Care Management Registered Nurse
2 weeks ago
Enjoy a wide range of benefits from the very first day, including:
- Paid Time Off from Day One
- Debt-free Education opportunities (Certifications and Degrees without out-of-pocket tuition costs)
Our Commitment:
At AdventHealth, we believe in the holistic well-being of every individual.
We foster a community that uplifts others in body, mind, and spirit.
AdventHealth is a place where you can excel in your career while nurturing your spiritual growth, all while contributing to the Healing Ministry of Christ. You will be appreciated for your unique contributions and experiences within our purpose-driven team, knowing that together we achieve more.Work Schedule:
Full-Time
Shift:
Days, Monday to Friday, with a weekend rotation
About the Community:
AdventHealth East Orlando is a 265-bed community hospital that has been a cornerstone for East Orlando residents since 1941, providing essential healthcare services in a rapidly growing area.
Our recent expansion has enhanced our facilities, offering a spacious patient tower and 80 new private rooms designed to improve the holistic care experience.
Role Overview:
The RN Care Manager collaborates with patients, families, social workers, nurses, physicians, and the interdisciplinary team to ensure coordinated, patient-centered care throughout the continuum.
The RN Care Manager is supervised by the Care Management Supervisor or Manager and is responsible for evaluating post-hospital needs, developing transition of care plans, and initiating these plans prior to patient discharge.
Key responsibilities include optimizing patient flow to enhance continuity of care, ensuring smooth transitions, improving patient satisfaction, ensuring safety, preventing readmissions, and managing length of stay.
Daily communication with the interdisciplinary team during rounds is crucial for this role. Core competencies include care coordination, discharge planning, and understanding medical necessity.
The RN Care Manager facilitates collaborative patient care management across the continuum, addressing barriers to timely and effective care delivery and reimbursement.
Education on resource utilization, medical necessity, and care coordination is provided to nurses, physicians, and the interdisciplinary team.
Knowledge of post-hospital care services available to patients is essential, including Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, and more.
The RN Care Manager adheres to departmental and organizational goals, policies, and procedures, ensuring quality patient care and compliance with regulations.
Actively participates in delivering exceptional customer service and maintaining respectful relationships with all stakeholders.Value Contribution:
Conducts initial evaluations for transition of care needs for all identified patients within one calendar day of admission, documenting according to established policies.
Engages with patients and caregivers (as permitted) and reviews current and past medical records during the initial evaluation.
Reviews necessary patient information, including labs, medications, history, therapy notes, and progress notes.
Incorporates patient and family care goals into transition planning and communicates these to the multidisciplinary team.
Identifies and collaborates with the interdisciplinary team to resolve potential barriers to achieving transition of care plans.
Participates in daily multidisciplinary rounds to facilitate high-quality patient care progression and transition plans.
Monitors readmission risks throughout the patient stay and coordinates interventions to mitigate these risks.
Consults with Social Work for specialized services related to psychosocial needs and complex cases.
Develops discharge plans with contingency strategies to adapt to evolving patient care needs and ensure timely coordination.
Assists with end-of-life discussions and documentation as needed.Establishes and updates anticipated transition dates and destinations based on multidisciplinary input.
Actively engages in daily rounds to review care progression and discharge plans for all assigned patients.Identifies patients who no longer meet medical necessity and escalates potential denials, documenting avoidable days and facilitating care progression.
Collaborates with Utilization Management staff regarding patient status changes and medical necessity discussions.
Ensures timely patient notifications for compliance with regulations.
Promotes professional growth by meeting educational requirements and supporting departmental goals that contribute to organizational success.
Qualifications:
Minimum Requirements:
- Associate's Degree in Nursing
- Current valid State of Florida or multistate Registered Nurse license
- 2 years of medical/hospital nursing experience
Preferred Qualifications:
- Bachelor's Degree in Nursing
- Health-related Master's Degree or MSN
- Prior experience in Care Management or Utilization Management
- Professional Certification
This facility is an equal opportunity employer, adhering to all federal, state, and local anti-discrimination laws.
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