Registered Nurse Care Manager

2 weeks ago

Saint Petersburg, United States Bayfront Health Full time

Position Summary:
Promotes and facilitates effective management of hospital resources from admission to discharge, collaborating with the assigned clinical team to identify patient most likely to benefit from care coordination services to include assessing patients’ risk factors and the need for care coordination, clinical utilization management and the transition to the next appropriate level of care.

**Responsibilities**:
**Essential Functions**
- Initially and concurrently assesses all patients within assigned population to include, but not limited to:

- Accurate medical necessity screening and submission for Physician Advisor review
- Care coordination that includes admitting diagnosis/ medical history, current treatments, age, payment source, resources, support systems, anticipated needs, expected length of stay, appropriate level of service, special/ personal needs, and other relevant information.
- Leading and facilitating multi-disciplinary patient care conferences
- Managing concurrent disputes
- Making appropriate referrals to other departments
- Identifying and referring complex patients to Social Work Services
- Communicating with patients and families about the plan of care
- Leading and facilitating Complex Case Review
- Identification and documentation of potentially avoidable days
- Identification and reporting over and underutilization
- Ensures compliance with all regulatory standards including Federal, State, Local and Joint Commission with review requirements for Managed Contracts, Medicare, Medicaid, and Campus related to admission and continued stay approval.
- Adheres to Utilization Management Plan.
- Integrates National standards for care management scope of services including:

- Utilization Management supporting medical necessity and denial prevention
- Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
- Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and appropriate level of care
- Education provided to physicians, patients, families, and caregivers.
- Communicates appropriately and timely with the interdisciplinary team and third-party payers.
- Prioritizes activities in assigned areas to focus on high risk, high cost, and problem prone areas.
- Develops, collaborative relationships with patient business, nursing, physicians, and patient/family to facilitate efficient movement through the continuum of care.
- Monitors and evaluates data, fiscal outcomes, and other relevant information to develop and implement strategies for improvement.
- Forwards identified quality and/or risk issues appropriately.
- Maintains positive relationships with outside/onsite reviewers and other payer representatives.
- Identifies cultural, socio-economic, religious, and other factors that may impact treatment.
- Involves patient’s family in the development of the treatment plan as appropriate while explaining procedures, therapies, systems treatment plans, and discharge plans in age/developmental/educational specific terms to patient/family.
- Reviews patient’s discharge plan at multidisciplinary meetings and/or staffing to facilitate communication with other healthcare team members.
- Prioritizes workload to manage multiple priorities while using problem-solving skills to meet goals.
- Enhances professional growth by participating in educational programs, current literature and/or workshops.
- Possesses excellent interpersonal skills and ability to work in a team environment.
- Respects the rights and privacy of others and holds staff member information in strict confidence.
- Maintains regular attendance and complies with time and attendance policy and procedures.
- Adheres to Orlando Health’s policies and procedures, Mission, Vision and Values statement and Code of Conduct.
- Enhances professional growth by participating in educational programs, current literature and/or workshops.

**Other Related Functions**
- Maintains records and documentation of work performed in an organized and easily retrievable fashion while maintaining confidentiality of data and patient information.
- Reviews current literature on a regular basis, maintains reference materials and updates as required, and keeps abreast of relevant reimbursement information.
- Actively serves on committees and task forces to promote quality, cost-effective care for patient population.
- Required skills include 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 and problem-solving skills and
computer literacy.
- Performs other duties as assigned or required

Qualifications:
**Education/Training**
- Graduate of an approved school of nursing.

**Licensure/Certification**
- Maintains current Florida RN license and BLS/Healthcare Provider certification are required.
- BLS/Hea

  • Registered Nurse Case Manager

    1 week ago

    Saint Petersburg, United States The Kidz Club Full time

    Job DescriptionJob DescriptionJoin our team of passionate pediatric healthcare professionals empowering Kidz to be kids through PPEC daily skilled nursing!The RN Case Manager (RNCM) is responsible for managing the care of pediatric patients, according to their individual needs and care plan using a multidisciplinary method. The Registered Nurse facilitates...

