What are the responsibilities and job description for the PRN Case Manager - Acute Hospital position at Healthcare Recruitment Partners?
PRN Case Manager – Acute Hospital
Southern 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
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