- Initially and concurrently assesses all patients within assigned population to include, but not limited to: o Accurate medical necessity screening and submission for Physician Advisor review o Care coordination that includes admitting diagnosis/ medical history, current treatments, age, payment source, resources, support systems, anticipated needs, expected length of stay, appropriate level of service, special/ personal needs, and other relevant information. o Assignment of initial DRG to determine GMLOS, while concurrently monitoring and managing LOS and transition planning as appropriate through assessment and reassessment and the application of InterQual guidelines. o Leading and facilitating multi-disciplinary patient care conferences o Managing concurrent disputes o Making appropriate referrals to other departments o Identifying and referring complex patients to Social Work Services o Communicating with patients and families about the plan of care o Leading and facilitating Complex Case Review o Identification and documentation of potentially avoidable days o Identification and reporting over and underutilization Ensures compliance with all regulatory standards including Federal, State, Local and Joint Commission with review requirements for Managed Contracts, Medicare, Medicaid, and Campus related to admission and continued stay approval. Adheres to Utilization Management Plan.
- Initially and concurrently assesses all patients within assigned population to include, but not limited to: o Accurate medical necessity screening and submission for Physician Advisor review o Care coordination that includes admitting diagnosis/ medical history, current treatments, age, payment source, resources, support systems, anticipated needs, expected length of stay, appropriate level of service, special/ personal needs, and other relevant information. o Assignment of initial DRG to determine GMLOS, while concurrently monitoring and managing LOS and transition planning as appropriate through assessment and reassessment and the application of InterQual guidelines. o Leading and facilitating multi-disciplinary patient care conferences o Managing concurrent disputes o Making appropriate referrals to other departments o Identifying and referring complex patients to Social Work Services o Communicating with patients and families about the plan of care o Leading and facilitating Complex Case Review o Identification and documentation of potentially avoidable days o Identification and reporting over and underutilization Ensures compliance with all regulatory standards including Federal, State, Local and Joint Commission with review requirements for Managed Contracts, Medicare, Medicaid, and Campus related to admission and continued stay approval. Adheres to Utilization Management Plan.
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Management of the Child Day Care Service in
Found in: Orion Innovations US - 6 days ago
Sapphire Technologies Conway, FL, United States Freelance**DISTRICT OFFICE CHARLOTTENBURG-WILMERSDORF OF BERLIN** · Charlottenburg-Wilmersdorf is home to around 320,000 people from over 170 nations. We, at the district office, shape our district as an attractive living and working space. The district has been awarded the title of "Fair ...
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care manager
Found in: Lensa US 4 C2 - 5 days ago
Cohen Veterans Network Orlando, United StatesPosition Details - Aspire Health Partners careers · CARE MANAGER · Care Manager · Who are we? · Forover fifty years, Aspire Health Partners, has been one of the leadingnon-profit behavioral health companies in the Southeast. Serving nearly 40,000clients per year, with location ...
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Care Manager
Found in: Lensa US 4 C2 - 4 days ago
Bobit Business Media Orlando, United StatesJob Code: · Department: · FACT Team · FT/PT Status: · Full Time Regular · Job Location: · Crawfordville, Florida · Description: · Apalachee Center, Inc. is best known for helping individuals and families of North Florida succeed in recovering from emotional, psychiatric, and ...
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Care Manager
Found in: Lensa US 4 C2 - 6 days ago
Bobit Business Media Orlando, United StatesJob Code: Department: FACT TeamFT/PT Status: Full Time RegularJob Location: Crawfordville, FloridaDescription:Apalachee Center, Inc. is best known for helping individuals and families of North Florida succeed in recovering from emotional, psychiatric, and substance abuse crises. ...
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Manager, Care Management
Found in: Lensa US 4 C2 - 6 days ago
Orlando Health Orlando, United StatesPosition Summary: · Leads the care management team in facilitating appropriate use of hospital resources and effective discharge planning and coordination of services to transition patients to the next appropriate level of care. · Responsibilities: · Essential Functions · Man ...
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Care Manager I
Found in: Lensa US 4 C2 - 18 hours ago
Spectraforce Technologies Orlando, United StatesCare Manager I (RN) · 02 months · 60-day contract position. Compact License · Licenses/Certifications: Current state's RN license. · Remote (Florida residency is required.) · Position Purpose: · Perform care management duties to assess, plan, and coordinate all aspects of m ...
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Care Manager I
Found in: beBee S2 US - 5 days ago
Centene Corporation Orlando, United States Full timeYou could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. ...
