Case Manager RN (H) Remote

NurseRemotely; United States; Remote; USD 75,000 - 105,000; Full time

Job summary

The University of Miami Health System is seeking a full-time Case Manager RN to coordinate interdisciplinary care from admission to discharge, evaluating patient needs and resources while liaising with patients, families, clinicians, and insurers.

The role emphasizes developing discharge plans, facilitating insurance authorization, ensuring timely care, and improving quality outcomes. Requires a Bachelor’s degree and RN license with at least two years of relevant experience.

Qualifications

• Bachelor’s degree required.
• RN license in good standing.
• Minimum 2 years of relevant experience.
• Strong communication and problem-solving abilities.

Responsibilities

• Identifies risk factors or obstacles to care, discharge and readmission risk.
• Evaluates care plans through chart review and patient interviews with medical team.
• Educates patients and families on progression of care.
• Liaises between patients, families and healthcare personnel to ensure care is provided promptly and effectively.
• Promotes quality care and medically appropriate services.
• Facilitates ongoing insurance authorization for continued stay.
• Notifies and secures patient signatures per policy.
• Maintains knowledge of insurance reimbursement policies.
• Plans discharge and transition care meeting physical, social and emotional needs.

Skills

Communication

Problem solving

Prioritization

Interpersonal skills

Education

Bachelor's Degree

Job description

The University of Miami UHealth Department of UMHC-SCCC Business Operations has an exciting opportunity for a full time Case Manager RN. The incumbent coordinates the overall interdisciplinary plan of care for patients, from admission to discharge. Monitors care and acts as a liaison between patient/family, healthcare personnel, and insurers. Evaluates the needs of the patient, the resources available, and recommends and facilitates the plan for the best outcome. Develops a discharge plan that provides the best available resources to meet ongoing patient needs and that encourages compliance with medical advice. Identifies patient care issues and suggests revisions to or new clinical pathways to improve quality of care.

CORE JOB FUNCTIONS

• Identifies the patients’ risk factors or obstacles to care, and discharge and readmission risk.
• Evaluates the plan of care regularly by chart review and patient interviews, as well as collaborates with the medical team to facilitate the patients’ movement through the system.
• Educates patients and families on the progression of care.
• Serves as a liaison between patients, families, and healthcare personnel to ensure necessary care is provided promptly, effectively, and in a fiscally responsible manner.
• Promotes quality care to ensure patients receive medically appropriate services in appropriate status and stay standards.
• Facilitates ongoing insurance authorization for continued stay.
• Facilitates regulatory notifications and patient signatures per policy.
• Maintains knowledge regarding insurance reimbursement policies.
• Relies on experience and judgement to plan and facilitate discharge and transition plans, and assures they meet the physical, social, and emotional needs of the patient.
• Adheres to University and unit-level policies and procedures and safeguards University assets.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS

Education:

Bachelor’s Degree

Certification and Licensing:

Registered Nurse Licensing (RN)

Experience:

Minimum 2 years of relevant experience

Knowledge, Skills and Attitudes:

• Ability to communicate effectively in both oral and written form.
• Ability to recognize, analyze, and solve a variety of problems.
• Ability to analyze, organize and prioritize work under pressure while meeting deadlines.
• Ability to maintain effective interpersonal relationships.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

Job Status:

Full time

Employee Type:

Staff