Care Management RN (Full Time, Mid shift) Position Available In Miami-Dade, Florida

Job Description:

DescriptionJob SummaryOversees the transition of the patientthrough the healthcare spectrum from admission to dischargeensuring optimal level of wellness. Enhances care coordinationthrough planning, assessing, re-assessing, implementing,monitoring, and evaluating care options and services to meet theindividual plan of care needs for the pediatric patient throughUtilization Resource Management, Transition of Care, DischargePlanning, and Care Management.

Job Specific Duties Transitions care to external providers, community partners, andservices to achieve quality outcomes for the patient andfamily. Facilitates efficient care transitions for the pediatricpatient through defining discharge and transition of care criteriathrough an individualized patient centered plan of care. Conducts initial assessment of the patient and family within 24hours to identify potential transition of care and dischargebarriers and needs. Develops a relationship with patients and families to partnerfor safe transition of care through the healthcare spectrum. Collaborates with the inter-professional team to implement safeand timely transition and discharge planning. Proactivelyidentifies, and resolves delays and obstacles for safedischarge. Coordinates and facilitates inter-professional team meetings,advocating on behalf of the patient, focusing on the transitionneeds of the patient. Drives and actively participates in case management and unitspecific conferences with Medical Director to facilitate transitionof care through discussion and identification of complexcases. Develops and implements a patient centered specific plan ofcare and makes referrals based on the needs assessment & availableresources in conjunction with members of the inter-professionalteam. Coordinates medical discharge planning needs specific topediatric patients including medication authorization, DME,supplies, home health nursing & inpatient/outpatient rehab,etc. Screens charts to determine admission and concurrent level ofcare criteria; monitors daily plan of care. Collaborates to eliminate barriers of efficient delivery ofcare in appropriate setting, LOS, and readmission prevention. Coordinates with health care team to assess & identifyissues/needs that may impact on transition of level of care &discharge. Applies cost benefit analysis when planning fordischarge needs. Collaborates with family, health care team, payers, providers,& community partners to achieve appropriate resource management toimplement safe transition and discharge plan established. Assists in identifying variances in utilization of resources &avoidable days/denials. Collaborates with Utilization ManagementRN, Appeals Management, & Medical Director in the appealsprocess. Responsible for the appropriate use of software andapplications when available and enters case management informationaccurately and in a timely manner. Participates in departmental initiatives/opportunities forimprovement through departmental and unit council assignments,including interdisciplinary rounds and LEANprojects.

QualificationsMinimum Job Requirements RN – Registered Nurse RN Licensure within the State of Floridaor Multi-State Enhanced Nursing License Compact (eNLC) – maintainactive and in good standing throughout employment 1-3 years pediatric or adult acute clinical hospitalexperience. 1-3 years experience in Case Management, designated/pediatricspecialty, program/project development, Utilization Management,and/or Clinical Pathways.

Knowledge, Skills, And Abilities BSN degree or currently enrolled in BSN program highlypreferred. National Certification in Case Management through an accreditedbody preferred. Experience in discharge planning, clinical pathways, andcontinuous quality improvement highly desirable. Leadership experience is highly preferred. Basic proficiency in Microsoft Word, Excel, and Outlook. Able and available to work a flexible/rotating scheduleincluding holidays and weekends. Able to communicate effectively both verbally and in writing ina clear, concise, and courteous manner. Fluent in Spanish preferred. Working experience with various technologies, hospitalinformation systems, and other tools used in patient financialservices, particularly Cerner. Able to interpret, adapt, and react calmly under stressfulconditions in a pleasant manner. Able to relate cooperatively and constructively with customersand co-workers. Able to maintain confidentiality of sensitive information. Able to establish necessary professional relationships, andinteract effectively with internal and external customers. Able to work in a fast paced environment, and effectivelymanages and uses resources to successfully meet the competingdeadlines of a variety of tasks, problems, and projects. Able to use logical and analytical thinking to interprettechnical data, and solve a broad range of problems. Able to work independently when interacting with organization’sclinical and non-clinical customers and outsidevendors/payors.

JobProfessionalDepartmentCASEMANAGEMENT-2100-866001

Job Status:

Full Time