  • RN -FULL TIME+BENEFITS -1 YR of Home Health Care Experience -Visits

    3 weeks ago

    Saint Petersburg, United States TGH Home Care Full time

    Job DescriptionJob DescriptionTGH Home Care powered by VNA of Florida provides a full array of home care services for TGH patients, and those in the community needing home care. This office continues the same level of care and experience received at Tampa General Hospital.The Visiting Nurse Association of Florida (VNA) is a 45-year-old home health agency...

  • Nurse Manager

    1 week ago

    Saint Petersburg, United States St Petersburg Pregnancy Center Inc Full time

    Job DescriptionJob DescriptionPurpose & ImpactThe Nurse Manager oversees the provision of patient care and clinic operations, provides support and care to patients, and maintains professional standards of care. The Nurse Manager is responsible for planning and performing nursing interventions. He/she is also responsible for supervising, organizing, planning,...

  • Registered Nurse ER Days

    1 week ago

    Saint Petersburg, United States BayCare Full time

    Job DescriptionWhere Expertise Meets Compassionate Care!Every day, our Registered Nurses deliver a level of excellence and compassionate care to our patients in the ER. Positions details: Location: St. Anthony’s Hospital 1200 Seventh Ave N, St. Petersburg, FL Status: Full TimeShift: 6:45 AM - 7:15 PMEvery other weekend requirementOn Call: NoAlways in...

  • Registered Nurse ER Nights

    12 hours ago

    Saint Petersburg, United States BayCare Full time

    Job DescriptionWhere Expertise Meets Compassionate Care!Every day, our Registered Nurses deliver a level of excellence and compassionate care to our patients in the ER. Positions details: Location: St. Anthony’s Hospital 1200 Seventh Ave N, St. Petersburg, FL Status: Full TimeShift: 6:45 PM - 7:15 AMEvery other weekend requirementOn Call: NoAlways in...

  • Registered Nurse

    1 week ago

    Petersburg, United States TotalMed Full time

    We are seeking a Registered Nurse-Intensive Care Unit for a travel assignment in Petersburg Virginia.

  • RN - Registered Nurse - ICU - Nights

    1 week ago

    Saint Petersburg, United States BayCare Full time

    Job DescriptionWhere Expertise Meets Compassionate Care!Every day, our Registered Nurses deliver a level of excellence and compassionate care to our patients in the Intensive Care Unit. Positions details: Location: St. Anthony's Hospital – Medical/Surgical ICU – St. Petersburg, FloridaStatus: Full TimeShift: 6:45 PM - 7:15 AMEvery other weekend...

  • RN - Registered Nurse - ICU - Nights

    12 hours ago

    Saint Petersburg, United States BayCare Full time

    Job DescriptionWhere Expertise Meets Compassionate Care!Every day, our Registered Nurses deliver a level of excellence and compassionate care to our patients in the ICU. Positions details: Location: St. Anthony's Hospital – Medical/Surgical ICU – St. Petersburg, FloridaStatus: Full TimeShift: 6:45 PM - 7:15 AMEvery other weekend requirementOn Call:...

  • Clinical Director

    3 weeks ago

    Saint Petersburg, United States NurseCore Full time

    Job DescriptionJob DescriptionRN / Registered Nurse - Clinical Director - Home Health CareRegistered Nurses, use your nursing skills and management experience to improve the healthcare industry! NurseCore is seeking a Clinical Director for our St. Petersburg, FL home care office. We are a national leader in home care services making this the perfect...

  • Registered Nurse ER Mid-shift

    11 hours ago

    Saint Petersburg, United States BayCare Full time

    Job DescriptionWhere Expertise Meets Compassionate Care!Every day, our Registered Nurses deliver a level of excellence and compassionate care to our patients in the ER. Positions details: Location: St. Anthony’s Hospital 1200 Seventh Ave N, St. Petersburg, FL Status: Full TimeShift: 10:45 PM - 11:15 AMEvery other weekend requirementOn Call: NoAlways in...

