Memorial Sloan-Kettering Cancer Center Veterans

Job Information

Memorial Sloan-Kettering Cancer Center RN Case Manager Denial and Appeals  Management, Fulltime, NYC in New York, New York

Company Overview

At Memorial Sloan Kettering (MSK), we’re not only changing the way we treat cancer, but also the way the world thinks about it. By working together and pushing forward with innovation and discovery, we’re driving excellence and improving outcomes. For the 28th year, MSK has been named a top hospital for cancer by U.S. News & World Report. We are proud to be on Becker’s Healthcare list as one of the 150 Great Places to Work in Healthcare in 2018, as well as one of Glassdoor’s Employees’ Choice Best Place to Work for 2018. We’re treating cancer, one patient at a time.Join us and make a difference every day.

Job Description

Are you interested in transitioning to RN Case Manager position at MSK? We are seeking a RN Case Manager in the area of Denial and Appeals Management.

Hours: 9am-5pm (Monday to Friday)

We are:

  • Providers of compassionate, evidence-based nursing care to Oncology patients and families living with cancer in a healing and innovative environment

  • You are:

  • Action-oriented and eager to embrace new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.

  • A good decision-maker, with proven success at making timely decisions that maintain high standards of patient care within the organization.

  • Actively seeking new ways to grow and be challenged, using both formal and informal development

  • Approachable and comfortable with diverse groups of people and able to make others comfortable with you.

  • An effective communicator, capable of determining how best to reach different audiences and executing communications based on that understanding.

  • Capable of building strong customer relationships and delivering customer-centric

You will:

  • Evaluate and respond to clinical and administrative denials referred to Case Management Department for appeal.

  • Participate in the daily management of the denials through resolution after the appeal is filed.

  • Perform chart reviews to support strategic planning initiatives.

  • Work with multidisciplinary team and acts as a liaison to insurance carriers and staff.

  • Perform utilization management/concurrent review for the inpatient population when necessary.

You need:

  • Current NYS Registered Nurse License/Registration and BSN required

  • 3-5 years acute hospital care experience

  • Experience with insurance industry and/or experience in reading and interpreting medical records strongly preferred.

  • Managed care/UR/CM experience strongly preferred.

  • Knowledge of state and federal regulations that affect health insurance coverage.

  • Strong writing skills required

  • Oncology experience preferred

  • Excellent interpersonal, problem solving and communication skills essential



MSK is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sexual orientation, national origin, age, religion, creed, disability, veteran status or any other factor which cannot lawfully be used as a basis for an employment decision.

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

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Job LocationsUSA-NY-New York

Posted Date1 week ago(11/29/2019 8:36 AM)

Requisition ID2019-38315

CategoryNursing - Case Management