Case Manager - RN

Case Manager - RN

Company: Margaretville Hospital

City/State: Margaretville, NY

Category: Allied Health Prof/Technical

Department: Case Management

Union: No

Position: Full Time

Hours: M-F

Shift: Day

Req #: 49476

Posted Date: Aug 24, 2026

Hiring Range: $41.51 - 52.19 hourly

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External Applicant link (https://pm.healthcaresource.com/cs/wmc1/#/preApply/33878) Internal Applicant link

*If you are hired by WMCHealth, your final base salary will be determined based on job-related factors, including employment status (full-time, part-time or per diem), relevant skills, qualifications and experience. Consistent with our commitment to pay equity, we also consider internal equity among similarly situated employees when determining final compensation.

Job Details:

Case Manager coordinates care and service of selected patients across the health care continuum. Promotes effective utilization of resources and the highest quality of care for optimal clinical and resource outcomes. Ensures appropriate lengths of stay based on medical necessity. Assesses and implements effective discharge planning through identification of appropriate services and facilities across the continuum of care. Assumes a leadership and communication role with the patient/family, interdisciplinary team members, and providers of appropriate services across the continuum. Provides ongoing monitoring and evaluation of the plan across the continuum as appropriate. Integrates evidence-based clinical and preventative guidelines in the development of patient-centered tools to assist patients in decision-making that benefits their optimal health. Provide targeted interventions to avoid unnecessary hospitalizations and emergency room visits.

Responsibilities:

• Providing interpretation and support for those who are awaiting placement in a nursing home or physical rehabilitation. Completion of Referrals, including PRI.

• Provide appropriate resources and referrals for treatment of alcohol abuse, drug abuse, child abuse, domestic violence and other mental health issues.

• Reviews incoming referrals for swing bed placement.

• Supports Mountainside Residential Care Center as needed, including PRI's.

• Discharge planning, implementation and serve as a liaison between hospital and all community agencies and institutions who are interested in the well-being of patients.

• Helping patients and families get information and services to meet special needs not provided by the hospital, or that will be needed after discharge planning in an institutional or non-institutional setting.

• Locating community and other local resources which are available to patients in the hospital and after discharge.

• Developing and implementing appropriate and well-coordinated referral procedures with these resources.

• Following through on such referrals to ensure that necessary treatment plans have been implemented.

• Swing Bed Coordinator.

• Interprets, supports, and recommends Swing Bed policies and procedures.

• Covers UMR and attendsUMR meetings.

• Maintains compliance with social services standards, hospital policies and procedures and regulatory agency requirements.

• UR-Reviews all acute/swing admission medical records.

• UR-Reports concerns regarding admissions and continued stay to Utilization Review Chairperson and Medical Director.

• UR- Prepares monthly statistical report for monthly review at the UR Committee meeting.

• UR-Provides clinical reviews to medical insurance companies as requested.

• UR-Collaborates with the Health Information Manager to appeal insurance denials. Set up peer to peer if needed.

• UR- Reports UR statistics to Board Quality quarterly.

• Call all patients s/p hospital stay. Review understanding of discharge instructions and assist with f/u PCP appointments, medications, if needed.

• Other duties as assigned.

Experience:

• Two (2) years hospital-based preferred. One (1) year QA/UR or Case Management preferred. Current knowledge of Federal and State regulations

Education:

• RN, graduate of an accredited school of Nursing or CSW preferred; or B.A. or B.S. in related field -Meets requirements of NYS Department of Health

Licenses/Certifications:

• PRI certification required.

Other:

• Excellent verbal and written communication skills; strong organizational skills

• Self-motivated

• Able to make sound clinical decisions

• Knowledgeable about community resources

• Able to use/enhance coaching skills over a varied patient population

• Able to share coaching knowledge and act as a role model for staff

• Able to delegate

• Work in organized fashion

• Understands the importance of time management relative to meeting patient needs in a efficient, effective manner

• Able to identify and intervene when concerns arise

• Engages with team members to promote cohesive workflow

About Us:

Margaretville Hospital

Margaretville Hospital, in Margaretville, NY, is home to Delaware County’s most advanced critical-care access hospital. This 15-bed facility cares for more than 240 inpatients annually while performing 14,000 outpatient procedures each year. Margaretville Hospital was named one of the top 100 critical-access hospitals in the nation by the National Rural Health Association. It provides emergency care, ambulatory care services, laboratory testing, medical imaging, physical and occupational therapy, swing-bed rehabilitation programs, respite care, and board-certified specialist and wellness education.

Benefits:

We offer a comprehensive compensation and benefits package that includes:

• Health Insurance

• Dental

• Vision

• Retirement Savings Plan

• Flexible Savings Account

• Paid Time Off

• Holidays

• Tuition Reimbursement

Apply Now

External Applicant link (https://pm.healthcaresource.com/cs/wmc1/#/preApply/33878) Internal Applicant link

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