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Job Information

AdventHealth RN Case Manager Emergency Department Full Time Days in United States

Description

"RN Case Manager Emergency Department Full Time Days" AdventHealth Carrollwood

Location Address: 7171 North Dale Mabry Highway Tampa, Florida 33614

Top Reasons to Work At AdventHealth Carrollwood

  • Family-like culture

  • Teamwork driven both inter Dept and multidisciplinary

  • Positive working climate to support a well-balanced work life balance

Work Hours/Shift:

Full Time Days

You Will Be Responsible For:

  • Assesses clinical information to participate in the development of patient care plans on a continuum through communication with direct nursing caregivers, physicians, and other members of the health care team.

  • Assesses and make decisions which include age-specific assessment of the patients, and/or patient population served (neonate, child, adult, geriatric).

  • 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.

  • Identifies and directly addresses issues that effects patient care outcomes, collaborates with appropriate providers to prevent recurrence of issues; utilize best practice, evidence based guidelines or monitoring tools in order to develop systems to achieve optimal outcomes for patient and family/caregiver.

  • Establishes networks and referral sources to maximize utilization of available community/regional resources; value the expertise of other team members in the creation of the highest quality care.

  • Provides nursing and discharge planning expertise in collaboration with other health care professionals, to include the emergency room physician(s), Hospitalists, primary care physician and specialists, if required.

  • Acts as an advocate for an individual’s health care needs post ED discharge.

  • Establishes a trusting relationship with patients and families by active listening.

  • Provides a referral base or community-based healthcare provider partnership, and advocacy to gain access to services and resources for patients.

  • Identify patient’s barriers to self-care and the additional services needed at discharge, eg., home health, DME, caregiver support.

  • Provides recommendations for community resources to patients and families including alert systems, community partners, and prescription assistance.

  • Implements skills and intervention processes to include coaching, coordination, education of patient/family, health team members.

  • 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’s wellness and functional level.

  • Works with patients and families to assist them in understanding and participating in the development of a transition plan for community-based care; incorporates self- care, and any shared decision making with medical/durable power of attorney designee.

  • Utilizes teach back techniques to reinforce discharge instructions by the emergency department physician or nurse.

  • Assesses post hospital medical, social, and financial needs, working with the patient/family/significant other in obtaining assistance in meeting the needs; completes referrals to Social Services Staff, as needed.

  • Maintains familiarity with laws, regulations, and interpretation of the same as relates to utilization review and discharge planning.

  • Reviews and follows regulations related to HIPAA, Patient Bill of Rights, EMTALA, and Patient Choice.

  • Knowledgeable of resource management, including hospital services and funding, clinical standards and outcomes.

  • Demonstrates the understanding of requirements for pre-certification process by payers; familiar with ICD-10 and DRG coding principles.

  • Acts as liaison between the third-party payers, health care team and patient/family/significant other.

  • Coordinates continuum of care services with third party payers, ensuring the most appropriate cost-effective quality services are provided for patients.

  • Analyzes the clinical assessment data to identify immediate short term and long term patient needs across the continuum, and collaborates with ED physicians and other team members regarding the patient’s severity of presenting signs and symptoms during the final determination of the medical necessity and rationale for either an emergency room discharge or hospitalization.

  • Maintains knowledge of care delivery and length of stay through collaborative care planning, hospital/ ED protocols, recognized national practice guidelines, including CMS Quality Indicators.

  • Additional duties as required

Qualifications

What You Will Need:

  • Minimum two (2) years of experience in an acute care hospital required.

  • Minimum required – Associate of Arts in Nursing or Diploma in Nursing

  • Licensed Registered Nurse in the State of Florida

  • Case Management in an acute care setting, or Case Management in a Home Health Care setting; or Case Management for an insurance company

  • 2 hours Stroke Education within 6 months or hire date, then 1 hour annually

  • 1 hour Hip and Knee Replacement Education within 6 months of hire date, then annually

  • Emergency department experience

KNOWLEDGE AND SKILLS PREFERRED:

  • BS in Nursing (BSN)

  • Emergency department case management experience preferred

  • Case Management Certification (CCM) or American Case Management Association (ACMA)

Job Summary:

Responsible for coordinating and assuring optimum care delivery to an identified patient caseload in the Emergency Department and other areas as assigned. Identifies physical and psychological factors that could potentially increase the patient’s morbidity/mortality. Monitors resource consumption and evaluates cost/benefit to assure effective and efficient utilization of hospital resources. Promotes and provides for optimum patient outcomes through use of Case Management concepts. Identifies potential readmissions and works with providers to discuss alternatives to admission when possible. Utilizes community resources to facilitate meeting the demands of the patient/family or significant other. Utilizes community resources to facilitate meeting the demands of the patient/family significant other. Participates in the coordination and development of the Clinical Case Management program.

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.

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