Lead RN Case Manager

Cleveland Clinic; United States; On-site; USD 85,000 - 110,000; Full time

Job summary

The Lead RN Case Manager at Cleveland Clinic Florida leads the care coordination process, acting as the key information and education resource for the interdisciplinary team and ensuring continuity of care after discharge.

You will develop patient-specific plans of care, collaborate with post-acute providers, and support documentation accuracy while guiding physicians, payors, and staff toward optimal outcomes in a day-shift schedule with on-call duties.

Qualifications

• Registered Nurse with Florida license (RN).
• BSN or bachelor's degree in healthcare field.
• CCM certification within one year of eligibility.
• Six years of experience in Care Management, Utilization Review or Discharge Planning.
• Excellent interpersonal communication and negotiation skills.
• Demonstrated leadership and strong analytical abilities.
• Knowledge of discharge planning, utilization management and managed care.

Responsibilities

• Act as the key information and education resource for the interdisciplinary team.
• Develop patient-specific plans of care and coordinate with post-acute providers.
• Ensure continuity of care after discharge.
• Support clinical documentation efforts and align with physicians and payors.
• Lead and model compliant, data-informed care management practices.

Skills

RN license

Interpersonal communication

Leadership

Analytical skills

Data management

Discharge planning knowledge

Education

BSN

Florida RN license

Job description

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

We all have the power to help, heal and change lives — beginning with our own. That's the power of the Cleveland Clinic Health System team, and The Power of Every One.

### Job Title
Lead RN Case Manager

### Location
Stuart

### Facility
Martin Health North

### Department
CRP Case Management-Cleveland Clinic Martin Health

### Job Code
000253

### Shift
Days + Call

### Schedule
8:00am-4:30pm

Job Summary

Job Details

Join the Cleveland Clinic Florida team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

The Lead RN Case Manager acts as the key information and education resource for the interdisciplinary team and works to develop organization-wide approaches to problem solving. Using your effective communication and interpersonal skills, you will help to prepare a plan of care that is patient specific and coordinate with post-acute providers to ensure continuity of care after discharge. This is a very hands-on team who feel valued in the work they do each day knowing that they have a direct impact on the patient.

A caregiver in this position works days from 8:00AM – 4:30PM, with on-callrequirement s.

A caregiver who excels in this role will:

• Promote the achievement of optimal clinical and resource outcomes.
• Facilitate pre-certification and payer authorization processes.
• Facilitate the collaborative management of patient care across the continuum, proactively identify and effectively address barriers for identified patient populations.
• Identify, develop and apply process improvement methodologies in evaluating and improving outcomes of care.
• Act as the expert involved in the clinical documentation efforts and serving as a clinical resource for coders and staff ensuring that documentation accurately reflects severity of illness and intensity of service.
• Be utilized as a sought-out expert with physician relations and communications.
• Support and act as a role model for the compliance of team members ensuring regulatory requirements are met.
• Work with leadership to align goals and visions.

Minimum qualifications for the ideal future caregiver include:

• Registered Nurse and a Bachelor's of Science in Nursing (BSN) OR Bachelor's in Healthcare field
• Current and valid license to practice as a Registered Nurse (RN) in Florida
• Case Manager Certification (CCM) required within one year of eligibility
• Six years of experience in Care Management, Utilization Review or Discharge Planning in a Healthcare setting
• Excellent interpersonal communication and negotiation skills
• Demonstrated leadership skills
• Strong analytical, data management and PC skills
• Current working knowledge of discharge planning, utilization management, Care Management, performance improvement and managed care reimbursement
• Understanding of pre-acute and post-acute venues of care and post-acute community resources
• Strong organizational and time management skills
• Can work independently and exercise sound judgment in interactions with physicians, payors and patients and their families

Preferred qualifications for the ideal future caregiver include:

• Master's of Science in Nursing (MSN) or Master's in Healthcare related field

Physical Requirements:

• Requires direct patient care.
• Requires extensive walking, telephone use, bending, reaching, and lifting items weighing twenty pounds or less.
• Must be able to work well under pressure and maintain professional demeanor under adverse conditions.
• Extensive reading, writing, use of pagers, fax machines, computers, and copiers.
• Sedentary Work - Exerting up to 10 pounds of force occasionally (Occasionally: active or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body.
• Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time.
• Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/

Please review the Equal Employment Opportunity poster .

Cleveland Clinic is pleased to be an equal employment opportunity employer.