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Patient Care Manager

2 months ago


Miami, Florida, United States Jackson Health System Full time
Job Summary

We are seeking a highly skilled and experienced Clinical Resource Coordinator to join our team at Jackson Health System. As a key member of our healthcare team, you will be responsible for coordinating, monitoring, and managing patient care resources to promote cost-effective delivery of patient care services.

Key Responsibilities
  • Lead the assessment, planning, implementation, and evaluation of new department models and initiatives.
  • Identify practice issues, systems issues, and trends utilizing medical criteria, clinical data systems, and protocols.
  • Perform problem resolution activities to maintain quality patient care.
  • Presents at administrative meetings, providing case management and social work metrics and productivity data.
  • Manage oversight of patient throughput, including assessment and evaluation to determine appropriate level of care and admission status.
  • Follow up in the outpatient setting for patients enrolled in the CRM Placement EDP program.
  • Collaborate with the Manager for Clinical Resource Management to transition CRM Placement EDP program patients to the appropriate level of care.
  • Provide management oversight for referral and problem resolution of complex discharges.
  • Collaborate with family, attending physicians, and other healthcare professionals to ensure safe discharge plans.
  • Concurrently review employee schedules for appropriate staffing coverage based on patient census.
  • Collaborate with the Chief Utilization Officer on utilization management committee activities and case consultation.
  • Demonstrate behaviors of service excellence and CARE values (Compassion, Accountability, Respect, and Expertise).
Requirements
  • Generally requires 3 to 5 years of related experience.
  • Clinical experience as a Utilization Review RN in a hospital acute care setting is strongly preferred.
  • Leadership experience in case management is highly preferred.
  • Experience with using InterQual or MCG guidelines is highly preferred.
  • BSN or Bachelor's degree in a related field is required. Master's degree is preferred.
  • Valid Florida RN license is required.
  • American Heart Association Basic Life Support (BLS) and any additional applicable life support certification for Healthcare Providers is required upon hire.