Registered Nurse Case Manager (RN)

Conifer Health Solutions•Palm Beach Gardens, FL

2d•Onsite

About The Position

The RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: 1. Care Coordination by driving progression of care, appropriate use of resources, and patient safety through readmission prevention while simultaneously considering patient choice and goals of care; 2. Education provided to physicians, patients, families, and caregivers. 3. Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy.

Requirements

Active Registered Nurse license
At least two years acute hospital patient care experience
Current BLS certification
Demonstrated organizational skills
Excellent verbal and written communication skills
Ability to lead and coordinate activities of a diverse group of people in a fast paced environment
Critical thinking skills
Problem solving skills
Computer literacy

Nice To Haves

BSN
Certification as Accredited Case Manager (ACM) or equivalent
Acute hospital case management experience

Responsibilities

care coordination
transition-planning assessment and reassessment
implementation or oversight of implementation of the transition plan
communicating with patients, families and the healthcare team regarding the plan of care
leading and facilitating unit TEMPO (Team Engagement to Manage Patient Outcome)
leading and facilitating multi-disciplinary patient care conferences
active participation and knowledge sharing in Complex Case Review
identifying and escalating complex patients to CM leadership and physician advisor
collaboration with the healthcare team including physicians, office staff, ancillary departments, payors, and post-acute facilities
assuring patient/family education is completed to support post-acute needs
timely, complete and concise documentation in the Case Management system
maintenance of accurate patient demographic and insurance information
identification and documentation of potentially avoidable days
identification and reporting over and underutilization
other duties as assigned