Manager - Case Management - Registered Nurse - Case Management

Company: Cleveland Clinic in Florida - Weston
Location: Weston
Posted on: August 3, 2022

Job Description:

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 teaching facility.

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 level.

Responsibilities:

* Assists with hiring, orienting, evaluating and supervising performance of the care management and social work staff.
* Arranges schedules, evaluate caseloads and makes daily assignments.
* Evaluates and addresses educational needs of staff, conducts performance improvement management and issues corrective action as needed and ensures consistent applications of policies and compliance.
* 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 regulations.
* Analyzes productivity and other outcome measures to identify opportunities for continuous improvement.
* Manages information systems to maximize the efficiency of discharge planning.
* 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 disciplines.
* Other duties as assigned.

Education:

* Registered Nurse: Bachelor of Science in Nursing (BSN) or Bachelor's in related field required. Master's degree in nursing or related field preferred.

Certifications:

* 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.

Work Experience:

* 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.

Physical Requirements:

* 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 negligible.
* 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 as required.

Keywords: Cleveland Clinic in Florida - Weston, Fort Lauderdale , Manager - Case Management - Registered Nurse - Case Management, Executive , Weston, Florida