Registered Nurse Case Manager Full Time
Florida Hospital Wesley Chapel
Florida Hospital Wesley Chapel has provided faith-based, whole person care to the community since it opened in 2012. Every detail of our 83-bed facility is purposefully designed to create an environment of healing for mind, body and spirit. Our hospital is equipped with state-of-the-art equipment from outpatient services to our surgical suites and inpatient care. In 2013, we also opened a 50,000-square foot Health and Wellness Center that includes an indoor track, group exercise areas, and an aquatics center with a lap pool to help community members achieve optimal health. In August 2015, the hospital began construction on am expansion that will open in December of 2016, significantly increasing the number of inpatient beds, surgical suites, and emergency department rooms.
You will be responsible for:
• Establishes treatment goals that meet the patient’s health care needs and the referral source requirements.
• Assess clinical information to develop treatment plans through frequent patient rounds and communication with direct nursing caregivers, physicians, and other members of the health care team.
• Assures the progress pathway/patient plan of care is initiated within 24 hours of admission identifying individualized patient goals/expected outcomes.
• Communicates case objectives to individuals involved in providing care to optimize compliance with the plan of care and intervenes when variances occur in the patient’s individualized plan of care.
• Acts as a resource on complex care activities.
• Identifies and directly addresses issues that affect patient care outcomes, collaborates with appropriate providers to prevent recurrence of issues.
• Establishes networks and referral sources to maximize utilization of available community/regional resources.
• Provides nursing and discharge planning expertise in collaboration with other health care professionals, especially the primary care physician and specialists if required.
• Identifies case with potential for high-risk complications and initiates a preventive plan of care.
• Acts as an advocate for an individual’s health care needs.
• Understands the physical and psychological characteristics of the disease process in the service specialty and utilizes this knowledge to coordinate resources to meet the needs of the patient.
• Understands the psychological characteristics of wellness to optimize the patient’s functional level.
• Works with patients and families to assist them in understanding and participating in the development of the plan of care.
• Assesses post hospital medical, social, and financial needs, working with the patient/family/significant other in obtaining assistance in meeting the needs.
• Evaluates the quality of services and communicates any concerns related to the service path/plan of care to the primary care physician or other members of the health care team.
• Maintains familiarity with laws, regulations, and interpretation of the same as relates to utilization review and discharge planning.
• Demonstrates the understanding of requirements for pre-certification process by payers.
• Identifies cases that would benefit from alternative care and makes appropriate recommendations to the primary care physician or payers as needed.
• Acquires data necessary to conduct review of the care delivery for the purpose of managing the length of stay and resource consumption.
• Monitors service path/plan of care, collects and analyzes variance data to modify the plan of care as necessary.
• Acts as liaison between the third party payers, health care team and patient/family/significant other.
• Coordinates, with third party payers, the progress toward established treatment goals in the most cost-effective way.
• Provides routine verbal and written documentation of the initial assessment and progress of the individual patient to the payer and/or appropriate other on a timely basis.
• Demonstrates the understanding and ability to execute the role of Case Manager, remaining up to date on changes in regulations, policies and procedures.
• Documents effectiveness of Case Management services, utilizing Case Management logs, variance analysis theory and PI monitoring.
• Applies advanced problem solving techniques in planning, assessing, implementing and evaluation of patient care.
• Understands the Case Management philosophy and principles of Interdisciplinary Team management and collaborative practice.
• Demonstrates the ability to evaluate the effectiveness of Case Management utilizing the PI process to evaluate patient outcomes.
• Utilizes tools and resources (clinical paths, databases) to develop a comprehensive plan of care.
• Demonstrates an understanding of planning and goal development techniques.
• Intervenes when variances occur in the patient’s individualized plan of care.
• Demonstrates an understanding of interviewing techniques, obtaining information needed for the plan of care from patient/family/significant other.
• Demonstrates ability to explain services and available resources (including limitations) to individuals with disabilities.
• Organizes and develops a client’s support system to facilitate an effective transition to another appropriate level of care.
• Demonstrates knowledge of assistive devices needed by individuals with disabilities.
• Demonstrates an understanding of the patient’s needs for religious and vocational services.
• Develops specialty services paths/plan of care and prioritizes program needs.
• Collaborates with physicians in developing clinical protocols.
• Collaborates with educator to review/revise clinical protocols.
• Collaborates with physicians and staff in developing needed patient education material.
• Coordinates interdisciplinary patient care conferences for target population.
• Utilizes variance information to evaluate and refine service specialty care delivery model.
• Plans, coordinates and leads patient care conferences, patient care rounds and PI teams.
• Conducts informal/formal staff education.
What will you need:
• Associate of Arts in Nursing or Diploma in Nursing
• Must obtain one (1) hour of annual Stroke education
• Must obtain one (1) hour of annual Hip Knee Joint Replacement education.
• Minimum – two (2) year’s experience in an acute care hospital required.
• Case Management in an acute care setting, or Case Management in a Home Health Care setting; or Case Management for an insurance company.
• Licensed Registered Nurse in the State of Florida
• American Case Management Association (ACMA)
• BS in Nursing preferred
• Case Management Certification (CCM) preferred
• American Case Management Association (ACMA preferred