RN Case Manager

6 days ago


Orlando, United States Healthcare Recruitment Partners Full time

RN Case Manager
Greater Orlando Area, Florida

The RN Case Manager collaborates with patients, families, social workers, nurses, physicians, and interdisciplinary teams to ensure patient-centered Care Coordination. In the RN Case Manager role, it focuses on efficient, cost-effective care, smooth transitions, and patient satisfaction. The RN Case Manager is supervised by the Care Management Supervisor/Manager and is pivotal in discharge planning, Transitions of Care, and ensuring regulatory compliance.

Qualifications:

Required:

  • Registered Nurse (RN) with acute hospital nursing experience
  • Associate Degree in Nursing (ADN)
  • Prior hospital experience in Care/Utilization Management in an Acute Hospital Setting

Preferred:

  • Bachelor's or Master’s in Nursing (BSN/MSN)
  • Certification in Case Management (CCM/ACM)

Responsibilities:

Care Planning & Evaluation:

  • Conduct initial evaluations for transition needs within one day of admission
  • Review patient records (labs, medications, test results) and incorporate patient/family goals into care plans
  • Develop and adapt discharge plans based on patient progress and evolving needs

Coordination & Communication:

  • Participate in daily interdisciplinary rounds for Care Coordination
  • Collaborate with social work for complex psychosocial cases
  • Escalate care delivery barriers to leadership

Patient Support:

  • Facilitate discussions about discharge options, end-of-life care, and advance directives
  • Ensure accurate scheduling for follow-up appointments post-discharge
  • Educate patients and families about payer requirements and potential out-of-pocket costs

Compliance & Documentation:

  • Maintain accurate discharge data in EMR and compliance with Medicare requirements
  • Monitor readmission risks and implement mitigation strategies

Continuous Improvement:

  • Engage in performance improvement activities and maintain clinical competency
  • Provide education to the healthcare team on resource utilization and regulatory standards

Key Competencies

  • Care Coordination, discharge planning, and medical necessity expertise
  • Knowledge of post-hospital care services (e.g., home health, hospice, outpatient services)
  • Effective communication and problem-solving skills in a multidisciplinary environment



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