Summary Case Manager RN is a professional member of the health care team who has 24/7 accountability for the coordination, monitoring and management of patient care resources to promote the most efficient delivery of patient care services at the appropriate level of care while maintaining a single high standard of care delivery to all patients. The Case Manager RN acts as a resource to all levels of staff in defining/educating/implementing and evaluating patient care and nursing practice standards utilizing the nursing process, current concepts/principles of case management/utilization management/disease management, education, quality improvement, clinical practice and health care trends.
Responsibilities Assess complex patient care needs/situation/acuity levels, obtaining significant data from assessments (physical/functional, mental, psychosocial, environmental, family support, spiritual, cultural, financial, legal).
Coordinate patient care through out an episodic / continuous course of care for a specific DRG/diagnosis/procedure/population using InterQual, Millikan or other specific criteria and evidence based guidelines.
Complete electronic documentation for case management activities such as discharge planning, patient throughput, appropriate level of care, communication with physician, nursing and patient / family member.
Articulate information pertinent to clinical condition, LOS, discharge delays, outcomes, resource utilization, discharge planning, etc. at team meetings / presentations, patient care rounds, interdisciplinary rounds and to administration, medical director and physician advisors.
Follow and perform all related unit specific policies and procedures, as detailed on the unit specific competency check-list.
Utilize job and unit specific equipment as required.
Demonstrate behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).
Perform all other related job duties as assigned.
Experience Generally requires 1 to 3 years of related experience.
Education Bachelor's degree in Nursing is required. Employees hired prior to June 1, 2022 are grandfathered in for the BSN degree.
Skill General Competencies: Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines; ability to communicate effectively in both oral and written form; ability to handle difficult and stressful situations with professional composure; ability to understand and follow instructions; ability to exercise sound and independent judgment; knowledge and skill in use of job appropriate technology and software applications.
Credentials Valid, unrestricted Florida RN license required. Case Management certification (CCM or ACM) is preferred. Must meet and maintain valid and current all unit specific and organizational skills/competencies, certifications/licensures, as required by regulatory and/or nursing standard of practice for the specialty.
Physical Requirements Job function requires extended standing or walking. Must be able to carry objects weighing 21 to 50 pounds. Able to lift or move objects weighing 51 to 100 pounds with the use of appropriate devices. Jobs in this group require frequent visual acuity to perform activities related to extended use of computers. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
Environmental Conditions – Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Exposure to various environments such as: communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May also be exposed to needle sticks, airborne infections, medical gases, X-Ray, chemical exposures and other potential hazards. Must wear Personal Protective Equipment (PPE) when exposed to infectious/clinical hospital environment. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions.
Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
Seniority Level Entry level
Employment Type Full-time
Job Function Health Care Provider