PRN Case Manager – Acute Hospital
Southern Greater Orlando Area, Florida

The RN Case Manager collaborates with patients, families, social workers, nurses, physicians, and interdisciplinary teams to ensure patient-centered Care Coordination. In the RN Case Manager role, it focuses on efficient, cost-effective care, smooth transitions, and patient satisfaction. The RN Case Manager is supervised by the Care Management Supervisor/Manager and is pivotal in discharge planning, Transitions of Care, and ensuring regulatory compliance.

Qualifications:

• Registered Nurse (RN) with acute hospital nursing experience required
• Associate Degree in Nursing (ADN) required
• Prior hospital experience in Care/Utilization Management in an Acute Hospital Setting required
• Bachelor's or Master’s in Nursing (BSN/MSN) preferred
• Certification in Case Management (CCM/ACM) preferred

Responsibilities:

• Completes Initial Evaluation for transition of care needs on all identified patients within one calendar day of admission and documents according to policies and procedures
• Interviews patient and involved care givers as well as a review of the current and past inpatient and outpatient medical record in the Initial Evaluation
• Reviews necessary patient information including labs, medications, History and Physical, Therapy notes, ED notes, test results and progress notes
• Incorporates the patient/family care goals and preferences as much as possible into the transition of care planning and communicates these goals and preferences to the multidisciplinary team
• Meets with patient/families to discuss realistic and appropriate discharge options and providers of post-hospital care
• Incorporates social determinants of health into transitions of care planning and applies risk mitigation interventions to meet the individual needs of each patient
• Identifies and collaborates with the interdisciplinary team and hospital operations to resolve potential barriers to transition of care plan achievement
• Collaborate with the multidisciplinary healthcare team daily in multidisciplinary rounds to efficiently communicateand facilitate high quality patient progression of care and transitions plans
• Evaluates the potential for readmissions throughout the patient stay through the monitoring of each patient's readmission risk scores and coordinating readmission mitigation interventions
• Consults Social Work for specialty services related to psychosocial needs, decision making needs for patients who lack capacity, patient/family adjustment needs and psychosocially complex cases
• Develops discharge plan with appropriate contingency plans throughout the hospital stay to enable adaptation to evolving patient care needs and ensure timely Care Coordination
• Assists with End-of-Life conversation, Living Wills, Advance Directives, Power of Attorney, Community DNR
• Facilitates patient care conferences with multidisciplinary team
• Establishes and documents, based on the predicted DRG and multidisciplinary team member's input, Anticipated Date of Transition (ADOT) and destination and updates
• Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all assigned patients
• Proactively identifies patients who no longer meet medical necessity and escalates potential denials, documents avoidable days, and facilitates progression of care
• Collaborates with Utilization Management staff for collaboration on patient status changes and medical necessity discussions
• Ensure patient notifications are provided and documented in a timely manner for compliance: Important Medicare Letters (IML), Medicare Outpatient Observation Notice (MOON), Patient Choice, and Beneficiary Notice Letter (BNL)
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization

For our Case Management opportunities, feel free to forward a resume to Michelle Boeckmann at Michelle@HCRecruiter.com or visit our Case Management website at https://www.HealthcareRecruitmentPartners.com/Careers.

If this opportunity is of interest or know someone that would have interest, please feel free to contact me at your earliest convenience.

Michelle Boeckmann | President Case Management Recruitment
Direct Dial 615-465-0292

Michelle@HCRecruiter.com
https://www.HealthcareRecruitmentPartners.com

A member of the Sanford Rose Associates® network of offices
America's Best Professional Recruiting Firms | Forbes 2024

Top 10 U.S. Search Firm – Executive Search Review