ER Point of Entry - RN Case Manager - FT - Days - 10K Sign on Bonus - MHW

The role of the Entry Point Case Manager is to provide utilization management and safe discharge planning for patients presenting to the Emergency Department (ED) or other entry points in need of care. Works in collaboration with the healthcare team to problem solve patient difficulties in the case management arena. Addresses the patient’s healthcare service needs as identified in the Emergency Department.

Responsibilities

Provide utilization management and safe discharge planning for patients presenting to the Emergency Department (ED) or other entry points in need of care; Work in collaboration with the healthcare team to problem solve patient difficulties in the case management arena; Address the patient’s healthcare service needs as identified in the Emergency Department; Respond to requests about status in the PACU; Support the Care Coordination Center in decision making regarding acute care transfers and direct admits; Identify and address patients with frequent ED use for non-urgent care or high hospital admission rates; Work with attending/ED medical staff to assign appropriate designation; Provide discharge planning focusing on identification of available services or options for placement for ED patients; Identify high risk patients at greater risk for recurrent visits to the ED; Work with multi-visit patients to offer resources in the community and/or refer to ED Social Work; Perform utilization management responsibilities focused on determination of appropriate admission status utilizing criteria-based review; Assign appropriate admitting status: place in observation vs. admit; Support appropriate medical record documentation; Develop working relationships with community health resources to improve outpatient access to healthcare for ED population; Screen all ED patients with potential for admission identifying payer source

Requirements

Accredited Program: Nursing (Required); BLS American Heart E-Card; BLS American Heart RQI E-Card; BLS Cert American Heart_non ecard; BLS Certification Grace; BLS Cert Red Cross; Registered Nurse Compact License; Registered Nurse License - State of Florida; Three (3) years’ RN experience; Experience with medical necessity criteria, discharge planning in an acute care setting or emergency department setting; Decisive judgment with the ability to build and foster positive relationships; Ability to lead others and take appropriate action when required; Ability to provide education and resources relevant to the effective progression of care, utilization of services, appropriate level of care, and safe patient transition to the patient/family and health care team; Solid clinical assessment, critical thinking, decision making and organizational skills; Demonstrated interpersonal skills, effective written and verbal communication skills; Ability to work collaboratively with internal and external customers

Nice to have

Bachelor of Science in Nursing preferred; Certification of Case Management (CCM) preferred; Knowledge of relevant Federal and State utilization review and appeal requirements preferred

Benefits

10K Sign on Bonus; Veteran’s Preference