RN Case Manager PC 00002266

The RN Case Manager is responsible and accountable to be fully engaged in providing Quality / No Harm, Customer Experience, and Stewardship by coordinating the care and services for assigned patients in collaboration with the patient, family, physician, patient care team, and payers.
The RN Case Manager utilizes advanced clinical skills to facilitate the provision of care, which includes the assessment, planning, intervention, and evaluation of patient care.
The RN Case Manager promotes and evaluates the effective utilization of resources using current clinical knowledge, awareness of community services, and functioning as a role model to achieve optimal clinical and resource outcomes.
Primary AccountabilitiesIdentifies and documents discharge plan and coordinates complex discharge plans to ensure communication across the continuum, assesses patient/family collaborating with physicians and the interdisciplinary team to identify possible clinically related discharge needs, coordinates transitional care/post-acute care referrals, communicates all discharge plans and options to patient/family, physicians and staff members and assures plan is carried out in a timely manner outcomes.
Collaborates with patient, family, physicians, transitional care facility representatives, interdisciplinary teams, and any other parties to assure progression towards desired goals.
Identifies "at risk" patient populations and/or strengths of patient/family support systems on admission.
Makes referrals for consultations as indicated.
Completes mandatory legal reporting processes.
Assures compliance with regulatory standards of care at both the state and federal level.
Assess all patients for potential risk management and quality issues through appropriate intervention or referral.
Actively participates in performance improvement opportunities.
Provides education to patient/family regarding plan of care and expected outcomes and documents the education in the medical record.
Provides education for members of the team regarding appropriate utilization of services and levels of care indicated by a clinical situation.
Actively participates in the education of healthcare team members on current healthcare economic issues impacting practice patterns, reimbursement and positive patient outcomes.
Maintains knowledge of Interqual criteria and current developments in Utilization Review/Case Management fields.
Current FL RN license required.
Bachelor‚EUR(TM)s Degree or college degree in related field preferred.
Case Management Certification preferred.
Minimum of 3 years of professional nursing experience in an acute clinical care setting required.
One year of ICU or PCU experience or other appropriately related patient care setting preferred.
Minimum of 3 years of population specialty experience preferred.
Previous insurance and/or case management experience preferred.
Demonstrated computer experience.

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