Location:
Hollywood, Florida
We have an outstanding reputation for providing patient- and family-centered care that exceeds all expectations. Together, we have created an award-winning, nationally-recognized system where every effort is focused on delivering Deeper Caring and Smarter Healthcare throughout our communities. Career opportunities exist on diverse teams across our many facilities where you can search open positions and apply online to join #teamMHSflorida.
Learn more below.
Summary:
The role of the Entry Point Case Manager is to provide utilization management and safe discharge planning for patients presenting to the Emergency Department (ED) or other entry points in need of care. Works in collaboration with the healthcare team to problem solve patient difficulties in the case management arena. Addresses the patient's healthcare service needs as identified in the Emergency Department.
Responsibilities:
Develops working relationships with community health resources to improve outpatient access to healthcare for ED population.a. Tracks clinic patients/frequency of ED use for non-acute care.b. Provides clinic patients options for future non-acute care.c. Tracks barriers to clinic access.Screens all ED patients with potential for admission identifying payer source.Provides support for other entry points as indicated, which includes: Responding to requests about status in the PACU, and supporting the Care Coordination Center in decision making regarding acute care transfers and direct admits.Identifies and addresses patients with frequent ED use for non-urgent care or patients with high hospital admission rates.Works with attending/ED medical staff to assign appropriate designation.Provides discharge planning which focuses on the identification of available services or options for placement for ED patients. Identifies high risk patients who are greater risk for recurrent visits to the ED.Works with multi-visit patients to offer resources in the community and/or refer to ED Social Work for referrals to social service organizations.Performs utilization management responsibilities focused on determination of appropriate admission status utilizing criteria-based review and provision of resources and education to the healthcare team. Assigns appropriate admitting status: place in observation vs.admit.Works to support appropriate medical record documentation.
Competencies:
ACCOUNTABILITY, ANALYSIS AND DECISION MAKING, CLINICAL POLICIES AND STANDARDS, CUSTOMER SERVICE, DISCHARGE PLANNING CLINICAL EFFECTIVENESS, PATIENT AND FAMILY CENTERED CARE, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR, TEAM WORK
Education and Certification Requirements:
Accredited Program: Nursing (Required)BLS American Heart E-Card (BLS AHA ECARD) - American Heart Association (AMERICAN HEART), BLS American Heart RQI E-Card (BLS AHA-RQI ECARD) - American Heart Association (AMERICAN HEART), BLS Cert American Heart_non ecard (BLS AHA) - American Heart Association (AMERICAN HEART), BLS Certification Grace (BLS GRACE) - Employee Grace Period for Essential Credential (GRACE), BLS Cert Red Cross (BLS RC) - Red Cross (RED CROSS), Registered Nurse Compact License (RN LICENSE COMPACT) - Compact RN Multistate, Registered Nurse License (RN LICENSE) - State of Florida (FL)
Additional Job Information:
Complexity of Work: This role requires decisive judgment with the ability to build and foster positive relationships. The incumbent must be able to lead others and take appropriate action when required. Must be able to provide education and resources relevant to the effective progression of care, utilization of services, appropriate level of care, and safe patient transition to the patient/family and health care team. Solid clinical assessment, critical thinking, decision making and organizational skills. Demonstrated interpersonal skills, effective written and verbal communication skills, and ability to work collaboratively with internal and external customers. Knowledge of relevant Federal and State utilization review and appeal requirements preferred. Required Work Experience: Five (5) years' RN experience. Experience with medical necessity criteria, experience in discharge planning in an acute care setting and experience in an ED setting preferred. Other Information: Additional Education Info: Bachelor of Science in Nursing preferred.Additional Certification Info: Certification of Case Management (CCM) preferred.
Working Conditions and Physical Requirements:
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