Registered Nurse (RN) Case Manager, Per Diem, Day Shifts

Hialeah Hospital; Florida; On-site; USD 68,000 - 90,000; Full time

Job summary

Hialeah Hospital in Florida is seeking a Case Manager RN to perform Case Management activities to ensure medical necessity of admissions and the appropriateness of continued stay using Interqual Criteria. You will monitor resource utilization and maintain confidential communication with physicians and a multidisciplinary team to meet patient needs.

The role combines independent contribution with strong teamwork in a busy acute care setting.

Qualifications

• Three or more years of acute care hospital experience preferred.
• Familiar with the operations of the healthcare industry and healthcare delivery systems.
• Able to use the medical record in order to obtain clinical information to perform Interqual reviews.
• Utilize Outlook, and the computer-based systems (AllScripts) to perform reviews.
• Work experience in Medical-Surgical, Telemetry, Critical Care, and/or Pediatrics, NICU preferred.

Responsibilities

• Perform Case Management activities to assure medical necessity of admissions and appropriateness of continued stay using Interqual Criteria.
• Monitor the utilization of resources of all patients reviewed.
• Maintain confidential communication with physicians and multi-disciplinary personnel to meet individual needs or the patients served.
• Functions as an independent contributor as well as a team member.

Skills

Acute care experience

Tools

AllScripts

Outlook

Job description

Job Summary:

Performs Case Management activities to assure medical necessity of admissions and appropriateness of continued stay utilizing the Interqual Criteria guidelines. Monitors the utilization of resources of all patients reviewed. Maintains confidential communication with physicians and multi-disciplinary personnel to meet individual needs or the patients served. Functions as an independent contributor as well as a team member.

Position Qualification:

Possess three or more years of acute care hospital experience preferred.

Familiar with the operations of the healthcare industry and healthcare delivery systems.

Able to use the medical record in order to obtain clinical information to perform Interqual reviews.

Utilize Outlook, and the computer-based systems (AllScripts) to perform reviews.

Work experience in Medical-Surgical, Telemetry, Critical Care, and/or Pediatrics, NICU preferred.

Required Licenses/Certifications:

Current Florida RN Licensure BLS Certification.

Must possess a solid clinical background to accomplish extensive Medical Record review.

Computer skills preferred

What Should I Know About Hialeah Hospital?

Our 378-bed acute care hospital opened in 1951 to serve the Hialeah, Florida community. Our team is committed to honoring the trust that our patients place in us by providing compassionate, safe, high-quality care in the right place, and at the right time.

Hialeah Hospital has been honored to receive a number of awards and designations for our superior health care services, including:

Cardiac

American Heart Association Get with the Guidelines - Heart Failure Gold Plus Award, 2018

American Heart Association Get with the Guidelines - Target Stroke Gold Plus Award, 2018

Bariatric

American College of Surgeons/American Society for Metabolic and Bariatric Surgery - MBSAQIP Accredited Center

BCBS â€" Blue Distinction Specialty Care Bariatric Surgery, January 2018

Neurology

Advanced Primary Stroke Center Re-accreditation, April 2018

Women's Services

American College of Radiology granted Stereotactic Breast Biopsy Re-accreditation, March 2016

Hyperbaric Unit

Healogics Center of Distinction Award, 2017

Laboratory Services/Blood Bank

Certificate of Accreditation from College of American Pathologist