"Registered Nurse Case Manager ED Full Time Days" AdventHealth Carrollwood
Location Address: 7171 North Dale Mabry Highway Tampa, Florida 33614
- Family-like culture
- Teamwork driven both inter Dept and multidisciplinary
- Positive working climate to support a well-balanced work life balance
- Demonstrates through behavior performance, Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork.
- Meet organizational goals for patient satisfaction scores, HCAHPS Discharge Planning question percentile target score.
- Strive to provide excellence in service to hospital staff, patients and families.
- Consistently utilize five fundamentals of AIDET Acknowledge, Introduce, Duration, Explanation, Thank you.
- Committed to working as a team to improve employee satisfaction and engagement scores.
- Demonstrate care for one another and respect for each person’s unique contributions.
- Provides utilization review care that is non-judgmental and non-discriminatory.
- Demonstrates respect for human dignity and self-worth.
- Respects patient privacy, confidentiality, and dignity by adherence to all HIPAA regulations.
- Maintains a professional appearance and manner.
- Consider factors related to patient safety, effectiveness, cost and impact on practice in the delivery of Case Management services. Strives to reduce Medicare and ALOS below established benchmarks.
- Assess appropriateness of setting as indicated for medical necessity according to the approved InterQual ISD criteria. Initial and concurrent clinical reviews contain needed elements to sufficiently support.
- Utilizes InterQual®ISD criteria to ensure appropriate level of care settings.
- Passes Annual Inter-Rater reliability testing for InterQual®.
- Strives to reduce the Medicare & ALOS to below established benchmarks.
- Identifies and updates current information on community resources.
- Maintains knowledge of current managed care contracts, federal statutes, regulations and procedures and applies them in performance of review activities.
- Enhances professional knowledge and development through participation in educational programs and in-service meetings. Stays current with journal articles etc.
- Completes annual mandatory education.
- Refers cases and issues to Care Management Physician Advisor in compliance with Department procedures and follows up as indicated.
- Graduate of an accredited School of Nursing, Specific Degree/Major: Nursing
- Current license of registered nurse in Florida or licensure from another state with verification of application of eligibility for Florida licensure by endorsement
- One year acute-care nursing, charge nurse, emergency department, or crucial care nursing experienced.
- Experience in the emergency department
- Application of InterQual® Criteria set.
- Greater than three years’ experience in healthcare
- Any combination of education, training or experience that provides the knowledge, skills and abilities required to successfully accomplish the assigned duties and responsibilities of the position.
- Case Management Certification
The Case Manager is accountable for the organization, to facilitate the flow of patients to the next site (level) of care including inpatient acute care, community services or transfer to another facility/campus, sequence of services and resources that are necessary and appropriate for the achievement of patient care outcomes within effective time frames on a specific group of patients. In addition, the Case Manager will coordinate the plan of care among all members of the health care team. The Case Manager must have the professional ability to practice under minimal supervision and perform the following seven essential activities of Case Management: Appropriateness of Setting, Assessment, Planning, Implementation, Coordination, Monitoring and Evaluation, with emphasis on decreasing length of stay and monitoring cost effective health care across the continuum of care. The Case Manager must continually review the patient to facilitate status, patient needs with the appropriate level and type of medical, psychosocial, or social service as they relate across the continuum of care. The Case Manager evaluates patients for appropriateness, medical necessity, benefit systems and cost benefit analysis within the caseload according to Case Management Department Plan, policies and procedures.