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Registered Nurse, Care Manager (Pool)

 

Registered Nurse, Care Manager (Pool) - Orlando Health Orlando Regional Medical Center (ORMC)

Orlando Health is one of Floridas most comprehensive private, not-for-profit healthcare systems providing access to nearly two million Central Florida residents and has provided care for more than 4,600 international visitors annually. Our physician practices, diagnostic centers, hospitals and advanced medical treatments and procedures, along with our highly qualified team of medical specialists, have distinguished Orlando Health as a healthcare leader. We are one of Central Floridas largest employers with more than 15,000 employees and nearly 3,000 affiliated physicians supporting our philosophy of providing a continuum of care that revolves around patients needs. As a leading healthcare resource, providing world-class medical care as well as training our future healthcare providers, Orlando Health will continue to foster growth and development throughout the region for generations to come. We are looking for talented individuals to be part of our team.

Orlando Regional Medical Center at Orlando Health is seeking a Registered Nurse, Care Manager to join our ORMC Care Management team on a pool, days shift.

The Care Manager promotes and facilitates effective management of hospital resources from admission to discharge, collaborating with the assigned clinical team to identify patient most likely to benefit from care coordination services to include assessing patients risk factors and the need for care coordination, clinical utilization management and the transition to the next appropriate level of care.

Education/Training

  • Graduate of an approved school of nursing.

Licensure/Certification

  • Maintains current Florida RN license and BLS/Healthcare Provider certification are required.
  • BLS/Healthcare Provider Certification within 90 days of hire.

Experience

Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care.

Essential Functions

  • Initially and concurrently assesses all patients within assigned population to include, but not limited to:
  • Ensures compliance with all regulatory standards including Federal, State, Local and Joint Commission with review requirements for Managed Contracts, Medicare, Medicaid and Campus related to admission and continued stay approval.
  • Adheres to Utilization Management Plan.
  • Integrates National standards for care management scope of services including:
  • Communicates appropriately and timely with the interdisciplinary team and third party payers.
  • Prioritizes activities in assigned areas to focus on high risk, high cost, and problem prone areas.
  • Develops, collaborative relationships with patient business, nursing, physicians, and patient/family to facilitate efficient movement through the continuum of care.
  • Monitors and evaluates data, fiscal outcomes and other relevant information to develop and implement strategies for improvement.
  • Forwards identified quality and/or risk issues appropriately.
  • Maintains positive relationships with outside/onsite reviewers and other payer representatives.
  • Identifies cultural, socio-economic, religious, and other factors that may impact treatment.
  • Involves patients family in the development of the treatment plan as appropriate while explaining procedures, therapies, systems treatment plans, and discharge plans in age/developmental/educational specific terms to patient/family.
  • Reviews patients discharge plan at multidisciplinary meetings and/or staffing to facilitate communication with other healthcare team members.
  • Prioritizes workload to manage multiple priorities while using problem-solving skills to meet goals.
  • Enhances professional growth by participating in educational programs, current literature and/or workshops.
  • Possesses excellent interpersonal skills and ability to work in a team environment.
  • Respects the rights and privacy of others and holds staff member information in strict confidence.
  • Maintains regular attendance and complies with time and attendance policy and procedures.
  • Adheres to Orlando Healths policies and procedures, Mission, Vision and Values statement and Code of Conduct.
  • Enhances professional growth by participating in educational programs, current literature and/or workshops.

Other Related Functions

  • Maintains records and documentation of work performed in an organized and easily retrievable fashion while maintaining confidentiality of data and patient information.
  • Reviews current literature on a regular basis, maintains reference materials and updates as required, and keeps abreast of relevant reimbursement information.
  • Actively serves on committees and task forces to promote quality, cost-effective care for patient population.
  • Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast-paced environment, critical thinking and problem solving skills and computer literacy.


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