Under general supervision of the Director and/or Manager of Case Management, in collaboration with the patient/family, social workers, physicians and interdisciplinary team, the RN Case Manager ensures patient progression through the continuum of care in an efficient and cost-effective manner. The RN case manager is responsible for identifying, initiating and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. Care coordination, utilization review and management, as well as discharge planning are accountabilities of this role. Education is provided to physicians and other members of the team on the issues related to utilization review including inappropriate admissions and placements. Payer-based requests regarding individual members are fulfilled, where appropriate and pertinent. The Case Manager adheres to departmental and organizational goals, objectives, standards of performance and policies and procedures, continually ensuring quality patient care and regulatory compliance. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
KNOWLEDGE AND SKILLS REQUIRED:
* Ability to communicate effectively with diverse populations
* Interpersonal skills that promote teamwork
* Critical thinking and problem-solving skills
* Effective organizational skills
* Proficiency in the daily use of standard office equipment such as computer, phone, fax, pager, copier etc. and skill in utilizing Microsoft Word and Outlook tools
KNOWLEDGE AND SKILLS PREFERRED:
* Superior clinical skills to determine appropriate clinical and other information for medical necessity reviews and identify appropriate mechanism to address delays or variation for expected care practices.
* Significant knowledge and understanding of availability of community and post-acute resources and related payer requirements.
EDUCATION AND EXPERIENCE REQUIRED:
* Associates Degree in Nursing
* Minimum of two years' recent acute care experience
* Minimum of an additional two years' experience in healthcare related fields
EDUCATION AND EXPERIENCE PREFERRED:
* Master's degree in Nursing
* Minimum of two years of utilization review/case management experience and a minimum of one year of experience in discharge planning in an acute care setting highly desirable.
LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED:
* Current valid State of Florida or multi state license as a Registered Nurse
LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:
* Case Management certification highly desirable - ACM (Accredited Case Manager), CCM (Certified Case Manager), RN-BC (Board Certified in Case Management)
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
AdventHealth Greater Orlando (formerly Florida Hospital) is one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.