Lead RN Case Manager
Cleveland Clinic
full-time
Posted on:
Location Type: Office
Location: Stuart • Florida • United States
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Job Level
About the role
- Act as the key information and education resource for the interdisciplinary team
- Develop organization-wide approaches to problem solving
- Help prepare a plan of care that is patient specific
- Coordinate with post-acute providers to ensure continuity of care after discharge
- 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 clinical documentation efforts
- Serve as a clinical resource for coders and staff ensuring documentation accurately reflects severity of illness and intensity of service
- Support and act as a role model for compliance of team members ensuring regulatory requirements are met
- Work with leadership to align goals and visions
Requirements
- 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.
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
Registered NurseBachelor's of Science in NursingCase Manager CertificationCare ManagementUtilization ReviewDischarge PlanningPerformance ImprovementManaged Care ReimbursementData ManagementClinical Documentation
Soft skills
Interpersonal CommunicationNegotiation SkillsLeadership SkillsAnalytical SkillsOrganizational SkillsTime ManagementIndependent WorkSound Judgment
Certifications
Registered Nurse LicenseCase Manager Certification