SHR Talent is partnering with a healthcare client in Tallahassee, FL in its search for a Case Manager RN. This permanent, onsite opportunity is ideal for an experienced Registered Nurse with a background in acute care case management, utilization review, discharge planning, or bedside nursing who is interested in coordinating patient care across the continuum. The current priority is an evening shift from 12:00 PM to 8:30 PM with rotating weekends. Reporting to the Director of Case Management, the Case Manager RN will collaborate with physicians, nursing teams, patients, families, payors, and community resources to facilitate high-quality, efficient patient care and successful discharge planning.
The Case Manager RN will coordinate interdisciplinary plans of care with a focus on medical necessity, appropriate level of care, utilization management, patient throughput, resource utilization, and discharge planning. This individual will assess clinical and psychosocial needs, identify barriers to care, communicate with third-party payors, and ensure patients have access to the resources and services necessary for a safe transition from the hospital.
The ideal candidate is a collaborative and patient-focused Registered Nurse with strong clinical judgment, communication skills, and an understanding of acute care operations. In addition to experienced hospital Case Manager RNs, candidates with recent bedside nursing experience in Med/Surg, Telemetry, Neuro, ICU, PCU, or Emergency Department settings may be considered, making this an excellent opportunity for experienced acute care nurses interested in transitioning into RN Case Management.
Responsibilities:
- Perform comprehensive assessments of patients' clinical, psychosocial, resource, and discharge needs while developing and coordinating individualized case management plans of care
- Facilitate interdisciplinary care coordination and discharge planning by collaborating with physicians, nursing staff, patients, families, payors, outside agencies, and community resources to support safe transitions of care
- Evaluate medical necessity, admission status, observation status, level of care, and resource utilization while performing utilization management reviews and communicating relevant information to third-party payors
- Identify and address barriers to patient throughput, discharge, and quality outcomes while coordinating post-acute services and resources for high-risk, under-resourced, and chronically ill patient populations
- Document case management interventions, care coordination activities, recommendations, and discharge plans while ensuring compliance with hospital policies, regulatory requirements, quality initiatives, and patient safety standards
Qualifications:
- Associate Degree in Nursing (ADN) or Diploma in Nursing required; Bachelor of Science in Nursing (BSN) preferred
- Current Registered Nurse (RN) license in the State of Florida or appropriate Compact RN license required; candidates practicing under a Compact license must obtain an active Florida RN license within 90 days of hire
- Case Management, Nursing, or Utilization Review certification preferred but not required
- Minimum of 3 years of recent acute care Case Manager RN experience preferred; candidates with 3 years of current acute care bedside RN experience in Med/Surg, Telemetry, Neuro, ICU, PCU, or Emergency Department settings will also be considered
- Candidates with Case Manager experience in home health or insurance may be considered with at least 3 years of total acute care experience, including a minimum of 1 year of acute care experience within the past 5 years
- Strong knowledge of case management, utilization review, medical necessity, discharge planning, patient throughput, care coordination, resource management, and transitions of care preferred
- Proficiency with electronic medical records and clinical documentation systems with the ability to accurately document case management activities, patient care plans, and utilization reviews
- Excellent communication, clinical assessment, critical thinking, problem-solving, organizational, and relationship-building skills with the ability to effectively collaborate with patients, families, physicians, payors, and interdisciplinary healthcare teams
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