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Inventory Specialist, Micro-Fulfillment Center
Found in: SonicJobs Direct Apply US - 5 days ago
WALGREENS Orlando, United States Full timeJob Summary: · Responsible for executing, monitoring, and training inventory best practices and standard operating procedures for the entire facility or pharmacy. Supports pharmacy inventory management activities, including receiving, counting, ordering, and facilitating returns. ...
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Care Managers
Found in: Lensa US 4 C2 - 5 days ago
Compass Senior Solutions Care Manag Maitland, United StatesJob Description · Job Description · The care manager will ensure all healthcare providers involved are up to date with case information and collaborate with patients' families, friends, and caretakers to effectively share information. The care manager will continually develop a ...
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Care Managers
Found in: ZipRecruiter Standard US C2 - 4 days ago
Compass Senior Solutions Care Manag Maitland, United StatesJob Description · Job DescriptionThe care manager will ensure all healthcare providers involved are up to date with case information and collaborate with patients' families, friends, and caretakers to effectively share information. The care manager will continually develop a netw ...
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Care Coordinator/Office Manager/Nurse
Found in: Betterteam US S2 T2 - 1 day ago
Athena Care Resources Orlando, United States Full timeCare Coordinator/Office ManagerLooking for a highly skilled office care coordinator/office manager with vast knowledge of home health care office management. · Home Health Nurse (Full-Time, Part-Time, Per-Diem) · Athena Care Resources Home Health Agency. · We're looking for new h ...
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Marketing and Sales Manager Home Health Care
Found in: Lensa US 4 C2 - 18 hours ago
Right At Home Orlando, United StatesAre you looking for a challenging role that allows you to leverage the personal connections you have in the community? Are you energized by achieving sales goals, closing the deal, and gaining market share? If so, Right at Home has the opportunity for youWe are a locally owned ho ...
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Marketing and Sales Manager Home Health Care
Found in: One Red Cent US C2 - 4 days ago
Right at Home Greater Orlando Orlando, United StatesRight at Home Greater Orlando - Are you looking for a challenging role that allows you to leverage the personal connections you have in the community? Are you energized by achieving sales goals, closing the deal, and gaining market share? If so, Right at Home has the opportunity ...
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registered nurse rn case manager home care downtown
Found in: Careerbuilder One Red US C2 - 4 days ago
Adventist Health System Orlando, FL , USA, United StatesAll the benefits and perks you need for you and your family: · * Benefits from Day One · * Paid Days Off from Day One · * Career Development · Our promise to you: · Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in ...
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Caregiver (male/female/diverse)
Found in: Orion Innovations US - 6 days ago
Emerald Enterprises Holden Heights, FL, United States FreelanceThe town of Holden Heights, FL is currently seeking a · 'Caregiver' (m/f/d) · for an indefinite part-time position of 15 to 25 hours per week at the multifunctional building in Bardowick. · The multifunctional building is set to open in April 2023 and will welcome various clubs, ...
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registered nurse rn case manager home care north orange county
Found in: Careerbuilder One Red US C2 - 4 days ago
Adventist Health System Orlando, FL , USA, United StatesAll the benefits and perks you need for you and your family: · * Benefits from Day One · * Paid Days Off from Day One · * Career Development · * Whole Person Wellbeing Resources · * Mental Health Resources and Support · Our promise to you: · Joining AdventHealth is about being pa ...
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registered nurse rn case manager home care visits winter park
Found in: Careerbuilder One Red US C2 - 4 days ago
Adventist Health System Orlando, FL , USA, United StatesAll the benefits and perks you need for you and your family: · * Benefits from Day One · * Paid Days Off from Day One · * Career Development · Our promise to you: · Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in ...
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Home Health Care Clinical Manager
Found in: Appcast Linkedin GBL C2 - 4 days ago
Parx Home Health Care Winter Park, United StatesParx Home Healthcare is seeking a friendly and experienced Clinical Manager to join our team. As the Clinical Manager, you will be responsible for overseeing the clinical operations of our agency to ensure clients receive high-quality care. Our agency believes in treating patient ...
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Home Health Care Clinical Manager
Found in: ZipRecruiter Test10S US C2 - 2 days ago
Parx Home Health Care Winter Park, United StatesJob Description · Job DescriptionParx Home Healthcare is seeking a friendly and experienced Clinical Manager to join our team. As the Clinical Manager, you will be responsible for overseeing the clinical operations of our agency to ensure clients receive high-quality care. Our ag ...
