Under the general supervision of the Director, Case Management, is responsible for the management and coordination of total plan of patient care from the point of admission to the point of discharge. Patient case management includes utilization review for appropriateness and efficiency, initial assessment and planning for discharge needs.
- Assess and evaluates the patient's plan of care within 24 hours of admission an at least every 96 hours utilizing Milliman criteria determining appropriate patient status and medical necessity of hospital admission.
- Documents and conveys appropriate information regarding patient's admission and continued hospitalization to various payors for authorization and reimbursement purposes.
- Collaborates with physician and other members of the health care team to develop, plan, and facilitate a safe and realistic discharge plan, adjusting as needed throughout patient's hospitalization.
- Proactively monitors patient activity, identifying and resolving delay and obstacles for discharge. Monitors length of stay, readmissions, and documents avoidable days for trending and performance improvement purposes.
Work requires only minor physical exertion and/or physical strain. Work environment involves infrequent exposure to disagreeable elements.
- Bachelors or Associates Degree required. Major(s) required: Nursing.
- 2 years to <3 years
Required Licenses, Certifications, Registrations:
- State of Florida RN License