Care Manager-Care Management-Full Time-Day-Mount Sinai ...

Job Description Care Manager-Care Management-Full Time-Day-Mount Sinai Queens Responsible for coordinating the care of the patients across the continuum. Ensuring and facilitating the achievement of quality, clinical and cost outcomes; Negotiating, procuring and coordinating services and resources needed by the patient and family. Qualifications + Education: Registered professional nurse licensed to practice in the state of New York + Experience: 3 - 5 years acute care experience. Experience in Care Management duties and managed care reviews. + License/Certification: Registered professional nurse licensed to practice in the state of New York. PRI Certification Collective bargaining unit: SEIU Local 144-MSQ-NonRN SEIU Local 144 at Mount Sinai Queens, 140 - Care Management - MSQ, Mount Sinai Queens Responsibilities + Review charts for appropriateness of admission/continued stays + Communicate with various departments when indicated to ensure tests that were ordered, are completed and followed up on + Follow up of abnormalities/delays: documentation, investigation, and treatment. + Facilitate interdisciplinary rounds with house physician, social service, nursing and ancillary departments. + Refer cases to Risk Management when appropriate. + Concurrent and retrospective managed care reviews. + Identify patientu2019s stability for Alternate Level of Care; obtain proper signatures and complete form after communication with attending. + Enter appropriate ICD-9 codes and data entry codes for the Care Management worksheets + Complete any forms necessary in the discharge planning process including (but not limited to) PRI, M11Q, 485, and as requested by the Social Service Department. + When managed care denies payment for days during concurrent review, contact the attending with this information. The attending can either evaluate for discharge or we will give telephone number and case number to facilitate attending contacting medical director for concurrent appeal of the denial About Us 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 Sinaiu2019s 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 u2014 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 patientsu2019 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

Created: 2025-10-04