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Care Manager
Found in: MyJobHelper US C2 - 1 hour ago
Orlando Health Ocoee, United StatesPosition Summary Med Surg/Inpatient Acute Care Rehab Nursing Who are we: Commission on Accreditation of Rehabilitation Facilities (CARF International Accreditation)- more than 25 years Specialty Rehabilitation Registered nurses - currently 68% CRRN certified Patient population - ...
RN Care Manager - Orlando, FL, United States - Orlando Health
Description
RN Care Manager
Position Summary Promotes and facilitates effective management of hospital resources from admission to discharge, collaborating with the assigned clinical team to identify patient most likely to benefit from care coordination services to include assessing patients' risk factors and the need for care coordination, clinical utilization management and the transition to the next appropriate level of care.
o Utilization Management supporting medical necessity and denial prevention o Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction o Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and appropriate level of care o Education provided to physicians, patients, families, and caregivers.
Communicates appropriately and timely with the interdisciplinary team and third-party payers. Prioritizes activities in assigned areas to focus on high risk, high cost, and problem prone areas. Develops, collaborative relationships with patient business, nursing, physicians, and patient/family to facilitate efficient movement through the continuum of care. Monitors and evaluates data, fiscal outcomes, and other relevant information to develop and implement strategies for improvement. Forwards identified quality and/or risk issues appropriately. Maintains positive relationships with outside/onsite reviewers and other payer representatives. Identifies cultural, socio-economic, religious, and other factors that may impact treatment.Involves patient's family in the development of the treatment plan as appropriate while explaining procedures, therapies, systems treatment plans, and discharge plans in age/developmental/educational specific terms to patient/family.
Reviews patient's discharge plan at multidisciplinary meetings and/or staffing to facilitate communication with other healthcare team members. Prioritizes workload to manage multiple priorities while using problem-solving skills to meet goals. Enhances professional growth by participating in educational programs, current literature and/or workshops. Possesses excellent interpersonal skills and ability to work in a team environment. Respects the rights and privacy of others and holds staff member information in strict confidence. Maintains regular attendance and complies with time and attendance policy and procedures. Adheres to Orlando Health's policies and procedures, Mission, Vision and Values statement and Code of Conduct. Enhances professional growth by participating in educational programs, current literature and/or workshops. Qualifications Education/Training Graduate of an approved school of nursing. Licensure/Certification Maintains current Florida RN license and BLS/Healthcare Provider certification are required. BLS/Healthcare Provider Certification within 90 days of hire.Experience Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care.
Education/Training Graduate of an approved school of nursing. Licensure/Certification Maintains current Florida RN license and BLS/Healthcare Provider certification are required. BLS/Healthcare Provider Certification within 90 days of hire.Experience Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care.
o Utilization Management supporting medical necessity and denial prevention o Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction o Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and appropriate level of care o Education provided to physicians, patients, families, and caregivers.
Communicates appropriately and timely with the interdisciplinary team and third-party payers. Prioritizes activities in assigned areas to focus on high risk, high cost, and problem prone areas. Develops, collaborative relationships with patient business, nursing, physicians, and patient/family to facilitate efficient movement through the continuum of care. Monitors and evaluates data, fiscal outcomes, and other relevant information to develop and implement strategies for improvement. Forwards identified quality and/or risk issues appropriately. Maintains positive relationships with outside/onsite reviewers and other payer representatives. Identifies cultural, socio-economic, religious, and other factors that may impact treatment.Involves patient's family in the development of the treatment plan as appropriate while explaining procedures, therapies, systems treatment plans, and discharge plans in age/developmental/educational specific terms to patient/family.
Reviews patient's discharge plan at multidisciplinary meetings and/or staffing to facilitate communication with other healthcare team members. Prioritizes workload to manage multiple priorities while using problem-solving skills to meet goals. Enhances professional growth by participating in educational programs, current literature and/or workshops. Possesses excellent interpersonal skills and ability to work in a team environment. Respects the rights and privacy of others and holds staff member information in strict confidence. Maintains regular attendance and complies with time and attendance policy and procedures. Adheres to Orlando Health's policies and procedures, Mission, Vision and Values statement and Code of Conduct. Enhances professional growth by participating in educational programs, current literature and/or workshops.
RN Care Manager professionals in Orlando
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myah alba
Server
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Jillian Pinnock
Hard-working, dedicated and supportive accounting professional with proven experience working in a c ...