CASE MANAGER - RN - FT

About the role

HSS is an innovative, supportive, and inclusive environment dedicated to transforming healthcare through exceptional orthopedic and rheumatology care. We seek candidates who align with our mission and are passionate about maximizing growth and success.

Responsibilities

• Develops/Manages Processes & Systems - Assists with contracts
• Assists in the negotiation of physician managed care contracts, analytics, and financial modeling
• Coordinates enrollment
• Ensures compliance
• Resolves payor issues
• Acts as liaison
• Schedules, coordinates, and documents for all PHO related meetings
• Maintains documentation & manages information
• Maintains tracking logs
• Oversees PHO line
• Maintains satisfactory attendance record
• Reports for duty punctually
• Adjusts to changing situations and work assignments

Requirements

• Two years experience in case management with discharge planning or equivalent in acute or home care clinical setting
• Orthopedic nursing
• Knowledge of regulatory agency standards
• Strong problem solving skills
• Ability to manage multiple tasks and projects independently
• Ability to assess clinical and discharge needs of orthopedic surgical patients
• Knowledge of Milliman (MCG) criteria
• PRI/screen certification

Qualifications

• Bachelor's degree in nursing

Skills

• Ability to assess clinical and discharge needs of orthopedic surgical patients
• Knowledge of Milliman (MCG) criteria
• PRI/screen certification

Benefits

The salary of the finalist selected for this role will be determined based on various factors, including but not limited to: scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation.

Pay

The base pay scale for this position is $140,016.47 - $157,666.47.

Schedule

Compensation Range