Registered Nurse Case Manager PRN

Work Hours/Shift
Per Diem
Florida Hospital North Pinellas
Florida Hospital North Pinellas is a full-service, 168-bed facility dedicated to helping our neighbors in beautiful Tarpon Springs and beyond. As a regional medical center, we offer a wide range of comprehensive services, testing and education opportunities for our community. We?ve been focused on meeting the needs of North Pinellas residents for nearly 90 years, and Florida Hospital has built its reputation for compassionate, patient-centered care for more than a century.
Important Note: Florida Hospital North Pinellas is a Smoke/Tobacco Free Campus.
Tobacco use is defined as the use of any tobacco product including the use of temporary aids to stop smoking such as nicotine patches, nicotine gum or other similar products.
Applicants being considered for employment at Florida Hospital North Pinellas will be tested for nicotine use as part of their regular pre-employment screening. Those who are identified as tobacco users will be ineligible for employment, but may reapply in six months
Drug Free/Tobacco Free Workplace
You will be responsible for:
+ Facilitate clinical patient progression through a defined plan of care to achieve optimal outcomes.
+ Facilitate a physician-specific plan of care, ensure appropriate resource utilization, and coordinate utilization review and approval by a payer.
+ Support or coordinates discharge planning services and act as an effective member of the interdisciplinary team in improving quality, services, and financial aspects of overall patient care management.
+ Complete all initial utilization reviews within 24 hours of inpatient admission.
+ Conduct concurrent reviews as appropriate per payer requirements and the Utilization Management Plan.
+ Evaluates patients for appropriateness, medical necessity, benefit systems and cost benefit analysis within the case load according to Case Management Department Plan, policies and procedures.
+ Demonstrate knowledge of payer contracts and provides clinical information to payers, in a fiscally responsible manner.
+ Participate in discharge planning role by completing initial discharge planning assessments, formulating and implementing an appropriate discharge plan.
+ Function in a team approach to coordinate appropriate and safe discharge planning from the newborn to the geriatric patient.
What will you need?
+ Experience with PC applications required. (Such as word processing, spreadsheet and graphics)
+ Knowledge/experience with DRG and ICD-9 coding preferred.
+ Must have excellent interpersonal skills, written and oral communication skills.
+ Excellent organizational skills and high degree of self-motivation highly desirable.
+ Knowledge of Interqual, utilization review, and discharge planning regulations (Preferred).
+ Diploma or AS in Nursing
+ Five (5) years prior work experience in an acute care hospital as a Registered Nurse.
+ Minimum of one (1) year prior experience in a Case Manager or Utilization Management role.
+ OR (If Applicable): Any combination of education, training or experience that provides the knowledge, skills and abilities required to successfully accomplish the assigned duties and responsibilities of the position. (Preferred)
+ Florida RN license
+ CCM or other Case Management certification preferred; experience with data analysis and interpretation (Preferred)
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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