Lead RN Case Manager

Cleveland Clinic

5d • Onsite

About The Position

Join Cleveland Clinic Weston Hospital’s team of caregivers that remain on the leading edge of technology and education, all while consistently providing patient-centered healthcare. As part of Cleveland Clinic’s Florida region, Weston Hospital is recognized as one of the top hospitals in the Miami-Fort Lauderdale and Florida regions. Here, you will receive endless support and appreciation while building 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 role works days from 8:00 a.m. – 4:30 p.m.

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
• 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
• Ability to 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
• Previous supervisory experience

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