  • Registered Nurse PRN

    1 week ago

    Saint Catharine, United States Addiction Recovery Care Full time

    Job DescriptionJob DescriptionAre you looking for the best place to work?  Join Addiction Recovery Care, LLC (ARC) which was selected as one of the 2024 Best Places to Work in Kentucky by the Kentucky Chamber of Commerce, based on surveys of our employees!Are you passionate about serving in an environment of shared purpose and shared goals while driving the...

  • RN - Registered Nurse - CV ICU - Nights

    1 week ago

    Saint Petersburg, United States BayCare Full time

    Job DescriptionWhere Expertise Meets Compassionate Care!Every day, our Registered Nurses deliver a level of excellence and compassionate care to our patients in the ICU. Positions details: Location: St. Anthony's Hospital – Cardiovascular ICU – St. Petersburg, FloridaStatus: Full TimeShift: 6:45 PM - 7:15 AMEvery other weekend requirementOn Call:...

  • Registered Nurse Med Surg

    1 week ago

    Saint Petersburg, United States All Med Search Full time

    Job DescriptionJob DescriptionNIGHTS ONLYAs a Medical/Surgical Registered Nurse, you will play a crucial role in the healthcare team, providing compassionate and high-quality patient care in a medical-surgical setting. Your responsibilities will include assessing, planning, implementing, and evaluating nursing care for patients with diverse medical and...

  • Registered Nurse

    Found in: Jooble US O C2 - 2 days ago

    Saint Augustine, FL, United States Community Home Health Care Full time

    We are hiring for a Full-Time Registered Nurses in the St. Augustine area! At Community Home Healthcare, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve—it truly is all about helping people. You...

  • Registered Nurse

    1 week ago

    Petersburg, United States Healthcare Staffing Professionals, Inc Full time

    Job DescriptionJob DescriptionHealthcare Staffing Professionals, Inc. is looking for a Registered Nurse (RN) to work in a Psychiatric Hospital Setting in Petersburg, VA. A successful candidate will have at least 1 year of experience as an RN and will be able to meet submission and compliance deadlines as positions are limited and submission timelines are...

  • Rn Case Manager

    1 hour ago

    Saint Charles, United States Duly Health and Care Full time

    Overview: - Full-Time, 40 hours per week. Monday through Friday, 8:00 a.m. to 5:00 p.m.; flexibility to work later as needed - Location: St. Charles, IL - Good enough isn’t for us. Duly Health and Care’s team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our...

  • Registered Nurse II

    2 weeks ago

    Petersburg, United States Encompass Health Full time

    Job DescriptionJob DescriptionRegistered Nurse Career OpportunityStarting Min. $40/hourEncompass Health: Where Nursing Meets Heart, Home, and HealingAre you seeking a nursing career deeply rooted in purpose, close to your heart and home? Encompass Health offers a transformative journey where your expertise as a Registered Nurse becomes an integral part of...

  • RN Case Manager

    Found in: Resume Library US A2 - 13 hours ago

    Saint Charles, Illinois, United States Duly Health and Care Full time

    Overview: Full-Time, 40 hours per week. Monday through Friday, 8:00 a.m. to 5:00 p.m.; flexibility to work later as needed Location: St. Charles, IL Good enough isn’t for us. Duly Health and Care’s team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our...

  • Registered Nurse

    1 week ago

    Saint Paul, United States All About Caring Home Care, LLC. Full time

    Communities of Care is seeking a Private Duty Nurse to add to our dedicated team of experienced nurses who do some of the most crucial work in the world.- Looking for 12-hour days M-F in Golden Valley.- Client: 13 yr. old trach/vent/GT/nonverbalWe offer world class care with heartfelt small community values.We'll train you.Responsibilities:- Administer...

  • Registered Nurse

    1 week ago

    Saint Paul, United States All About Caring Home Care, LLC. Full time

    Communities of Care is seeking a Private Duty Nurse to add to our dedicated team of experienced nurses who do some of the most crucial work in the world. - Looking for 12-hour days M-F in Golden Valley. - Client: 13 yr. old trach/vent/GT/nonverbal We offer world class care with heartfelt small community values. We'll train you. Responsibilities: -...