RN jobs in Harrington Park, NJ

RN Jobs in Harrington Park, NJ

Case Management Nurse

Overview The Case Manager has a day-to-day responsibility for assessing the medical necessity of patient admissions, and continued stays, based on the clinical documentation in the Electronic Health Record (EHR) in accordance with Milliman Care Guidelines (MCG). The Case Manager assists in coordination of care among multidisciplinary team members such as Medical Attending’s, Residents, Interns, Specialists, Social Workers, Nursing, Dietary, Finance, and Clerical staff. Case managers identify triggers to re-admissions and needed community/social/financial support to maintain appropriate and safe discharges related to ongoing medical management of patient care needs. The goals of the Case Management services are to identify Physician and staff documentation opportunities to support Quality and Pay for Performance indicators and execute prudent and sequential care by bringing about awareness to all treatment team members on length of stay reduction, and advocacy for compliance to plan of care. Responsibilities 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. 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 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.) 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. Qualifications Education: Bachelor's degree in Nursing (BSN), required Experience: Minimum three (3) years clinical experience in one or more of the following: Acute care Medical-Surgical Intensive Care Emergency Department Community Nursing (Home Care) Licnese / Certification: Current New York State Registered Nurse licensure, required Basic Life Support (BLS) certification, required Advanced Cardiovascular Life Support (ACLS) certification, required Must maintain valid New York State Registered Nurse License, BLS and ACLS certifications throughout employment at One Brooklyn Health Patient Review Instrument (PRI) certification, required Pediatric Advanced Life Support (PALS) certificastion, preferred Case Manager Certification (CCM), preferred Knowledge, Skills and Abilities: Knowledge of Federal, State and JCAHO guidelines for utilization review, discharge planning/quality assurance/infection control. Physical Demands: Involves occasional prolonged standing, walking, sitting, talking, hearing and bending Must be physically mobile May include some repetitive motions Must be able to work well under stress Must have good health and demonstrate emotional stability 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 can 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., site, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity). Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of One Brooklyn Health (OBH). OBH is an equal opportunity employer, it is our policy to provide equal opportunity to all employees and applicants for employment without regard to race, color, religion, national origin, marital status, military status, age, gender, sexual orientation, disability or handicap or other characteristics protected by applicable federal, state, or local laws.

Full-time

3 months ago

Registered Nurse-Emergency Department - Mount Sinai Queens - Full-Time Days; EOW

Mount Sinai Health System New York, NY

$58.19 / year

Description Responsible for the care activities and goal achievements of assigned patients by assessing, diagnosing, planning and intervening in actual or potential health problems and evaluating patient's response to care Responsibilities Assists in development, implementation, and evaluation of standards of care and professional practice in collaboration with members of the health care team and in accordance with institutional policies and regulatory agency requirements. Assesses and evaluates patient needs for, and responses to, care rendered and applies sound nursing judgment in patient care management decisions. Provides direct, continuous, (where applicable), care for a specific caseload of patients through application of the nursing process based upon theory, research, and approved Department of Nursing and institutional standards. Coordinates patient care activities, based on established priorities, including teaching, rounding, counseling, and discharge planning, and directs/delegates appropriately to members of the health care team. Communicates effectively and professionally with patients, significant others, and members of the health care team about the patient's plan of care. Participates in performance improvement, nursing quality, nursing research activities and utilizes same in clinical practice. Participates in the design, measurement, and assessment of care related structures, processes, and outcomes to improve the quality of patient care. Demonstrates responsibility and accountability for nursing practice and the delivery of safe, competent patient care. Participates in maintaining a safe, therapeutic, and consumer oriented environment. Collaborates with members of the health care team, the patient, and significant others to plan and implement the patient's care. Coordinates discharge planning from the day of admission to day of discharge or transfer to alternate care continuum. Conducts discharge phone calls on selected patients. Performs charge responsibilities, as assigned. Maintains clinical competence and is responsible for own professional growth and development along the continuum from advanced beginner to expert. Functions as a professional role model and preceptor for students, new hires, and staff. Supports the mission, philosophy, standards, and objectives of the institution and department. Demonstrates a professional commitment to patients, significant others, and members of the health care team. Participates in identification, response to, and investigation of potential and actual risk management issues. Projects a professional image and maintains a positive attitude. Incorporates ethical principles in decision making. Utilizes available financial and other resources prudently. Promotes positive consumer interactions and upholds the Patient Bill of Rights. Treats co-workers, patients and families with dignity and respect. Encourages scholarship, a spirit of inquiry, life-long learning, innovation, and research in self and colleagues. Participates actively in institutional committees, community agencies, and professional organizations. Qualifications Bachelor of Science with a major in Nursing required for all new graduates and experienced clinical nurse positions. Exception; Associate Degree or Diploma in Nursing graduates considered for identified specialized areas of practice. Must have current matriculation in a BSN program with graduation date within one year of hire for consideration. Must have relevant clinical competence in area of nursing practice; new graduates possess current knowledge of the nursing process and its application. Name: Registered Nurse Issuing Agency: DOH/Office of Professions Name: Basic Life Saver (BLS) Issuing Agency: AHA Certification: NRP (Labor and Delivery, NICU dept) Certification: ACLS (in ED; PACU/AzSU; ICUs; Telemetry Units; SDU; IR, Interventional Cardiology (CCL/EP/Echo); L&D; Endoscopy, and APN Adult Oncology Certification: PALS (in ED; PACU; IR; Peds ICU, and APNs Pediatric Oncology depts.) Employer Description Strength through Unity and Inclusion The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. About the Mount Sinai Health System: Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. Equal Opportunity Employer The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. Compensation The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $58.1907 - $58.1907 Hourly. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.