Job Description

Job Description

Pride Health is hiring an RN Case Manager in Altamonte Springs, FL! (Contract)

Schedule: Monday-Friday (8am-5pm)

Contract: 3 month contract

Pay Rate: $40-45/hour

Specific Duties:

• Prioritizes patient care needs upon initial visit and addresses emerging issues.
• Meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan as delineated in Transitions of Care program.
• Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings.
• Consults with physician and other team members to ensure that care plan is successfully implemented.
• Coordinates treatment plans with the care team and triages interventions appropriate to the skill set of the team members.
• Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize clinical outcomes.
• Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management.
• Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care.
• Works in coordination with the care team and demonstrates accountability with patient management and outcome.
• Discusses Durable Power of Attorney (DPoA) and advanced directive status with PCP when applicable.
• Maintains effective communication with the physicians, disease management, hospitalists, extended care facilities, patients and families.
• Provides accurate information to patients and families regarding plan benefits, community resources, referrals and other related issues.
• Documents pertinent patient information in Electronic Health Record and FOCUS as appropriate.
• Demonstrates a thorough understanding of the cost consequences resulting from Care Management decisions through utilization of reports and systems such as Health Plan Benefits, utilization of metrics and CM reports.
• Adheres to departmental policies and procedures as approved by Best Practice Committee and QMOC (Quality Medical Oversight Committee).
• Ability to work collaboratively with the provider and care team to carry out nursing interventions under proper scope of practice

Must have qualifications/experience:

• Active RN License
• BLS Certification
• Previous care management, utilization review or discharge planning experience.
• HMO experience is a plus
• IV Certification is a plus

Apply for this role with Pride Health!

“Pride Global offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto home insurance, pet insurance, and employee discounts with preferred vendors."

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