Manager - Case Management - Registered Nurse - Case Management
Company: Cleveland Clinic in Florida - Weston
Posted on: August 3, 2022
Manager - Case Management - Registered NurseWhy Cleveland
Clinic? Because here you can make an impact in the lives of our
patients, our caregivers, and our community. At Cleveland Clinic,
you'll be surrounded by individuals who are committed to making a
meaningful difference in the lives of others in a state-of-the-art
The Manager of the Case Management Department at Cleveland Clinic
Weston supervises a staff of 30 caregivers, including case
managers, clinical referral coordinators, nurse reviewers, social
workers, administrative, and clerical support, and manages the day
to day operations of the department. The Manager utilizes clinical
expertise and understanding of utilization review requirements,
discharge planning process, and Medicare regulations and
contributes to the goals of cost containment and quality care. The
Manager also provides safe and appropriate discharge plans, and
minimizes avoidable commercial payer denials. A current Registered
Nurse license for the state of Florida and a BSN degree are
required; an MSN is preferred. The ideal candidate for this
position has RN Case Manager experience and knowledge of the
Utilization Review process, strong communication skills, and enjoys
creating and maintaining structured processes that enhance the
caregiver and patient experience. This position is an integral part
of Cleveland Clinic's Care Management team and is the opportunity
for an experienced RN Case Manager to take their career to the next
* Assists with hiring, orienting, evaluating and supervising
performance of the care management and social work staff.
* Arranges schedules, evaluate caseloads and makes daily
* Evaluates and addresses educational needs of staff, conducts
performance improvement management and issues corrective action as
needed and ensures consistent applications of policies and
* Provides input into the department budget, policies and
procedures. Assists in the development of department practices and
procedures for utilization review and discharge planning, ensuring
compliance with managed care contracts and Medicare
* Analyzes productivity and other outcome measures to identify
opportunities for continuous improvement.
* Manages information systems to maximize the efficiency of
* Develops and monitors routine data quality validation.
* Acts as liaison with other review-related and discharge planning
related functions and communicates with departments as necessary to
ensure coordination of related processes and functions.
* Establish relationships with post acute care providers.
* Serves as a clinical subject matter expert for teams lead by
* Other duties as assigned.
* Registered Nurse: Bachelor of Science in Nursing (BSN) or
Bachelor's in related field required. Master's degree in nursing or
related field preferred.
* Current and valid license to practice as a Registered Nurse (RN)
in the State of Ohio.
* Professional certification as a Case Manager (CCM) required
within one year of eligibility. Preferred
Complexity of Work:
* Within scope of job, requires critical thinking skills, decisive
judgment and the ability to work with minimal supervision.
* Must be able to work in a stressful environment.
* Minimum three years of experience in utilization management, case
management, or discharge planning and three years clinical
experience required, with at least three years of experience in a
hospital/health care setting, including experience with data
collection and performance improvement activities preferred.
* Previous supervisory experience in the field of care management
or social work preferred.
* Requires the ability to sit and be stationary for prolonged
periods of time, normal or corrected vision and manual dexterity
sufficient to perform work on a personal computer.
* Requires the ability to walk to various locations throughout the
Clinic and facilities.
* Light Work - Exerting up to 20 pounds of force occasionally,
and/or up to 10 pounds of force frequently, and/or a negligible
amount of force constantly (Constantly: activity or condition
exists 2/3 or more of the time) to move objects.
* Even though the weight lifted may be only a negligible amount, a
job should be rated Light Work: (1) when it requires walking or
standing to a significant degree; or (2) when it requires sitting
most of the time but entails pushing and/or pulling of arm or leg
controls; and/or (3) when the job requires working at a production
rate pace entailing the constant pushing and/or pulling of
materials even though the weight of those materials is
* Note: The constant stress and strain of maintaining a production
rate pace, especially in an industrial setting, can be and is
physically demanding of a worker even though the amount of force
exerted is negligible.
Personal Protective Equipment:
* Follows standard precautions using personal protective equipment
Keywords: Cleveland Clinic in Florida - Weston, Fort Lauderdale , Manager - Case Management - Registered Nurse - Case Management, Executive , Weston, Florida
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