Nurse Case Manager II - Transition OD Care Registered Nurse

SGS Consulting; Tallahassee (FL); On-site; USD 60,000 - 80,000; Full time

Job summary

SGS Consulting of Florida is seeking a registered nurse to join our field-based care coordination team. The role requires residency in Florida and 75% travel to meet members face to face across counties, with at least 2 years of clinical experience.

You must be bilingual in Spanish and English and hold an active RN license in Florida (BSN preferred). Responsibilities include assessing home environments, coordinating care plans, and working with case managers to improve transitions and member

Qualifications

• Active, unrestricted RN license in Florida.
• Minimum 2 years clinical experience.
• Bi-Lingual Spanish/English required.
• Willing to travel 75% of the time to meet members.

Responsibilities

• Reside in FL and cover area.
• Perform weekly NF member assessments (min 10).
• Support rebalancing initiative and transitions.
• Assess home needs prior to discharge; coordinate ramps and DME.
• Conduct in-person Significant Change visits within 5 days of transition.
• Coordinate services, establish Plan of Care, document actions.
• Coordinate with facility business office weekly to follow census and discharge.
• Collaborate with case managers to identify high-risk members and interventions.
• Drive member satisfaction, retention and new membership growth.
• Participate in at least two community events per year.
• Build strong relationships contributing to satisfaction.

Skills

Bilingual Spanish/English

Discharge coordination

Transition of care

Home Health

Case management

Computer skills

Education

RN license in Florida

Associate Degree in Nursing

BSN preferred

Tools

EHR systems

Job description

Job Responsibilities:

• Candidate must reside in FL and area of coverage.
• Minimum 2 years of clinical experience.
• Bi-Lingual Spanish/ English required and willing and able to travel 75% of their time to meet members face to face and surrounding counties/areasComplete at least 10 NF member assessments weeklySupport the Health Plan Rebalancing Initiative goal of successful transitions: Assess, identify, screen and transition NH members into the communityFollow up on CM referrals and visit current NH members in-person at least twice a week to complete the rebalancing events and screening assessments.
• Complete telephone or in-person contact to assess the home prior to discharge and identify any environmental support needed to support transition (i.e. ramp, DME installation etc.).
• Conduct an in-person Significant Change Visit with members and Rep if applicable, within 5 days of transition.
• Coordinate provision of services as needed, establish Plan of Care, and document all actions taken.
• Contact facility's Business Office once a week to follow-up on mbr's census and will coordinate with Social Services and CM to facilitate discharge.
• Work collaboratively with case managers to identify high risk community members and implement appropriate interventions to prevent lapses or coordinate safe transition (Upon receiving referral)
• Drive enhanced value of health care to increase member satisfaction and retention and drive new membership growth.
• Be involved in at least two community relations events per year
• Engage in building strong relationships that contribute towards member satisfaction and retention

Skills:

Preferred Skills: Managed Care experience, Discharge coordination experience, Transition of care experience, Home Health experience, Case Management experiencePosition requires proficiency with computer skills which includes navigating multiple systems and ability to work in a fast-paced environmentExperience Level: Specify the level of experience required mid-levelEducation/Experience:

Active, unrestricted and good standing RN license in the state of Florida with Associate Degree Required and BSN preferred.