The Case Manager RN coordinates the overall interdisciplinary plan of care for patients, from admission to discharge. Monitors care and acts as a liaison between patient/family, healthcare personnel, and insurers. Evaluates the needs of the patient, the resources available, and recommends and facilitates the plan for the best outcome. Develops a discharge plan that provides the best available resources to meet ongoing patient needs and that encourages compliance with medical advice. Identifies patient care issues and suggests revisions to or new clinical pathways to improve quality of care.

• Identifies the patients’ risk factors or obstacles to care, and discharge and readmission risk.

• Evaluates the plan of care regularly by chart review and patient interviews, as well as collaborates with the medical team to facilitate the patients’ movement through the system.

• Educates patients and families on the progression of care.

• Serves as a liaison between patients, families, and healthcare personnel to ensure necessary care is provided promptly, effectively, and in a fiscally responsible manner.

• Promotes quality care to ensure patients receive medically appropriate services in appropriate status and stay standards.

• Facilitates ongoing insurance authorization for continued stay. Facilitates regulatory notifications and patient signatures per policy.

• Maintains knowledge regarding insurance reimbursement policies.

• Relies on experience and judgement to plan and facilitate discharge and transition plans, and assures they meet the physical, social, and emotional needs of the patient.

• Adheres to University and unit-level policies and procedures and safeguards University assets.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

MINIMUM QUALIFICATIONS:

Education:

• Graduate from an accredited school of nursing, Bachelor’s degree (BSN).

Certification and Licensing:

• Valid Florida Registered Nurse License, BLS certification from the American Heart Association required.

Experience:

• Minimum 2 years of relevant experience. Minimum of one 1 year in Hospital Case Management/nursing.

• Working knowledge of patient assessment, and medical terminology.

Knowledge, Skills and Attitudes:

• Ability to communicate effectively in both oral and written form.

• Ability to recognize, analyze, and solve a variety of problems.

• Ability to analyze, organize and prioritize work under pressure while meeting deadlines.

• Ability to maintain effective interpersonal relationships.