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Clinical Nurse Case Coordinator
2 months ago
ABOUT NCH HEALTHCARE SYSTEM
NCH Healthcare System is a locally governed, independent non-profit organization dedicated to providing exceptional comprehensive healthcare services. Our system includes two hospitals, a network of over 700 physicians, and numerous medical facilities throughout Southwest Florida, all committed to delivering high-quality, nationally recognized healthcare.
As we evolve into an Advanced Community Healthcare System(TM), we are proud to offer: Enhanced acuity care and Centers of Excellence; Graduate Medical Education and fellowship opportunities; Endowed chairs; Research initiatives and participation in national clinical trials; Partnerships with leading healthcare organizations.
We are on a mission to promote longer, healthier, and happier lives for everyone we serve. Our commitment to care ensures that there is always more to discover at NCH.
POSITION SUMMARY
The RN Case Manager acts as a patient advocate, providing support, guidance, and coordination of care for patients, families, and caregivers throughout their health journeys. This role involves collaborating in the creation of the patient's care plan, ensuring efficient resource utilization, identifying patient needs, and establishing safe discharge plans.
KEY RESPONSIBILITIES
Responsibilities include, but are not limited to:
- Assessing all patients for clinical, psychosocial, financial, and other factors influencing their care progression, and collaborating with patients and families to set meaningful goals.
- Evaluating the understanding and engagement of patients and families in achieving their goals, integrating findings into the care plan.
- Coordinating services among community agencies, healthcare providers, and involved parties to ensure comprehensive care.
- Providing patients and families with resources and tools to make informed healthcare decisions.
- Developing clinically appropriate care plans aligned with patient needs and preferences.
- Facilitating effective communication during transitions of care, ensuring all stakeholders are informed and involved.
- Identifying community resources and advocating for solutions to address gaps in care.
- Maintaining compliance with relevant federal, state, and local regulations affecting patient advocacy.
- Ensuring patients receive appropriate care levels and participating in multidisciplinary team discussions.
- Documenting interventions and facilitating discharge processes when medical necessity is not met.
- Tracking and addressing avoidable delays in care and resource utilization.
- Educating patients and families on the financial implications of care options.
- Providing necessary clinical information for appeals related to care denials.
- Engaging in performance improvement initiatives to enhance care delivery.
- Collaborating with the utilization review team to meet organizational goals.
- Recognizing and referring situations requiring quality or risk management intervention.
EDUCATION AND QUALIFICATIONS
• Associate Degree in Nursing required; BSN preferred.
• Minimum of 1 year of experience in discharge planning, case management, managed care, or as a Registered Nurse in a clinical setting.
• Current Registered Nurse (RN) license in the state of Florida.
• Basic Life Support (BLS) certification from a recognized provider.
• Case Management Certification is preferred.
