Case Manager RN (H) Remote

University of Miami•Miami, FL

2d•Remote

About The Position

The University of Miami UHealth Department of UMHC-SCCC Business Operations is hiring a full-time remote Case Manager RN. The incumbent coordinates the interdisciplinary plan of care from admission through discharge, monitors care, and serves as a liaison among patients, families, healthcare personnel, and insurers. The role evaluates patient needs and available resources, recommends and facilitates care plans, and develops discharge plans that address ongoing needs and encourage compliance with medical advice. The Case Manager RN also identifies patient-care issues and suggests revisions to or new clinical pathways to improve quality of care.

Requirements

Bachelor’s degree.
Registered Nurse (RN) license.
Minimum 2 years of relevant experience.
Ability to communicate effectively in oral and written form.
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

Identify patients’ risk factors and obstacles to care, including discharge and readmission risks.
Evaluate plans of care regularly through chart reviews 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.
Serve as a liaison among patients, families, and healthcare personnel to help ensure necessary care is provided promptly, effectively, and in a fiscally responsible manner.
Promote quality care by ensuring patients receive medically appropriate services in the appropriate status and within stay standards.
Facilitate ongoing insurance authorization for continued stays.
Facilitate regulatory notifications and patient signatures according to 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.
Identify patient-care issues and suggest revisions to or new clinical pathways to improve quality of care.