RN Case Manager - Per Diem

Jupiter Medical Center Physicians Group, Inc.; United States; On-site; USD 80,000 - 100,000; Full time

Job summary

Jupiter Medical Center is seeking an RN Case Manager to lead an interdisciplinary care team, coordinating patient plans and ensuring appropriate admission status. You will interact with physicians, nurses, discharge planners, and insurers to secure necessary treatment and services.

Responsibilities include assessing needs, coordinating care, and participating in utilization review to meet state, federal, and payor requirements. Strong communication and teamwork are essential.

Qualifications

• RN licensure in Florida (required).
• BLS certification (American Heart Association) for Healthcare Providers.
• Minimum 3 years acute care nursing experience.
• Knowledge of InterQual or Milliman admission criteria.
• Familiarity with Federal and State regulations.

Responsibilities

• Lead the interdisciplinary team in patient care coordination and discharge planning.
• Engage with physicians, nurses, discharge planners, insurance providers and others to ensure appropriate admission status.
• Assess, plan, coordinate and evaluate patient needs and services.
• Perform utilization review activities to ensure compliance with payor requirements.
• Contribute to performance improvement initiatives related to patient care.

Skills

Interpersonal skills

Critical thinking

Decisive judgment

Communication effectively

Emotional intelligence

Team collaboration

Change management

Diversity and inclusion

Rapport building

Education

BSN preferred

Tools

InterQual

Milliman

Job description

Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.

Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).

Education: Graduate of an accredited school of professional nursing, BSN preferred

Experience / Qualifications

RN- Current RN licensure in the state of Florida. BLS Certification American Heart Association for Healthcare Providers

3 years acute health care nursing experience. Excellent interpersonal skills with patients, case management staff, physicians, insurance providers, transportation services, and peers.

Critical thinking skills, Decisive judgment

Ability to work with deadlines and multiple tasks. Knowledge of InterQual or Milliman admission criteria. Knowledge of Federal and State regulations.

Position Summary

The RN Case Manager functions as the leader of the interdisciplinary team.

The RN Case Manager interacts via phone and face to face with the physicians, nurses, discharge planners, insurance providers and others to ensure the patient receives the appropriate and necessary treatment in the correct admission status.

Assesses plans, coordinates, and evaluates the needs and services of the patient.

Coordinates and completes utilization review activities to ensure compliance with State, Federal and other payor requirements. Participates in performance improvement initiatives related to the management of patient care as appropriate. Performs other duties as assigned.

Team Member Competencies

Establishing Relationships

Builds effective networks, working relationships, and alliances in order to collaborate effectively within department and organization. Can relate to all kinds of people regardless of background; find topics and common interests that can be used to build rapport with others.

Peer Support

Provides guidance and feedback to help others strengthen knowledge/skills needed to accomplish tasks, solve problems, and perform effectively within the team.

Inspiring and Motivating Others

Fosters commitment and cohesiveness by facilitating cooperation and working as a team within the organization toward goal accomplishments. Work well with others, build consensus, and ensure cooperation to complete tasks and positive workflow.

Demonstrating Emotional Intelligence

Exercises self-leadership, self-awareness, and self-regulation; manages emotions so that they are expressed appropriately; leads others by showcasing adaptability, empathy, and social skills.

Acting with Integrity

Interacts with others in a way that is seen as direct and truthful; ensures confidence in individual and organizational motives and representations. Acts in a way that is consistent with personal and organizational values by keeping confidence, promises, and commitments. Clearly states goals and beliefs; informs people of their true intentions, does what they say they will do; follows through on commitments.

Being a Champion for Change and Innovation

Supports people in their efforts to try new things. Things creatively, generates novel and valuable ideas and uses these ideas to develop new or improved processes. Accepts new ways of doing things and adapts to change.

Communicating Effectively

Speaks and writes clearly, conveys information in a concise, organized and logical manner. Is adept at tailoring the message to fit the interests and needs of the audience. Listens attentively and exercises tact, discretion and diplomacy when interacting with members of the department and organization.

Promoting Diversity and Inclusion

Treats all people with dignity and respect. Demonstrates an open-minded approach to understanding people regardless of their gender, age, race, national origin, religion, ethnicity, disability status, or other characteristics. Challenge's bias and intolerance. Develops all-inclusive groups in the realms of social interaction and communication. Shows respect for the beliefs of others; encourages and promotes practices that support cultural diversity; discourages behaviors or practices that may be perceived as unfair, biased, or critical toward people with certain backgrounds.

Physical Requirements

• Hand and Wrist (Test both left and right sides)
• Grip a dynamometer for 10 seconds with a force > 10 lbs
• Pinch together the thumb & forefinger for 10 seconds with a force > 2 lbs.
• Supported Elbows (Test both left and right sides)
• Rotate wrist from left to right while holding 10 lb. weight.
• Fully flex and extend elbow while holding a 10 lb. weight.
• Shoulders (Test both left and right sides) Sustain shoulder flexion > 135 degrees while holdi