Case Manager Registered Nurse - Full Time

University of Miami•Miami, FL

3d•Onsite

About The Position

The Case Manager Registered Nurse coordinates the interdisciplinary plan of care for patients from admission through discharge. The role monitors care and serves as a liaison among patients, families, healthcare personnel, and insurers. It evaluates patient needs and available resources, recommends and facilitates plans for optimal outcomes, and develops discharge plans that address ongoing needs and encourage compliance with medical advice. The Case Manager RN identifies patient-care issues and may suggest revisions to or new clinical pathways to improve quality of care. The position identifies risk factors and obstacles to care, discharge, and readmission; evaluates care plans through chart review and patient interviews; and collaborates with the medical team to facilitate patient movement through the system. It educates patients and families about care progression and promotes timely, effective, fiscally responsible, medically appropriate services that meet status and length-of-stay standards. The role also facilitates continued-stay insurance authorization, regulatory notifications, and patient signatures in accordance with policy, while maintaining knowledge of insurance reimbursement policies. Using experience and judgment, the Case Manager RN plans and facilitates discharge and transition arrangements that meet patients’ physical, social, and emotional needs. The position follows University and unit-level policies and procedures and safeguards University assets. Duties may be expanded as necessary. The position is full-time at UHealth Tower.

Requirements

Graduate from an accredited school of nursing.
Bachelor’s degree in nursing (BSN).
Valid Florida Registered Nurse license.
BLS certification from the American Heart Association.
Minimum 2 years of relevant experience, including at least 1 year in hospital case management/nursing.
Working knowledge of patient assessment and medical terminology.
Ability to communicate effectively orally and in writing.
Ability to recognize, analyze, and solve a variety of problems.
Ability to analyze, organize, and prioritize work under pressure while meeting deadlines.
Ability to maintain effective interpersonal relationships.

Responsibilities

Coordinate the interdisciplinary plan of care from admission through discharge.
Monitor care and act as a liaison among patients, families, healthcare personnel, and insurers.
Evaluate patient needs and available resources, and recommend and facilitate plans for the best outcomes.
Develop discharge plans that provide available resources for ongoing patient needs and encourage compliance with medical advice.
Identify patient-care issues and suggest revisions to or new clinical pathways to improve quality of care.
Identify patient risk factors or obstacles to care, discharge, and readmission.
Evaluate care plans regularly through chart review and patient interviews, and collaborate with the medical team to facilitate patient movement through the system.
Educate patients and families about the progression of care.
Promote timely, effective, fiscally responsible, and medically appropriate care in appropriate status and within stay standards.
Facilitate ongoing insurance authorization for continued stay, regulatory notifications, and patient signatures in accordance with policy.
Maintain knowledge of insurance reimbursement policies.
Plan and facilitate discharge and transition plans that meet patients’ physical, social, and emotional needs.
Adhere to University and unit-level policies and procedures and safeguard University assets.
Perform other duties or responsibilities as necessary.