RN Case Manager - Case Management
Palm Bay, Florida
Employer: Health First
Industry: Case Management
Salary: Competitive
Job type: Full-Time
Job Description
POSITION SUMMARY:
The RN Case Manager is fully engaged in providing quality/no harm, customer service and stewardship by utilizing advanced clinical skills in the assessment, planning, intervention and evaluation of patient care in accordance with Federal Conditions of Participation, State of Florida regulations, and The Joint Commission (TJC) accreditation standards. The RN Case Manager uses sound clinical judgment, working collaboratively with the interdisciplinary team, patient, family, and significant support personnel to achieve optimal clinical outcomes through effective utilization of resources and discharge planning for all hospital admissions.
PRIMARY ACCOUNTABILITIES
Qualifications:
MINIMUM QUALIFICATIONS
PREFERRED QUALIFICATIONS
PHYSICAL REQUIREMENTS (Sedentary)
POSITION SUMMARY:
The RN Case Manager is fully engaged in providing quality/no harm, customer service and stewardship by utilizing advanced clinical skills in the assessment, planning, intervention and evaluation of patient care in accordance with Federal Conditions of Participation, State of Florida regulations, and The Joint Commission (TJC) accreditation standards. The RN Case Manager uses sound clinical judgment, working collaboratively with the interdisciplinary team, patient, family, and significant support personnel to achieve optimal clinical outcomes through effective utilization of resources and discharge planning for all hospital admissions.
PRIMARY ACCOUNTABILITIES
- Initiates care transition at time of admission, developing and revising individualized discharge plans (as indicated by assessment/reassessment and response to treatment) to meet patient needs during their hospital stay, manage their length of stay, promote efficient utilization of resources, and plan for a safe discharge.
- Identifies at-risk populations using approved screening tool and following established referral processes for safe transition to next level care to prevent readmission.
- Practices autonomously, consistent with evidence-based standards.
- Serves as a case management resource expert for compliance with Medicare IM letter, 3008, 1823 PASSR, and DCF mandatory legal reporting, etc.
- Works with the Utilization Department, Physician Advisors, Hospitalists, Emergency and other physicians to ensure appropriate, cost-effective care with the best patient outcomes.
- Proactively identifies and either resolves or escalates delays and obstacles to discharge.
- Identifies reimbursement factors influencing choice of post-hospital providers and obtains authorizations as required, either directly or in collaboration with the payer's case manager.
- Evaluates overall patient daily plan for effectiveness and involves patient and family in formulating plan goals.
- Works collaboratively and maintains active communication with physicians, nursing, physician advisor, and other members of the interdisciplinary care team to effect timely, appropriate patient resource management and patient transition.
- Demonstrates professional accountability through supporting patient's rights, informed consents and advanced directives.
- Initiates appropriate referrals to ethics committee, clinical social worker, risk management or legal services as appropriate.
Qualifications:
MINIMUM QUALIFICATIONS
- Education: Associate Degree in Nursing
- Licensure: Current, valid State of Florida RN license or endorsement
- Certification: Current American Heart Association Basic Life Support Healthcare Provider Completion Card upon hire and maintained
- Work Experience: At least three (3) years of clinical experience in an acute care hospital
- Knowledge/Skills/Abilities:
- Strong analytical, data management and computer skills
- Excellent interpersonal communication and negotiation skills
- Demonstrated critical thinking in resolving or escalating barriers
- Ability to work autonomously and prioritize multiple tasks and role components
- Ability to exercise sound judgment in interactions with physicians, payers, patients and their families
- Flexibility to meet needs in sometimes high demand and stressful situations
PREFERRED QUALIFICATIONS
- Education: BSN or Bachelor's Degree in related field.
- Certification: CCM or ACM.
- Work Experience: Case Management experience in a acute care hospital.
- Knowledge/Skills/Abilities:
- Knowledge of care transitions, utilization management, case management, performance improvement and managed care reimbursement.
- Comprehensive knowledge of continuum-of-care post-acute community resources.
PHYSICAL REQUIREMENTS (Sedentary)
- Majority of time involves sitting or standing; occasional walking, bending, stooping.
- Long periods of computer time or at workstation.
- Light work that may include lifting or moving objects up to 20 pounds with or without assistance.
- May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise.
- Communicating with others to exchange information.
- Visual acuity and hand-eye coordination to perform tasks.
- Workspace may vary from open to confined; on site or remote.
- May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle.
Created: 2024-08-22
Reference: 074475
Country: United States
State: Florida
City: Palm Bay
ZIP: 32909
Similar jobs:
-
Field RN Case Manager Sr Community Care Osceola FL
UnitedHealth Group in Melbourne, Florida -
Case Manager, Acute Care-Case Management-$20K Sign-On-FT BHN #7957
Broward Health in Deerfield Beach, Florida -
Case Management Extender
Tampa General Hospital (TGH) in Tampa, Florida -
Case Manager II (Pool)
Encompass Health in Miami, Florida -
RN Case Manager
Amedisys in Port Orange, Florida -
Case Manager II (Pool)
Encompass Health in Tallahassee, Florida -
Nurse - Outpatient & Mental Health Intensive Case Management (MHICM)
Veterans Health Administration in Saint Petersburg, Florida -
Social Work Case Manager, Case Management, FT, 8A-6:30P
Baptist Health South Florida in Miami, Florida💸 $54322.45 - $70619.19 per year -
RN Case Manager
Amedisys in Gainesville, Florida💸 $75000 - $85000 per year -
Pool Social Work Case Manager, Case Management, Per Diem, Day Shift Varies
Baptist Health South Florida in Boca Raton, Florida💸 $35.25 per hour -
Case Manager RN - Remote in FL
UnitedHealth Group in Orlando, Florida -
Registered Nurse (RN) - Case Management
TLC Nursing in Kissimmee, Florida -
Care Management Discharge Plan Coordinator, Case Management, FT, 8A-4:30P
Baptist Health South Florida in Boca Raton, Florida💸 $18.59 - $24.17 per hour -
Registered Nurse (RN) - Case Management
TLC Nursing in Jacksonville, Florida -
Care Management Discharge Plan Coordinator, Case Management, FT, 8A-4:30P
Baptist Health South Florida in Boca Raton, Florida💸 $18.59 - $24.17 per hour -
Case Manager RN
Lee Health in Fort Myers, Florida💸 $30.27 - $40.86 per hour -
RN Case Manager
Amedisys in Port Orange, Florida💸 $68000 - $85000 per year -
Registered Nurse RN Case Manager Home Health
AdventHealth in Orlando, Florida -
Field RN Case Manager Sr Community Care Jacksonville FL
UnitedHealth Group in Jacksonville, Florida -
Social Worker MSW- Case Management
Tampa General Hospital (TGH) in Spring Hill, Florida