Manager of Case Management RN Full Time Days at AdventHealth

Date Posted: 9/11/2019

Job Snapshot

  • Job Schedule
  • Location:
    Tampa, FL
  • Job Category
  • Date Posted:
  • Job ID:
  • Job Family
    Case Management
  • Travel
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Tampa

Job Description

"Manager of Case Management RN Full Time Days" AdventHealth Tampa

Location Address: 3100 East Fletcher Avenue Tampa, Florida 33613

Top Reasons to Work at AdventHealth Tampa

  • Florida Hospital Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research.
  • Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery
  • Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
  • Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.
Work Hours/Shift:
Full Time Days

You Will Be Responsible For:

Demonstrates through behavior Florida Hospital Tampa Bay Division’s core values of Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork as outlined in organization’s Performance Excellence Program.

  • Patient satisfaction scores meet organizational goals for HCAHPS.
  • Strives to provide excellence in service to hospital staff, patients and families.
  • Consistently assumes authority for department activity.
  • Integrates the department services into the organization’s primary function.
  • Reviews current professional standards for each program and makes recommendations for changes in policy, procedures, equipment, and assignments.
  • Preparation of deliverables such as Avoidable Days, Denial, and DRG Options reports for the meetings as well as any other necessary reports.
  • Manages the staff activities to ensure fulfillment of the institutional and program objectives.
  • Establishes and implements department goals and outcomes with involvement of staff in accordance with Patient Business Services goals and the hospital’s strategic planning goals.
  • Keeps staff informed of their responsibilities as well as activities and accomplishments of the hospital-wide programs.
  • Demonstrates care for one another and respect for each person’s unique contributions.
  • Serves as a clinical role model for staff. Maintains current skills & knowledge base in Case management
  • Conducts regular scheduled and as needed staff meetings.
  • Prepares and administers performance evaluation for staff.
  • Interviews for positions and makes recommendations for hiring and terminating staff.
  • Works to have staff retention.
  • Ensures new staff receives complete orientation, as well as periodic review of progress toward independence.
  • Conducts 30 & 60-day new employee assessment, administers 90 day competency evaluation.
  • Appraises and counsels staff to improve performance through meaningful, timely feedback and performance review.
  • Consider factors related to patient safety, effectiveness, cost and impact on practice in the delivery of Case Management services.
  • Daily oversight of utilization review activities to ensure compliance with Medicare and Medicaid as well as contractual agreements with Managed Care contracts.
  • Ensures staff assign working DRG’s to establish geometric mean LOS, collaborate with CDIS staff to update working DRG as needed throughout the patients stay.
  • Aware of and educates the staff to remain vigilant in tracking avoidable days, educate how it influences and improves discharge planning practice.
  • Ensures concurrent denials addressed timely, keeps denial rate within benchmarks.
  • Additional duties required

What You Will Need:
  • Current license of RN in Florida or licensure from another state with verification of application of eligibility for Florida licensure by endorsement.
  • Graduate of an accredited School of Nursing.
  • Two years in Case Management or like experience
  • One-year experience at a supervisory/manager level.
  • Experience with PC applications required (such as word processing, spreadsheets, and graphics).
  • Individuals must possess these knowledge, skills and abilities and be able to demonstrate that s/he can perform the essential functions of the job, with or without reasonable accommodation, using some other combination of skills and abilities.
    • Application of InterQual® and or Milliman® Criteria set.
    • Assessment skills and knowledge application for all ages from newborn to geriatric.
    • Assessment of appropriate use of hospital services and care coordination.
    • Excellent oral and written communication skills.
    • Excellent computer skills for data analysis and reporting.
    • Ability to function independently and self-direct.
    • Experience with PC applications required (such as word processing, spreadsheets, and graphics).
    • Excellent interpersonal skills, oral and written communication skills required.
  • BSN or other health related degree
  • MSN or health related degree preferred
  • ACM certification or CCM preferred, must obtain within one year of hire date
Job Summary:

The Manager is responsible for the daily operations, long term planning and budget of the CM department in accordance with the Utilization Management Plan and department policy and procedures. The Manager is responsible for data management and reporting as mandated by Federal, State and Community regulatory agencies including QIO activities and Corporate required reporting. Personnel management and supervision of case management Fosters cooperative working relationship with members of the Case Management team, physicians and patients to provide quality coordination and progression of care activities including: discharge planning & utilization review.  Plans, organizes, implements, and evaluates the activities of the Case Management Department, which include the functions of utilization management, discharge planning, social work services, and spiritual care as well the integration of these functions with fiscal services. Works closely with directors, physicians, nursing/clinical staff, and fiscal services to ensure that services provided by the department serve to optimize quality of patient care, utilization of hospital resources, and reimbursement by third payers.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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