Care Management RN: Coordinate Transitions & Utilization

Orlando Health, Inc.; Orlando (FL); On-site; USD 75,000 - 105,000; Full time

Job summary

Orlando Health, Inc. seeks an experienced registered nurse to join the care coordination team in Orlando, FL.

The role centers on managing patient care from admission to discharge, collaborating with clinical teams to identify candidates for care coordination, and applying utilization management practices. Responsibilities include leading multidisciplinary conferences, ensuring regulatory compliance, and guiding transitions to the appropriate level of care while maintaining patient-centered

Qualifications

• Graduate of an approved school of nursing.
• Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care.
• Must hold and maintain a current Florida RN license.
• Handle with Care Certification is required for Behavioral Health Unit within 90 days of hire.

Responsibilities

• Assess all patients within assigned population, including medical necessity screening and physician advisor review.
• Coordinate admission, diagnosis, history, treatments, resources, and transition needs.
• Assign initial DRG to determine GMLOS and monitor LOS and transitions per InterQual guidelines.
• Lead multidisciplinary patient care conferences and manage complex referrals.
• Communicate with patients and families about the plan of care and discharge planning.
• Ensure compliance with Federal, State, Local, and Joint Commission requirements and utilization plans.
• Identify and report potentially avoidable days, utilization gaps, and improve care pathways.
• Collaborate with social work, payer representatives, and other departments to facilitate care.

Skills

Care coordination

Clinical utilization management

Leadership

Communication skills

Education

Graduate of an approved school of nursing

Florida RN license

Handle with Care Certification

Job description

Orlando Health, Inc. seeks an experienced registered nurse to join the care coordination team in Orlando, FL.

The role centers on managing patient care from admission to discharge, collaborating with clinical teams to identify candidates for care coordination, and applying utilization management practices. Responsibilities include leading multidisciplinary conferences, ensuring regulatory compliance, and guiding transitions to the appropriate level of care while maintaining patient-centered