RN Case Manager, Inpatient | New York, NY
Exciting Opportunity at MSK: Are you passionate about using your Case Management experience to support Oncology Patients? The MSK Case Management Department is made up of Registered Nurses (RNs), Licensed Practical Nurses (LPNs) and support staff. In this role, you will be responsible for evaluating and responding to clinical and administrative denials referred to Case Management Department for appeal. You will participate in the daily management of the denial through resolution after the appeal is filed. You will perform special chart reviews to support strategic planning initiatives, while working with multidisciplinary team and acts as a liaison to insurance carriers and staff.
Role Overview:
- Provide case management for a caseload of Oncology patients
- Assess discharge planning needs at the patient’s admission
- Perform regular concurrent review on all patients and coordinate all needed services including home care to facilitate the safe and timely transition to the next level of care and to follow selected patients in the outpatient setting
- Act as part of a multidisciplinary team to provide continuity of care throughout various stages of treatment and follow-up
- Connect with physicians and clinical nursing staff regarding ongoing patient care
- Work with insurance carriers and MSKCC billing departments to initiate appeals and acquire authorizations for treatment
Key Qualifications:
- Current NYS Registered Nurse License/Registration and BSN preferred
- At least 2-3 years of clinical hospital nursing experience
- Managed care/UR/CM experience strongly preferred
- Knowledge of state and federal regulations that govern health insurance coverage
- Knowledge of Microsoft: Outlook, Word, Excel, and PowerPoint
Core Skills:
- Excellent interpersonal, decision-making, and communication skills
- Strong decision-making and negotiation skills
Additional Information:
- Hours: Monday - Friday, Five Days x 8 hours remote hybrid or Four Days x 10 hours onsite. May require occasional Saturday work. (Training will be on site for the first 6+ months)
- Location: 1275 York Avenue, New York, NY
Pay Range: $108,400.00-$173,400.00
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