Nursing Jobs in Maspeth, NY
$90,000 - $145,000 / year
191521 Job Description Serves as liaison between the patient and facility/physician. Ensures a continuum of quality patient care throughout hospitalization and oversees provisions for patient's discharge. Assesses, plans, oversees and evaluates the appropriateness of care throughout admission and hospitalization of the patient. Job Responsibility Facilitates patient management throughout hospitalization. Performs concurrent utilization management using evidence based medical necessity criteria. Submits data to management regarding case management and/or quality initiatives. Serves as an in-patient liaison - planning, assessing, implementing and evaluating patient in collaboration with the health care team. Conducts chart review for appropriateness of admission and continued length of stay; Facilitates throughput. Conducts clinical reviews and interacts with third party payers to obtain approval of hospital days, pre-certification and post-discharge eligibility in relation to clinical course. Ensures compliance with current state, federal, and third party payer regulations. Documents the case management process in the medical record; completes and documents a care coordination assessment on the patient. Serves as a liaison to patient, family, admitting, primary care physician, health care team, and hospital departments. Completes applicable areas of the patients discharge instruction sheet and the patient transfer sheet; ensures case management documentation is current and accurate. Manage a caseload of adult inpatients, coordinating care from admission through discharge with confidence and clinical insight Engage in complex discharge planning, collaborating with interdisciplinary teams to ensure seamless transitions and continuity of care Partner with your team and coworkers to coordinate scheduling, supporting one another to maintain balanced and effective coverage Adapt and contribute across units by floating to areas of need, broadening your skills and strengthening department-wide care delivery Share in weekend and holiday rotations on an alternating basis, ensuring our patients receive consistent, high-quality support every day of the year through self-scheduling Performs utilization management using Milliman guidelines and assessing medical necessity criteria and conducts chart review for appropriateness of admission and continued length of stay; Facilitates throughput. Documents the case management process in the medical record; completes and documents a care coordination assessment on patients and ensures documentation is current, accurate, meets CMS guidelines and is in-line with our department and intuitional standard of practice Collaborates with interdisciplinary team including daily rounds, participation in family meetings, staff meetings Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Complete PRI’s Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification Graduate from an accredited School of Nursing. Bachelor’s Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two (2) years and obtain a BSN Degree within five (5) years of job entry date. Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. Emergency Department experience, preferred. Knowledge of Milliman guidelines, preferred Two years of experience in an acute care setting, preferred Ability to manage a diverse caseload, including complex discharge planning needs Strong time management, workflow, critical thinking and conflict resolution skills Team-oriented; able to coordinate self-scheduling collaboratively Flexible to float as needed Flexibility in days as needed Alternating weekends and holidays Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity). 
$93,600 - $109,200 / year
Description RN, Care Transitions Coordinator Welcome to Holy Name, a medical center where innovation is not just a goal — it's a commitment. Here, medical excellence thrives, allowing hope to reign supreme and leaving no room for fear. At our hospital, every patient is cared for with undivided attention — because healing every soul is our sole focus. Holy Name is New Jersey's only independent Catholic health system, comprising a 361-bed acute care hospital, a renowned cancer center, a state-of-the-art fitness center, a residential hospice, a prestigious nursing school, and an extensive physician network. Healing at Holy Name goes beyond medicine and technology – it is infused with faith, conviction, compassion, and a commitment to educating the next generation of healthcare professionals through a variety of residency and educational programs. Our mission to provide care for the body, mind, and soul spans education, prevention, diagnosis, treatment, rehabilitation, and overall wellness. This is at the core of who we are and what we do, and we've done it this way across generations, every single day, for nearly 100 years. Every innovation, medical breakthrough, and groundbreaking treatment is powered by some of the best minds in medicine, ensuring nothing is left on the table or the road to recovery. A Brief Overview The Care Transitions Coordinator is responsible for facilitating and coordinating services for patients through the continuum of care. The Care Transitions Coordinator ensures appropriate utilization of resources and safe delivery of care to all patients and provides quality and cost-effective care that will lower Length of Stay (LOS) and decrease the fragmentation of services that can potentially compromise patient care. Care Transitions Coordinator collaborates efforts as a team in order to perform one or more of the following roles: Discharge Planning and Disease Management of acute and chronic conditions, facility placement needs as needed and timely referrals and evaluations of all post-acute care needs. The Care Transitions Coordinator play a pivotal role for patients as part of the interdisciplinary team in order to ensure patient safety, quality of care and positive patient outcomes. Rotation of coverage for weekends and holidays will be required and are assigned throughout the year. What You Will Do Modification of plan of care, as necessary, to meet the ongoing needs of the patient Communicate relevant information to third party payors and the care team. Completion of all required documentation in patient records Issues Notices of Non-Coverage per hospital policy. Refers appropriate cases for social work intervention based on department criteria Knowledgeable about Indigent Medication Programs Verifies patient demographics and insurance information is correct Expedites execution of plan of care for patients in Observation units. Arranges transportation for patients slated for discharge. Uphold compliance of regulatory standards for Observation patients including CMS requirement for Code 44. Utilizes “Patient Choice” list for support services post discharge and documents. Initiates home care referrals for VNS, orders durable medical equipment and arranges ambulance transportation as needed for patients prior to discharge or transfer to another facility. Participates as an active, informative and cooperative team member of the health care staff by attending discharge rounds for case finding/follow up and participating in the discharge plan while acting as an advocate for the patient. Arranges family meetings to assist in discharge planning as indicated Other duties as assigned Education Qualifications Bachelor's Degree BSN Preferred or Experience Qualifications 4-6 years 3-5 years experience in an acute care setting Required and Disease Management and Discharge planning experience Preferred Knowledge, Skills, And Abilities Analytical and problem solving along with excellent verbal and written communication skills. Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required and CCM - Certified Case Manager Upon Hire Preferred At Holy Name, we believe in rewarding every team member with more than a paycheck—we invest in your future and well-being. Full-time and part-time employees have access to a comprehensive benefits package designed to support your health, financial security, and quality of life. We offer low-cost medical coverage with generous employer contributions, dental and vision plans, discounted prescriptions, and access to on-site child care. Additional benefits include 401(k) matching, tuition reimbursement, paid time off, flexible spending accounts, legal and voluntary coverage options, life insurance, and free on-site parking. If you are hired at Holy Name, your final base compensation will be determined based on factors such as employment status (Full/Part-Time or Per Diem) skills, education, and/or experience. In addition to those factors – we believe in the importance of pay equity and consider any internal equity of our current team members as a part of any final offer. Pay Range: $93,600.00 - $109,200.00 Holy Name is a mission-driven facility whose quality standards and philosophy are rooted in the principles of its founders, the Sisters of St. Joseph of Peace. Those principles are exercised daily by the Medical Center's dedicated and talented staff members. Holy Name is an Equal Opportunity Employer. 
