Case Manager RN- Care Coordination Yellow

Tampa General Hospital•Tampa, FL

17h

About The Position

The Case Manager RN ensures patient progression through the acute episode of care and facilitates safe, timely, and sustainable transitions across levels of care. In collaboration with physicians and the interdisciplinary team, the role develops, implements, and monitors individualized plans that address treatment needs, estimated length of stay, and anticipated discharge disposition. The Case Manager RN identifies and resolves clinical, psychosocial, environmental, and system barriers to care progression and discharge. The position participates in interdisciplinary rounds and huddles, reviews medical records to anticipate clinical stability, escalates barriers, documents avoidable days and anticipated discharge dates, and plans medical discharge needs. In partnership with Social Work and community resources, the Case Manager RN supports continuity of care, mitigates readmission risk, and ensures compliance with organizational, regulatory, and payer requirements. All duties align with Tampa General Hospital's mission, vision, values, and service excellence standards.

Requirements

Nursing education; no specific degree level is stated.
Five years of nursing experience, including at least two years in Case Management or two years in Emergency Medicine.
Advanced knowledge of acute care nursing, case management principles, discharge planning, and transitions of care across multiple post-acute settings.
Ability to assess medical necessity using InterQual or similar criteria, guide physicians toward appropriate levels of care, and support efficient patient placement.
Ability to analyze, triage, and prioritize complex clinical, psychosocial, and system issues; identify barriers to care progression; and implement effective, patient-centered solutions.
Ability to collaborate with physicians, nursing, social work, supporting departments, payers, and community agencies to achieve optimal patient outcomes.
Ability to communicate clearly and compassionately with patients and families, integrate the patient’s story into the plan of care, and advocate for patient needs and preferences.
Ability to accurately document care plans, utilization review findings, avoidable days, anticipated discharge dates, and required data across multiple electronic systems.

Responsibilities

Develop, document, and coordinate implementation of Discharge Plan A and alternative Plan B to support safe and sustainable transitions of care.
Collaborate with physicians and the interdisciplinary team to determine the plan of care, estimated length of stay, and anticipated discharge disposition.
Participate in rounds and huddles to communicate patient status, anticipate clinical stability, and align care progression goals.
Ensure patients progress through clinical milestones and adjust targeted discharge dates as clinically indicated.
Identify clinical, social, environmental, and system barriers to care progression and escalate issues through appropriate channels for resolution.
Work with physicians to consider and coordinate alternate levels of care when acute care criteria are no longer met.
Partner with Social Work to address complex psychosocial needs and coordinate post-acute services to reduce readmission risk and support community reintegration.
Monitor and document avoidable days, anticipated discharge dates, and utilization review findings in the medical record.
Participate in clinical performance improvement initiatives, readmission reviews, and team meetings for unplanned readmissions within 30 days.
Complete required documentation and processes to facilitate transitions of care; support HIM and Patient Accounts through accurate data entry; and uphold professional standards, confidentiality, and organizational values.
Create patient-centered plans that support community success, measured by decreased length of stay, readmissions, and ED revisits.