Posted:
12/11/2024, 4:00:00 PM
Location(s):
North Carolina, United States ⋅ Florida, United States
Experience Level(s):
Senior
Field(s):
Medical, Clinical & Veterinary
Lead RN Case Manager
Join Cleveland Clinic’s Martin South Hospital where research and surgery are advanced, technology is leading-edge, patient care is world-class, and caregivers are family. This 100-bed hospital provides top-quality patient care to the communities in and around Martin County. Here, you will work alongside passionate physicians, nurses, and other caregivers in a family-oriented, supportive environment.
The Lead RN Case Manager acts as the key information and education resource for the interdisciplinary team and works to develop organization-wide approaches to problem solving.
A caregiver in this position works days +calls, from 8:00am—4:30pm.
A caregiver who excels in this role will:
Promote the achievement of optimal clinical and resource outcomes.
Facilitate pre-certification and payer authorization processes.
Facilitate the collaborative management of patient care across the continuum, proactively identify and effectively address barriers for identified patient populations.
Identify, develop, and apply process improvement methodologies in evaluating and improving outcomes of care.
Act as the expert involved in the clinical documentation efforts and serving as a clinical resource for coders and staff ensuring that documentation accurately reflects severity of illness and intensity of service.
Utilized as a sought-out expert with physician relations and communications.
Support and act as a role model for the compliance of team members ensuring regulatory requirements are met.
Work with leadership to align goals and visions.
Minimum qualifications for the ideal future caregiver include:
Registered Nurse and BSN OR Bachelor's in Healthcare field.
Current and valid license to practice as a Registered Nurse (RN) in Florida.
Case Manager Certification (CCM) required within one year of eligibility.
Six years of experience in Care Management, Utilization Review or Discharge Planning in a Healthcare setting.
Excellent interpersonal communication and negotiation skills.
Demonstrated leadership skills.
Strong analytical, data management and PC skills.
Current working knowledge of discharge planning, utilization management, Care Management, performance improvement and managed care reimbursement.
Understanding of pre-acute and post-acute venues of care and post-acute community resources.
Strong organizational and time management skills.
Can work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families.
Preferred qualifications for the ideal future caregiver include:
MSN or Master's in Healthcare related field.
Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/
Physical Requirements:
Requires direct patient care.
Requires extensive walking, telephone use, bending, reaching, and lifting items weighing twenty pounds or less.
Must be able to work well under pressure and maintain professional demeanor under adverse conditions.
Extensive reading, writing, use of pagers, fax machines, computers, and copiers.
Sedentary Work - Exerting up to 10 pounds of force occasionally (Occasionally: active or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body.
Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time.
Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
Personal Protective Equipment:
Follows standard precautions using personal protective equipment as required.
The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for controlled substances and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System's Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.
Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.
Please review the Equal Employment Opportunity poster.
Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities
Website: https://clevelandclinic.org/
Headquarter Location: Cleveland, Ohio, United States
Employee Count: 1001-5000
Year Founded: 1921
IPO Status: Private
Last Funding Type: Grant
Industries: Health Care ⋅ Hospital ⋅ Medical ⋅ Non Profit