Job Description

Job Description

Description
RN Case Manager $5000 Sign-On Bonus Full Time Days AdventHealth Carrollwood

Location Address: 7171 North Dale Mabry Highway Tampa, Florida 33614

Top Reasons to Work At AdventHealth Carrollwood

* Family-like culture
* Teamwork driven both inter Dept and multidisciplinary
* Positive working climate to support a well-balanced work life balance

Work Hours/Shift:

Full Time Days

You Will Be Responsible For:

* Patient satisfaction scores meet organizational goals, HCAHPS Discharge Planning question percentile target score.
* Strive to provide excellence in service to hospital staff, patients and families.
* Consistently utilize 5 fundamentals of AIDET Acknowledge, Introduce, Duration, Explanation, Thank you.
* Committed to working as a team to improve Employee satisfaction and engagement scores.
* Demonstrate care for one another and respect for each persons unique contributions, provides utilization review care that is non-judgmental and non-discriminatory.
* Demonstrate respect for human dignity and self-worth.
* Respects patient privacy, confidentiality, and dignity by adherence to all HIPAA regulations.
* Maintains a professional appearance and manner.
* Consider factors related to patient safety, effectiveness, cost and impact on practice in the delivery of Case Management services. Strives to reduce Medicare and ALOS below established benchmarks.
* Assess appropriateness of setting as indicated for medical necessity according to the approved InterQual ISD criteria. Initial and concurrent clinical reviews contain needed elements to sufficiently support.
* Utilizes InterQualISD & or Milliman criteria to ensure appropriate level of care settings.
* Passes Annual Inter-Rater reliability testing for InterQual.
* Inpatient, Observation or Outpatient in a bed admission status.
* Introduce self to patient/family within 24 to 48 hours of identification of high risk criteria or referral for specified populations and explain CM role. Complete discharge planning screening tool within 24 to 48 hours for patients with high risk criteria, and cases received by referral. Provide Parent/Patient/ Guardian/ Significant Other with discharge planning education/instruction based on assessed education level, barriers to learning and learning preferences to assure a positive discharge outcome.
* Strives to reduce the Medicare & ALOS to below established benchmarks.
* Strives to reduce the number of observation cases and the number of hours patients remain in observation status.
* Ensures appropriate referral of cases to EHR for second level review.
* Identifies and updates current information on community resources.
* Maintains knowledge of current managed care contracts, federal statutes, regulations and procedures.
* Applies them in performance of review activities.
* Enhances professional knowledge & development through participation in educational programs and in-service meetings. Stays current with journal articles etc.
* Completes annual mandatory education, attend and contributes to 95% of staff meetings.

Qualifications
What You Will Need:

Individuals must possess these knowledge, skills and abilities and be able to explain and to demonstrate that s/he can perform the essential functions of the job, with or without reasonable accommodation, using some other combination of skills and abilities.

* Application of InterQual Criteria set.
* Assessment competency and knowledge application for all ages from newborn to geriatric.
* Assessment competency for appropriate use of hospital services and care coordination.
* Ability to work independently.
* Graduate of an accredited School of Nursing, Specific Degree/Major: Nursing.
* One year experience in Case Management in an acute care environment.
* Current license of registered nurse in Florida or licensure from another state with verification of application of eligibility for Florida licensure by endorsement.

Job Summary:

The Case Manager is accountable for the organization, sequence of services and resources that are necessary and appropriate for the achievement of patient care outcomes within effective time frames on a specific group of patients. In addition, the Case Manager will coordinate the plan of care among all members of the health care team. The Case Manager must have the professional ability to practice under minimal supervision and perform the following seven essential activities of Case Management: Appropriateness of Setting, Assessment, Planning, Implementation, Coordination, Monitoring and Evaluation, with emphasis on decreasing length of stay and monitoring cost effective health care across the continuum of care. The Case Manager must complete all initial admission assessments within 24 hours of inpatient admission and match the patients ongoing needs with the appropriate level and type of medical, health, psychosocial, or social service as they relate across the continuum of care.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.