Job Description

PRN Case Manager – Acute Hospital
West 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:

• Registered Nurse (RN) with acute hospital nursing experience required
• Associate Degree in Nursing (ADN) required
• Prior hospital experience in Care/Utilization Management in an Acute Hospital Setting required
• Bachelor's or Master’s in Nursing (BSN/MSN) preferred
• Certification in Case Management (CCM/ACM) preferred

Responsibilities:

• Completes Initial Evaluation for transition of care needs on all identified patients within one calendar day of admission and documents according to policies and procedures
• Interviews patient and involved care givers as well as a review of the current and past inpatient and outpatient medical record in the Initial Evaluation
• Reviews necessary patient information including labs, medications, History and Physical, Therapy notes, ED notes, test results and progress notes
• Incorporates the patient/family care goals and preferences as much as possible into the transition of care planning and communicates these goals and preferences to the multidisciplinary team
• Meets with patient/families to discuss realistic and appropriate discharge options and providers of post-hospital care
• Incorporates social determinants of health into transitions of care planning and applies risk mitigation interventions to meet the individual needs of each patient
• Identifies and collaborates with the interdisciplinary team and hospital operations to resolve potential barriers to transition of care plan achievement
• Collaborate with the multidisciplinary healthcare team daily in multidisciplinary rounds to efficiently communicate and facilitate high quality patient progression of care and transitions plans
• Evaluates the potential for readmissions throughout the patient stay through the monitoring of each patient's readmission risk scores and coordinating readmission mitigation interventions
• Consults Social Work for specialty services related to psychosocial needs, decision making needs for patients who lack capacity, patient/family adjustment needs and psychosocially complex cases
• Develops discharge plan with appropriate contingency plans throughout the hospital stay to enable adaptation to evolving patient care needs and ensure timely Care Coordination
• Assists with End-of-Life conversation, Living Wills, Advance Directives, Power of Attorney, Community DNR
• Facilitates patient care conferences with multidisciplinary team
• Establishes and documents, based on the predicted DRG and multidisciplinary team member's input, Anticipated Date of Transition (ADOT) and destination and updates
• Actively participates in daily Multidisciplinary Rounds to review progression of care and discharge plan for all assigned patients
• Proactively identifies patients who no longer meet medical necessity and escalates potential denials, documents avoidable days, and facilitates progression of care
• Collaborates with Utilization Management staff for collaboration on patient status changes and medical necessity discussions
• Ensure patient notifications are provided and documented in a timely manner for compliance: Important Medicare Letters (IML), Medicare Outpatient Observation Notice (MOON), Patient Choice, and Beneficiary Notice Letter (BNL)
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization

For our Case Management opportunities, feel free to forward a resume to Michelle Boeckmann at [email protected] or visit our Case Management website at

If this opportunity is of interest or know someone that would have interest, please feel free to contact me at your earliest convenience.

Michelle Boeckmann | President Case Management Recruitment
Direct Dial 615-465-0292

[email protected]

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Job Tags

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