Inpatient Case Manager RN

NEW YORK, NYPosted 18 days ago

Job summary

• Job post source

  This job is directly from MJHS

• Job overview

  The Inpatient Case Manager RN role at MJHS involves providing quality, cost-effective care by managing authorizations for various healthcare services to support patient independence.

• Responsibilities and impact

  The RN will evaluate and pre-authorize inpatient, outpatient, specialty care, home care, DME, and transportation services according to guidelines, ensuring compliance with managed care regulations and facilitating communication among members, providers, and staff.

• Experience and skills

  Candidates must be a registered nurse licensed in New York with at least three years of medical/surgical nursing experience, knowledge of utilization management, managed care regulations, and proficiency in Windows and Microsoft Office; a Bachelor's degree and CCM certification are preferred.

• Company information

  MJHS operates Medicare and Medicaid managed care health plans focused on expanding services to meet patient needs and promote independent living.

Company overview

MJHS, or Metropolitan Jewish Health System, is a prominent not-for-profit organization providing a wide range of healthcare services, including home care, hospice, palliative care, and skilled nursing. Founded in 1907, MJHS has a rich history rooted in serving the Jewish community, though it now caters to diverse populations across the New York metropolitan area. The organization generates revenue through government programs like Medicare and Medicaid, private insurance reimbursements, and donations. MJHS is known for its compassionate, patient-centered approach and commitment to high-quality care.

How to land this job

• Tailor your resume to highlight your nursing experience, particularly in medical/surgical settings, and emphasize your knowledge of utilization management and managed care regulations relevant to MJHS's Elderplan and HomeFirst programs.

• Showcase your ability to evaluate and pre-authorize a variety of healthcare services, demonstrating familiarity with inpatient, outpatient, specialty care, home care, DME, and transportation services as outlined in the job description.

• Apply through multiple platforms including the MJHS corporate career site and LinkedIn to maximize your application visibility for the Inpatient Case Manager RN role.

• Connect with current MJHS employees in the managed care or case management divisions on LinkedIn; initiate conversations by commenting on recent company initiatives or asking about their experience with Elderplan and HomeFirst programs as ice breakers.

• Optimize your resume for ATS by incorporating keywords such as 'utilization management,' 'managed care nurse,' 'medical/surgical nursing,' 'case management,' and 'CCM' to ensure it passes automated screenings effectively.

• Leverage Jennie Johnson's Power Apply feature to automate tailored applications, identify multiple application channels, and find relevant LinkedIn contacts, freeing you to focus on preparing for interviews and networking.