Registered Nurse Complex Case Management FT Days

Company: AdventHealth
Location: Maitland
Posted on: September 16, 2021

Job Description:

Description

Complex Care Manager AdventHealth Trickel Building

Work Hours/Shift:

• Full Time Days

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

• Collaborate and facilitate patient discharge plans initiated by acute Care Management team.
• Support and facilitate campus and system goals for capacity management through achieving length of stay goals, identification of avoidable delays, and other care management initiatives.
• Collaborate with the acute care management team, patient and family, to establish a realistic discharge plan, while identifying and documenting potential barriers to achieve the discharge plan.
• Engage in collaboration and discussion with the interdisciplinary care team when applicable.  
• Acts as patient advocate by negotiating for, and coordinating resources with payers, agencies and vendors during transition phases.
• Accurately document all interventions in compliance with CMS Conditions of Participation and DNV NIAHO standards.  Communicate effectively utilizing all available internal and external methods.  
• Identify and present cases to care management leadership at the campuses when barriers related to facilitation of movement through the healthcare continuum are evident and require leadership intervention.
• Evaluate and ensure appropriate utilization of SNFist referrals.
• Ensures proper documentation is completed for post-discharge contracts.
• Ongoing evaluation and maintenance of system discharge arrangement contracts.
• Reviews post-acute treatment plans to identify opportunities to facilitate smooth and safe transitions through the continuity of care and coordinate the discharge plan, ensuring effective and efficient utilization of resources.
• Works in collaboration with hospital and community agencies to obtain needed services and resources for patients/families/caregivers.
• Adapts quickly to changes in patient status and updates the assessment and discharge plan as the patient’s situation warrants. Stays abreast of changing healthcare trends, regulatory matters and third-party payer requirements related to discharge planning and precertification of after-care benefits.
• Performs other duties as assigned by the department manager. 

EDUCATION AND EXPERIENCE REQUIRED:

• Minimum of two years recent acute care experience
• Minimum of an additional two years of experience in healthcare related fields

EDUCATION AND EXPERIENCE PREFERRED:

• • Master’s degree in nursing

LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:

• Active Florida State License as a Registered Nurse

LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:

• Case Management certification - ACM (Accredited Case Manager), CCM (Certified Case Manager), RN-BC (Board Certified in Case Management)

GENERAL SUMMARY:

Under the general supervision of the Complex Care Supervisor, in partnership with the Care Management team, works with the patient/family, physicians, interdisciplinary team and external agencies to secure post-acute services for patients with complex, complicated post-acute needs. In collaboration with the acute Care Management team, the Complex Care RN is responsible for providing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs, in compliance with Care Management Department Policies and Procedures. The Complex Care RN ensures the patient’s progress along the continuum in an efficient and cost–effective manner. Ongoing evaluation of system discharge arrangement contracts. Payer-based requests regarding individual members are fulfilled, where appropriate and pertinent. Establishes and maintains positive working relationships with post-acute care providers. Collaborates with providers to coordinate and facilitate the discharge plan. Captures avoidable delays, especially related to transfer and/or patient discharge. Maintains compliance with CMS and DNV. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

Keywords: AdventHealth, Orlando , Registered Nurse Complex Case Management FT Days, Other , Maitland, Florida