Readmission Prevention Case Manager RN - West Palm Beach /Remote

Florida Blue; Jacksonville (FL); Remote; USD 69,000 - 87,000; Full time

Job summary

Florida Blue seeks a motivated clinical RN to support high-risk members post-discharge through assessments, care plans, and medication reconciliation. This role offers competitive pay, comprehensive benefits, and a culture focused on health and community service, making it ideal for dedicated nursing professionals.

Benefits

Medical, dental, vision insurance

Paid time off and holidays

Retirement Savings Plan

Wellness program

Qualifications

• 2+ years' clinical acute or case management experience required.
• Must have current Florida RN licensure.
• Hands-on experience with Microsoft Office necessary.

Responsibilities

• Conduct health assessments and create care plans for members.
• Perform Comprehensive Medication Reconciliation and document issues.
• Coordinate interventions and provide follow-up support post-discharge.

Skills

Clinical acute care experience

Case management experience

Communication skills

Bilingual English/Spanish

Education

Associate's degree in nursing

Tools

Microsoft Office Suite

Job description

What are the Key Responsibilities:

• Meet with members, (and/or their caregivers) who are at high risk for readmission, post discharge, in person preferrably, within 2 business days of discharge.


• Perform an assessment of members current health status, including potential knowledge deficits, environment, care giver(s) and others supports, creating a care plan identifying problems, goals and interventions, based on member's responses, conditions, needs and priorities, as appropriate.


• Conduct Comprehensive Medication Reconciliation process, including education, identification of potential medication concerns, document and address any possible issues with the ordering physician, pharmacy, etc. and provide CMR report to PCP


• Validate the initiation of planned care and services, reinforce understanding of discharge instructions utilizing teach back methods, answer questions as appropriate and address concerns.


• Coordinate/assign necessary interventions including any available community resources, enhanced benefits or flex benefit to overcome potential barriers to care, e.g. meals, transportation, etc.


• Facilitate appropriate practitioner office follow-up visit within 7-14 days of discharge. Follow-up with member and practitioner to confirm appointment was kept.


• Provide continuing telephonic support/follow up for at least 30 days post facility discharge.

What is Required:

• 2+ years' experience recent clinical acute, home care and/or case management experience


• Current Florida RN - Registered Nurse Licensure And/or Compact State Licensure Without Restriction


• Hands-on experience with Microsoft suite of products, including Word, Outlook, PowerPoint, etc., as well as navigating through multiple systems such as electronic medical records


• Ability to drive your own vehicle to and from home assessment visits, and/or in clinical settings, within Palm Beach County (West Palm Beach and surrounding areas), FL approximately 20-40% of work time


• Current and valid state driver's license


• Associate's degree in nursing

What is Preferred:

• CCM - Certified Case Manager Certification


• Home care Experience


• Bilingual English/Spanish


• Bachelor's degree in nursing

General Physical Demands
Medium work: Exerting up to 50 pounds of force occasionally and/or up to 20 pounds of force frequently to move objects.

Physical/Environmental Activities
Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Frequently May be exposed to outdoor weather conditions of cold, heat, wet, and humidity. Occasionally Must be able to ascend and descend ladders, stairs, or other equipment.

What We Offer:
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

• Medical, dental, vision, life and global travel health insurance;


• Income protection benefits: life insurance, Short- and long-term disability programs;


• Leave programs to support personal circumstances;


• Retirement Savings Plan includes employer contribution and employer match;


• Paid time off, volunteer time off, and 11 holidays


• Additional voluntary benefits available; and a comprehensive wellness program
  

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.


Typical Annualized Hiring Range: $69,400 - $86,800, within an annualized full salary range of $69,400 - $112,800

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.