Local Contract RN Case Manager
29 days ago
New York
Soloh Partners is seeking a local contract nurse RN Care Manager for a local contract nursing job in Brooklyn, New York. Job Description & Requirements • Specialty: Care Manager, • Discipline: RN, • Start Date: 01/06/2026, • Duration: 12 weeks, • 40 hours per week, • Shift: 8 hours Duties: • Performs face-to-face visits with patients that need assessment of physical, mental, and emotional barriers that prohibit self-care, prompt medical management assistance in the community, and initiation of referrals to social work by using nursing clinical judgment, • An interdisciplinary care team member responsible for daily EHR review of patient's medical necessity (severity of illness and intensity of service); either in bedside rounds, or Interdisciplinary team rounds, • Collaborate with social workers on identification on any social determinants of health domains, that could impede patients' health outcomes, • Functions as a liaison between Physicians and Physician Advisors, • Demonstrates the ability to correlate medical necessity (severity of illness and intensity of service) in achieving financial and quality care outcomes, • Monitors the electronic health records (EHR) daily or as needed, for assigned patients, and complete clinical documentation pertaining to hospitalization for submission to insurance companies (Initial, Concurrent or Retroactive), • Reviews all HMO admissions for medical necessity and submit to HMO, • Reviews admissions for medical necessity (severity of illness and intensity of service) within forty-eight hours of admission, • Knowledge of Milliman Care Guidelines, • Knowledge of CMS guidelines for post-acute plaements, • Communicate with Attending Physicians on admission guidelines, • Provide real time interventions to prevent delays and ensure compliance and revenue integrity with health care regulations Requirements: Case Managers are expected to have strong clinical backgrounds, and advocate for safe, timely adherence to executing the patient plan of care. Job training is available in addition to meeting the core qualifications for this position. Informs treatment team members of recommended EHR documentation needed based on Milliman Care Guidelines for approval of admission, transfer, length of stay, and safe discharge planning Identifies tests, procedures, and interventions early to advance the plan of care. Assess, and collaborate with the health care team the need for Alternate Level of Care designation. Document in EMR when patient is placed on ALC Assess current support and adherence to medical care in the community, with the evaluation of effectiveness towards health promotion Collaborate with treatment team members to create a care plan to reduce re-admission rates by identifying barriers to care and resolutions to those barriers Responsible for completion of home IV infusion and related home care referral to IV infusion companies and follow up with patient/family Responsible for completing wound vac and related home care referral for patients discharged home with wound vac. Makes appropriate referral to financial services prior to discharge Discusses discharge planning with the treatment team to create PRIs prior to discharge Document all activities in EPIC (submission of reviews, home care referrals, and completion of PRI's) any correspondence conducted with the Insurance companies and or Home Care Agencies through Careport. Documents Case Management notes in a brief and concise manner PRI proficient Follow provider recommendations for discharge planning including facility placement to SNF/SAR/Acute rehabilitation and home with services Arranges for community services prior to discharge to meet patient's post discharge needs with recognition of patient's choice of service providers Updates and /or modifies the plan of care according to recommendations to facilitate safe and timely discharges Communicates with Nursing staff the patients discharge plan Knowledge of the discharge appeal process Advocates for the patient/family with other health care disciplines and community agencies to facilitate the patient receiving the appropriate resources in the community Mandated reported of suspected abuse in all patient populations (domestic violence, elder, child abuse, etc.) Skills: • Required leadership competencies and position specifications:, • Communication: Strong written and verbal skills are demonstrated in reports, correspondence and presentations., • Informed of medical center and departmental policies., • Possesses the ability to negotiate and communicate with other disciplines, physicians practice groups, 3rd party reviewers and outside entities., • Professional Development: Participates in conferences, workshops, and other professional development activities to maintain licensure and/or remain professionally current with advances in field of expertise. (JCAHO, Annual HIPAA/ Corporate Compliance, Mandatory Re-orientation training, BLS, ACLS, OSHA, and Fire safety). Adheres to the Case Management Society of America (CMSA) standards, and the Nurse Practice Act., • Professional Problem Solving: Recommendations and decision making reflect strong analytical skills and focus on quality and cost containment, that impacts the financial status of the patient and the institution., • Customer Service Management: Incorporates the medical center's customer service goals in developing and/or revising departmental policies and systems. Continually reviews the service delivery process to exceed customer expectations., • Physical Effort: must have good health and demonstrate emotional stability. Must be physically mobile. Must be able to work well under stress. Occasional prolonged sitting Soloh Partners Job ID #L31630366. Posted job title: IMC - RN - Case Manager Nurse About Soloh Partners WHO WE ARE How you project yourself in the world says a lot about you. So, what do we think is important for you to know about us? Soloh Partners is proud to be a certified women-owned business. We are committed to diversity, equity and inclusion. We are driven by our passion for service: service to our clients & their mission and service to our candidates and employees. We believe in making things personal. It isn’t just business for us. This is about shaping careers and building an engaged workforce. To be successful at either you, need to be invested in both. OUR MISSION Our mission is to be recognized by our clients as an indispensable partner in their pursuit of high-impact Talent. We succeed by creating and maintaining intensely caring and mutually rewarding relationships with our internal employees, candidates and contingent workforce. We aren’t just a staffing agency; we fancy ourselves creatives. We create opportunity. We create excitement. We create and foster relationships built on trust, and partnerships based on mutual respect and understanding. Benefits • Medical benefits, • Dental benefits, • Vision benefits, • 401k retirement plan, • Weekly pay, • Sick pay, • Referral bonus, • Wellness and fitness programs