RN Case Manager - ER Entry Point - FT - Days - $10K Sign on Bonus - MHP

Memorial Healthcare • Pembroke Pines, FL

1d • Onsite

About The Position

The role of the Entry Point Case Manager is to provide utilization management and safe discharge planning for patients presenting to the Emergency Department (ED) or other entry points in need of care. Works in collaboration with the healthcare team to problem solve patient difficulties in the case management arena. Addresses the patient’s healthcare service needs as identified in the Emergency Department.

Requirements

• Accredited Program: Nursing (Required)
• BLS American Heart E-Card (BLS AHA ECARD) - American Heart Association (AMERICAN HEART), BLS Cert American Heart_non ecard (BLS AHA) - American Heart Association (AMERICAN HEART), BLS Certification Grace (BLS GRACE) - Employee Grace Period for Essential Credential (GRACE), BLS Cert Red Cross (BLS RC) - Red Cross (RED CROSS), Registered Nurse Compact License (RN LICENSE COMPACT) - Compact RN Multistate, Registered Nurse License (RN LICENSE) - State of Florida (FL)
• Three (3) years’ RN experience.
• Experience with medical necessity criteria, discharge planning in an acute care setting or emergency department setting.
• This role requires decisive judgment with the ability to build and foster positive relationships.
• The incumbent must be able to lead others and take appropriate action when required.
• Must be able to provide education and resources relevant to the effective progression of care, utilization of services, appropriate level of care, and safe patient transition to the patient/family and health care team.
• Solid clinical assessment, critical thinking, decision making and organizational skills.
• Demonstrated interpersonal skills, effective written and verbal communication skills, and ability to work collaboratively with internal and external customers.
• Knowledge of relevant Federal and State utilization review and appeal requirements preferred.

Nice To Haves

• Bachelor of Science in Nursing preferred.
• Certification of Case Management (CCM) preferred.

Responsibilities

• Performs ongoing chart review to identify actual or potential issues, which may include service delivery, patient outcomes, and satisfaction, compliance, cost, and reimbursement.
• Participates in discharge planning, including coordinating patient transfers to other facilities and coordinating community resources.
• Provides discharge education and resource referrals to patients.
• Monitors patient and family satisfaction.
• Responds to questions and complaints from patients, family members, and payers regarding care.
• Consults with Physicians' and multidisciplinary teams regularly to evaluate the patient's status and appropriateness of medical care, including admission, length of stay, transfer, and discharge.
• Makes appropriate referrals to Social Workers and identifies appropriate hospice candidates and communicates with a physician regarding options.
• May collect and assesses data to identify quality trends or actual sources of risk to patients and employees. Collaborates with multidisciplinary team and committees concerning quality outcomes.

What This Job Offers

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