Lead RN Case Manager

Cleveland Clinic • Stuart, FL

2d • Onsite

About The Position

Join the Cleveland Clinic Florida team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world. The Lead RN Case Manager acts as the key information and education resource for the interdisciplinary team and works to develop organization-wide approaches to problem solving. Using your effective communication and interpersonal skills, you will help to prepare a plan of care that is patient specific and coordinate with post-acute providers to ensure continuity of care after discharge. This is a very hands-on team who feel valued in the work they do each day knowing that they have a direct impact on the patient. A caregiver in this position works days from 8:00AM – 4:30PM, with on-call and rotating weekend and holiday requirements.

Requirements

• Registered Nurse and a Bachelor’s of Science in Nursing (BSN) OR Bachelor's in Healthcare field
• Current and valid license to practice as a Registered Nurse (RN) in Florida
• Case Manager Certification (CCM) required within one year of eligibility
• Six years of experience in Care Management, Utilization Review or Discharge Planning in a Healthcare setting
• Excellent interpersonal communication and negotiation skills
• Demonstrated leadership skills
• Strong analytical, data management and PC skills
• Current working knowledge of discharge planning, utilization management, Care Management, performance improvement and managed care reimbursement
• Understanding of pre-acute and post-acute venues of care and post-acute community resources
• Strong organizational and time management skills
• Can work independently and exercise sound judgment in interactions with physicians, payors and patients and their families

Nice To Haves

• Master’s of Science in Nursing (MSN) or Master's in Healthcare related field

Responsibilities

• Promote the achievement of optimal clinical and resource outcomes.
• Facilitate pre-certification and payer authorization processes.
• Facilitate the collaborative management of patient care across the continuum, proactively identify and effectively address barriers for identified patient populations.
• Identify, develop and apply process improvement methodologies in evaluating and improving outcomes of care.
• Act as the expert involved in the clinical documentation efforts and serving as a clinical resource for coders and staff ensuring that documentation accurately reflects severity of illness and intensity of service.
• Be utilized as a sought-out expert with physician relations and communications.
• Support and act as a role model for the compliance of team members ensuring regulatory requirements are met.
• Work with leadership to align goals and visions.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees