AdventHealth Lead Case Manager Full Time Days in Dade City, Florida
"L ead Case Manager Full Time Days " AdventHealth Zephyrhills
Location Address: 7050 Gall Boulevard Zephyrhills, Florida 33541
Top Reasons to Work at AdventHealth Zephyrhills
FH Zeph/Dade City Named One of America’s Best Hospitals for Heart Care, Orthopedics, Stroke Centers and Patient Safety three years in a row “2017-2019” by the Women’s Choice Award
Leapfrog Hospital Safety Grade A Spring/Fall 2018
One of only 35 Hospitals Nationally Named as a Top General Hospital by The Leapfrog Group
Four Star Recipient for Coronary Interventional Procedures in 2019 by Health grades
First in Florida to earn Advanced Certification for Total Hip and Total Knee by The Joint Commission
Full Time Days
You Will Be Responsible For
· Oversee daily operations of the Case Management utilization review/discharge planning processes, including development and/or participation in the daily assignment as well as delegation of resources to assure daily goals are met.
· Provide orientation, education and delegates responsibilities to staff based on governmental, regulatory, payor rules and regulations and staff competency.
· Provides oversight of daily initial authorization process to ensure authorization is obtained as soon as possible upon admission.
· Responsible for oversight of the daily observation management process.
· Monitor documentation compliance for required utilization review (UR) and discharge planning (DC) process efforts, through on-going monitoring of required regulatory elements within the UR/DCP process. Aligns review efforts toward goals of corporate and CMS compliance audits.
· Monitors documentation for the required CMS elements to maintain compliance with the 2 midnight rule, participates in physician education to in relation to documentation requirements as needed.
· Serves as a resource for the interdisciplinary team in problem-solving difficult cases.
· Ensures Readmission reviews are completed as necessary to identify process improvement efforts to reduce avoidable readmissions.
· Assists the Director of Case Management in monitoring the quality activities and compliance audits in the department.
· Performance Improvement (PI) Program for the Case Management Department.
· Identifies staff learning needs and works with department leaders to provide appropriate educational opportunities. Assists in the initiation of personal development activities based on identified needs
· Reports problems or concerns regarding the quality and appropriateness of patient care
delivered to the Director at the time of identification.
· Observes all established policies and procedures throughout the daily work routine.
· Performs in a calm manner during crisis or emergency situations.
· Reports observed deviations from established policies and procedures and standards of
care to the techniques in planning, assessing, implementing and evaluation of patient.
· Knowledgeable of Care Management (Cerner) System
· All other duties as assigned by the Case Management Department Director.
What You Will Need:
Licensed Registered Nurse in the State of Florida upon hire
2+ years in Case Management in an acute care setting, or Case Management in a post acute setting
EDUCATION AND EXPERIENCE PREFERRED:
BSN or MSN preferred
Case Management Certification (CCM) or
American Case Management Association (ACMA)
The Team Lead Case Manager is a non-management position directly accountable to the Director of Case Management/Care Management for certain tasks required for the daily operations of the Case Management Department in in accordance with the Utilization Management Plan, department policy and procedures, work standards, as well as assignments.
This individual will assist the Director in data management and reporting as mandated by Federal, State and Community regulatory agencies including assisting with Quality Improvement Organization (QIO) activities. The Lead Case Manager will be responsible for participating in the department process improvement monitoring and improvement activities related to utilization of hospital services requirements. The Lead will be responsible to assist the patient, family/guardian and all members of the healthcare team in the discharge planning process. Contributes to the monitoring of the quality and appropriateness of patient care delivered. Provides for safe and supportive environment for all patients, families and coworkers. Promotes and provides for optimum patient outcomes through use of Social Service concepts. Demonstrate positive communication and interpersonal skills with patients, families and coworkers.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.