Case Manager RN (H) Remote

University of Miami; United States; Remote; USD 85,000 - 100,000; Full time

Job summary

The University of Miami Health System is seeking a full-time Case Manager RN to coordinate the interdisciplinary plan of care from admission to discharge, monitor care, and serve as a liaison among patients, families, clinicians, and insurers.

The role assesses patient needs, develops discharge plans with available resources, and facilitates the plan to support ongoing medical and social needs while encouraging adherence to medical advice.

Qualifications

• Bachelor’s Degree required.
• Registered Nurse (RN) license.
• Minimum 2 years of relevant experience.
• Strong oral and written communication skills.
• Ability to analyze, organize, and solve problems.
• Ability to manage workload under pressure while meeting deadlines.
• Ability to maintain effective interpersonal relationships.

Responsibilities

• Identify risk factors affecting discharge and readmission.
• Evaluate care plans through chart reviews and patient interviews.
• Educate patients and families on progression of care.
• Serve as liaison among patients, families, and staff to ensure timely care.
• Promote quality and appropriate services while maintaining cost efficiency.
• Facilitate insurance authorization for continued stay.
• Assist with regulatory notifications and patient signatures.
• Stay informed on insurance reimbursement policies.
• Develop discharge plans with resources to meet ongoing needs.

Skills

Effective communication

Problem solving

Organizational skills

Care coordination

Discharge planning

Team collaboration

Education

Bachelor’s Degree

RN licensure

Job description

The University ofMiamiUHealth Department ofUMHC‐SCCC BusinessOperations 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.
• Knowledge, Skills and Attitudes: Ability to recognize, analyze, and solve a variety of problems.
• Knowledge, Skills and Attitudes: Ability to analyze, organize and prioritize work under pressure while meeting deadlines.
• Knowledge, Skills and Attitudes: 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.

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

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

The mission of the University of Miami is to transform lives through education, research, innovation, and service.

A vibrant and diverse academic and healthcare community, the University of Miami and the University of Miami Health System ("UHealth") have rapidly progressed to become one of the nation’s top research universities and academic medical centers in the nation.

Visit welcome.miami.edu/about-um to learn more about our points of pride.

The University ranks No. 55 on U.S. News & World Report’s 2022 Best Colleges list and ranked No. 49 in the 2022 Wall Street Journal/Times Higher Education College Rankings.

Bascom Palmer Eye Institute is ranked the #1 eye hospital in the USA and offers some of the nation’s premiere eye doctors to treat every eye condition for adults.

Sylvester Comprehensive Cancer, part of the Miller School of Medicine, received the prestigious National Cancer Institute designation in 2019.

The University of Miami and UHealth have also ranked among the Forbes Best Employers and Best Employers for Women on several occasions, most recently in 2022.

With more than 17,000 faculty and staff, the University strives for excellence, and is driven by a powerful mission to transform and impact the lives of its students, patients, members of the community, and people across the globe.

UHealth-University of Miami Health System ("UHealth").