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Registered Nurse Care Coordinator
2 months ago
Position Overview
The RN Care Manager is dedicated to delivering exceptional Quality/No Harm, Customer Service, and Stewardship as a vital member of a multidisciplinary team in an outpatient environment. This role serves as a patient advocate, educator, and care coordinator for a designated patient demographic throughout their healthcare journey.
Key Responsibilities
- Conduct evaluations to ensure that members are receiving care in the suitable environment and at the correct level.
- Perform comprehensive assessments to gather detailed information regarding a member's unique circumstances and functioning, including Social Risk Factors, to identify individual needs. This includes collecting direct client contact details and other pertinent information. Based on the identified needs, formulate a detailed case management strategy.
- Collaborate with the member and their care team, including the primary care physician and specialists, to create a tailored care management plan.
- Execute and document specific interventions, activities, and tasks to achieve the established objectives.
- Provide health coaching to members and their families, enhancing self-management skills and offering navigation support tailored to their specific health conditions.
- Maintain thorough documentation of all member interactions, assessments, updates to care plans, and coordination of care interventions, adhering to program requirements.
- Regularly assess the effectiveness of the care plan in achieving goals and outcomes, adjusting the plan as necessary based on the member's compliance with the treatment strategy.
- Ensure the confidentiality and privacy of members, upholding safety standards and adhering to advocacy ethics, legal, and regulatory requirements.
- Educate patients, families, and significant others, serving as a resource for healthcare professionals, patients, and the community.
- Assess the suitability of members for referrals to additional care management programs and community resources, assisting in the coordination of these services.
- Engage in performance improvement initiatives, data collection, and continuous quality improvement activities.
Minimum Qualifications
- Education: Associate's degree or higher; graduation from an accredited nursing program.
- Licensure: Current unrestricted Florida RN license, capable of practicing independently.
- Certification: None required.
- Experience: Minimum of three years in a clinical setting.
- Knowledge/Skills/Abilities: Proficient computer skills, including navigation within an EMR and Microsoft Office applications; ability to work independently with minimal supervision; strong attention to detail and critical thinking abilities; excellent communication skills; capacity to maintain composure in a fast-paced environment; flexibility to work various shifts, including on-call and weekends.
Preferred Qualifications
- Education: Bachelor's degree in nursing.
- Licensure: Compact State RN license.
- Certification: Case Management Certification; Lean Yellow Belt Certification.
- Experience: Two years in Utilization Management, Case Management, or Managed Care.
- Knowledge/Skills/Abilities: Understanding of Coordination of Benefits; knowledge of healthcare reimbursement processes; familiarity with alternative treatment options and community resources; bilingual skills are a plus.
Physical Requirements
- Predominantly involves sitting or standing; occasional walking, bending, and stooping.
- Extended periods of computer use or workstation activities.
- Light physical work, including lifting or moving objects up to 20 pounds.
- Exposure to varied indoor environments with different temperatures and noise levels.
- Effective communication with others to exchange information.
- Visual acuity and hand-eye coordination necessary for task performance.
- Work environment may vary from open to confined spaces, on-site or remote.
