Case Manager - AOMC
Company: Arnot Health System
Location: Elmira
Posted on: February 14, 2026
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Job Description:
Job Description Job Description CASE MANAGER This is an onsite
position. MAIN FUNCTION: The Case Manager coordinates, negotiates,
procures services resources for and manages the care of complex
patients to facilitate achievement of quality and cost, patient
outcomes. The Case Manager works collaboratively with
interdisciplinary staff internal and external to the organization.
The Case Manager participates in quality improvement and evaluation
processes related to the management of patient care. The Case
Manager will review all patients for utilization management and
appropriate discharge planning. The Case Manager's average caseload
will be: 15-25. The Case Manager will work cooperatively within the
care team. DUTIES AND RESPONSIBILITIES: Determines medical
necessity and appropriateness of admission and stay in accordance
with InterQual. Prepares Medicare/Non Medicare hospital notices of
no coverage (HINN) when patient's level of care is no longer
covered according to the guidelines. Identifies the appropriate
patients for Case Management services. Maintains a working
knowledge of the requirements of 3rd party payers most frequently
involved with their caseload population. Communicates,
collaborates, and coordinate with physicians, other members of the
team, the patient's payers and administrators to assess the needs
and provide a plan of care for their caseload population. In
conjunction with the patient/family, other members of the health
care team, the payer, and available resources, formulates a plan to
address assessed needs and issues, implements the plan, evaluates
the effectiveness of the plan in meeting established care goals and
revises the plan as needed to reflect the changing needs, issues
and goal. Explores and facilitates strategies to reduce length of
stay and resource consumption within case managed populations,
implements these strategies and documents the results. Manages each
patient's transitions through the Health Care system and maintains
appropriate documentation of the patient care and progress.
Identifies the need, arranges for and conducts health care team
meetings when necessary to facilitate the coordination of services
and resources in complex situations. Seeks and provides peer
consultation about cases presenting problemsand/or experiencing
significant deviation from the plan of care. Consistently attends
daily care rounds and participates in them. The Case Manager tracks
and trends LOS, resource utilization , outliers, readmissions,
denials, delay days and satisfaction of the case managed
population. Maintains a close working relationship with physicians
managing the care of their caseload population. Coordinates patient
discharge and transfers based on the patients need and available
resources. Coordinates services, i.e. home help, DME etc, based on
patient need and resources available. This job description lists
typical duties for the classification and is not to be considered
inclusive of all duties that may be assigned. MEETINGS: Case
management staff meeting. staff development meetings. Programs of
care. EDUCATION: Graduate of an approved registered nursing program
with a current license as a registered nurse. BSN or Case
Management Certification preferred. EXPERIENCE: Three to five years
clinical nursing in acute care hospital setting preferred. . Case
management experience preferred but not required. CARDIOPULMONARY
RESUSCITATION (CPR) REQUIREMENTS: Basic Life Support (BLS) required
within 90 days of hire date. PHYSICAL DEMANDS: Light physical
effort. Routine office job. Category I. Tasks that involve exposure
to blood, body fluids, or tissues. A.D.A. Essential Functions Job
Posted by ApplicantPro
Keywords: Arnot Health System, Binghamton , Case Manager - AOMC, Healthcare , Elmira, New York