Case Manager - PRN

ID144089
Per Diem
2708 SW Archer Road
Gainesville, FL 32608
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Job Description

UF Health Rehabilitation Hospital

Gainesville, FL

PRN Case Manager - RN, Registered Nurse, MSW

 

At UF Health Rehabilitation Hospital our services have been designed for patients who need a longer rehabilitation hospitalization for their recovery. We are currently seeking a Case Manager to join our team.

 

 

Overview of Select Medical Inpatient Rehabilitation Hospitals

 

Select Medical’s Inpatient Rehabilitation Hospitals provide advanced treatment and comprehensive care to best address the medical, physical, emotional and vocational challenges for individuals with:

  • Brain Injury
  • Spinal Cord Injury
  • Stroke
  • Amputation
  • Neurological Disorders
  • Orthopedic Conditions
  • Multiple Traumas

Responsibilities

Position Summary

The Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans.  The Case Manager, assesses the social work needs of the patient and provides social work intervention as part of the discharge planning process. The primary job functions in Case Management include: Clinical Interventions/Discharge and Care Planning Management; Fiscal Management; and Payer/Referral Management. 

Qualifications

Specific Duties

  • Clinical Interventions/Discharge and Care Planning Management: Responsible for functioning as the liaison among all parties involved with the patient both within the hospital and in the community as it relates to the development and implementation of a safe and appropriate discharge plan. The Case Manager participates as part of the interdisciplinary team developing, implementing, reviewing and revising the interdisciplinary plan of care.
  • Fiscal Management: Assures responsiveness to payer systems by maintaining ongoing communication and serving as the primary contact for all external payer sources, in turn generating revenue, enhancing reimbursement, minimizing financial risk and assuring payment for the hospital. Maintains a thorough understanding of insurance coverage and benefits, providing interpretation to patients/families of their insurance and providing patient advocacy as needed.
  • Payer/Referral Management: Identifies and fulfills the requirements and needs of payer and referral sources, overseeing negotiations of continued stay rationale, length of stays, and appeals process. Initiates activities to develop positive business relationships with payers and referral sources in order to promote repeat business and represent the hospital as a quality institution.
  • Carries a patient caseload.
  • Coordinates with other departments, i.e.: Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive fiscal management outcomes for the patient.
  • Is responsible for developing and maintaining effective interdisciplinary working relationships with other clinical treatment team members, i.e.: medical, psychology, nursing, therapy, therapeutic recreation, vocational and dietary, in order to assure clinical outcomes that are appropriate, cost-effective, and beneficial to the patient.

Minimum Education & Experience (Including Licenses)

  • BSN in Nursing or Social Work (or Bachelor’s Degree in related field) required.
  • If RN - Current state licensure as a Registered Nurse required.
  • Previous experience in case management or related area required.

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