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Registered Nurse Case Manager Full Time

Req #: 17006864
Location: ,
Job Category: Case Management
Organization: Florida Hospital Tampa

Description
Work Hours/Shift
Full Time/Days
Florida Hospital Tampa
 

Our hospital has celebrated many firsts in Tampa’s health care history since we opened our doors in 1968. Today, more than four decades later, Florida Hospital Tampa continues to offer innovative medicine as we elevate health care in the Tampa Bay region.

 

At Florida Hospital Tampa, our diverse clinical specialties provide world-class health care to our patients. We offer the most trusted, expert care in key specialties including cardiovascular care, neurosciences, orthopedics, women's health, cancer and surgery. Our skilled surgeons not only utilize minimally invasive and robot-assisted procedures, but they are also leaders in improving these advanced techniques.


You will be responsible for:
  • Patient satisfaction scores meet organizational goals, HCAHPS Discharge Planning question percentile target score.
  • Strive to provide excellence in service to hospital staff, patients and families.
  • Consistently utilize 5 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.
  • Demonstrate 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 & or Milliman criteria to ensure appropriate level of care settings.
  • Passes Annual Inter-Rater reliability testing for InterQual®.
  • Inpatient, Observation or Outpatient in a bed admission status.
  • Introduce self to patient/family within 24 to 48 hours of identification of high risk criteria or referral for specified populations and explain CM role.  Complete discharge planning screening tool within 24 to 48 hours for patients with high risk criteria, and cases received by referral.  Provide Parent/Patient/ Guardian/ Significant Other with discharge planning education/instruction based on assessed education level, barriers to learning and learning preferences to assure a positive discharge outcome.
  • Strives to reduce the Medicare & ALOS to below established benchmarks.
  • Strives to reduce the number of observation cases and the number of hours patients remain in observation status.
  • Ensures appropriate referral of cases to EHR for second level review.
  • Identifies and updates current information on community resources.
  • Maintains knowledge of current managed care contracts, federal statutes, regulations and procedures.
  • Applies them in performance of review activities.
  • Enhances professional knowledge & development through participation in educational programs and in-service meetings. Stays current with journal articles etc.
  • Completes annual mandatory education, attend and contributes to 95% of staff meetings.
 
 
Qualifications
What will you need?
  • Coordinates/facilitates patient care progression throughout the continuum.
  • Works collaboratively and maintains active communication with physicians, nursing and other members of the multi- disciplinary care team to effect timely, appropriate patient management.
  • Addresses/resolves system problems impeding diagnostic or treatment progress.  Proactively identifies and resolves delays and obstacles to discharge.
  • Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
  • Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues.     
  • Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.
  • Applies approved clinical appropriateness criteria (InterQual and CMS Compliance guidelines) to monitor appropriateness of admissions observations, inpatients, outpatients in a bed and continued stays, and documents findings based on Department standards.
  • Identifies at-risk populations using approved screening tool and follows established reporting procedures.
  • Monitors LOS and ancillary resource use on an ongoing basis.  Takes actions to achieve continuous improvement in both areas.
  • Refers cases and issues to Care Management Physician Advisor in compliance with Department procedures and follows up as indicated.
  • Assessment competency and knowledge application for all ages from newborn to geriatric.
  • Assessment competency for appropriate use of hospital services and care coordination.
  • Excellent oral communication skills.
  • Excellent written communication skills.
  • Excellent computer skills.
  • Ability to work independently
  • Graduate of an accredited School of Nursing, Specific Degree/Major: Nursing,
  • One year experience in Case Management in an acute care environment.
  • BSN (preferred)
  • Greater than 3 years’ experience (preferred)
  • 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 (preferred)
  • Current license of registered nurse in Florida or licensure from another state with verification of application of eligibility for Florida licensure by endorsement
  • Case Management Certification (preferred)

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
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