Manager - RN - Case Management - FT - Days - MRH

Assumes 24-hour accountability for managing the functions of Access, Care Coordination, and Discharge Planning. With the Manager - Social Work, serves as the central resource to the Director - Case Management to develop strategies which are efficient, effective, timely, patient-centered, and support appropriate financial reimbursement. To meet accountabilities of the Care Management Dashboard, collaborates with all disciplines, departments, payers, system partners, vendors, and community agencies to optimize clinical outcomes within best practice, ethical, legal, and regulatory parameters.

Responsibilities

Assists with the preparation and evaluation of departmental budgets, and ensures that the department operates in compliance with allocated funding; Coordinates and directs internal/external audits; May collect and assess data to identify quality trends or actual sources of risk to patients and employees; Collaborates with multi-disciplinary teams and committees with respect to quality outcomes; Assists with the development and implementation of Case Management goals, plans, and standards consistent with the clinical, administrative, regulatory, legal, and ethical requirements; Assists with the management and evaluation of department operations, including information technologies, service level determination and complaint management, to achieve performance and quality control objectives; Participates in clinical performance improvement activities, including the development of clinical paths, patient/family education programs, collaborative practice groups, Six Sigma, and other quality initiatives; Manages and constantly evaluates staffing levels, assignments, skills, learning needs, and deployment of staff; Monitors staffing activities, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives; Completes annual and interim performance reviews for all staff and contributes to performance reviews of other professionals and support staff as requested

Requirements

Accredited Program: Nursing (Required); Registered Nurse Compact License (RN LICENSE COMPACT) - Compact RN Multistate; Registered Nurse License (RN LICENSE) - State of Florida (FL); Minimum of three (3) years of case management experience; At least two (2) years of leadership experience within case management; Graduate of an accredited Registered/Professional Nursing program or Bachelor's degree in Nursing (BSN); Knowledge of State and Federal regulations governing discharge planning conditions of participation; Knowledge of hospital information systems (e.g., logician and IDX); Knowledge of staff development techniques; Knowledge of performance improvement processes; Strong background in clinical decision making, medical criteria, and discharge planning; Proficient with Interqual or Milliman guidelines; Proficient in process improvement and performance monitoring; Critical thinking and effective communication (verbal and written) skills; Decisive judgment; Ability to work with minimal supervision; Ability to work in a stressful environment and take appropriate action

Nice to have

Certification in Case Management preferred