Job Description

Applies the case management process in multiple environments by collaborating with Physicians, Managed Care Reviewers, Clinical Social Workers, Patient Financial Services, third party payers, and the multidisciplinary healthcare team to assess evaluate, plan, coordinates, and facilitate management of continuum of care for the patient needs

*Demonstrates leadership ability in the role of facilitator for the team/family conferences. Serves as a patient advocate. Requests ethics conferences, as required

*Supports the Medical Staff Peer Review Committee through concurrent identification of cases failing medical staff approved quality indicators

• Monitors an on-going basis case assignment for Insurance Carrier authorization of hospital stay

*Participates in clinical quality improvement by identifying problems and/or opportunities for improvement in clinical outcomes and utilization of resources, concurrent data collection, and participation of clinical quality improvement teams/committees

*Maintains clinical competency and participates in continuing education and workshops and seminars pertinent to new regulations, resources, and process improvement

Minimum Qualifications

• Graduation from an accredited school of Professional Nursing is required. BSN and CCM preferred.

• Minimum of two (2) years acute hospital clinical experience is required.

• Recent experience in case management, utilization review, discharge planning, ongoing monitoring and evaluation of patient care delivery process is necessary.

• Must be self-directed, assertive and creative in problem solving, systems planning and patient care management in high volume work environment.

• Ability to work effectively, collaboratively with multi-disciplinary teams in multiple environments is necessary

Licensure:

• Current licensure in the State of Florida.

Additional Information

All your information will be kept confidential according to EEO guidelines.