Case Manager RN (H) Remote

University of Miami•Miami, FL

1d•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 role coordinates the interdisciplinary plan of care for patients from admission through discharge and serves as a liaison among patients, families, healthcare personnel, and insurers. The Case Manager evaluates patient needs and available resources, recommends and facilitates plans of care, and develops discharge plans that address ongoing needs and encourage adherence to medical advice. The role also identifies patient-care issues and recommends revisions to or development of clinical pathways to improve care quality.

Requirements

Bachelor’s degree.
Registered Nurse (RN) license.
At least 2 years of relevant experience.
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

Identify patient risk factors or obstacles to care, discharge, and readmission.
Evaluate plans of care through chart review and patient interviews, and collaborate with the medical team to facilitate patient progression through the system.
Educate patients and families about the progression of care.
Liaise with patients, families, and healthcare personnel to 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 stay standards.
Facilitate ongoing insurance authorization for continued stay.
Facilitate regulatory notifications and obtain 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.
Follow University and unit-level policies and procedures and safeguard University assets.