - $72.00/ Hour (Depending on experience)