Care Manager, RN – ED/Observation PRN

Location Address: 2450 N Orange Blossom Trail

Top Reasons to work at AdventHealth Kissimmee

• AdventHealth Kissimmee is an 83-bed community-focused hospital
• Conveniently located near Walt Disney World
• The team here is dedicated to bringing mission-focused, faith-based care to residents and visitors of Osceola and Orange Counties
• AdventHealth Kissimmee has recently expanded to include a new medical office building, patient tower, and new main entrance

Virtual Tour: https://visit360five.com/start.php?id=14216310

Work Hours/Shift: PRN Days

You will be responsible For:

• *  Uses established medical necessity criteria as described by policy to conduct screening for medically appropriate admissions. Escalates cases as appropriate to Care Management Director/Manager.  Utilizes information obtained from information systems to accurately assess patient clinical needs and treatment if available and appropriate.
• *  Provides updates to the ED and/or Observation clinical team regarding Care Management involvement with the patient during the patient’s visit.
• *  Works as a resource to the ED and/or Observation clinical team as needed.
• *  Acts as a resource and provides staff and physician education related to resource utilization, medical necessity, and federal regulation and guidelines.
• *  Works with the ED and/or Observation team to achieve optimal patient flow/throughput to enhance continuity of care, smooth and safe transition, patient satisfaction, and patient safety. 
• *  Communicates effectively with physicians to obtain necessary information to complete all medical necessity reviews as required to prevent unnecessary delays and denials of service. Participates with the healthcare team regarding the patient’s treatment plan; may communicate with patient/family as needed.
• *  Refers and may assist the Social Worker for follow-up as needed.  
• *  Responds to processes to identify patients with frequent ED visits and/or readmissions to maintain and enhance the plan of care.
• *  Utilizes thorough knowledge of various computer/information systems to perform assigned duties.
• *  Documents activities, including clinical assessments and discharge plans in a thorough and timely manner or per Care Management Department policy.
• *  Thoroughly and efficiently provides information through documentation for continuity of care.
• *  Performs other duties as assigned by Care Management leadership.

GENERAL SUMMARY:

Under general supervision of the Director and/or Manager of Care Management, in collaboration with the patient/family, social workers, physicians and interdisciplinary team, the ED/Observation RN Care Manager provides guidance regarding admissions. The ED/Observation RN Care Manager, in a team approach with the ED Social Worker/ED staff, assists with identification of readmissions, patients with potential needs for community resources or potential post-acute needs.  The ED/Observation RN Care Manager complies with Care Management departmental goals, objectives, and policies and procedures, and supports the AdventHealth mission.  The ED/Observation RN Care Manager actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all