RN Full-time
Memorial Healthcare System

RN Case Manager - FT - Days - $10K Sign on Bonus - MHW

Location:

Pembroke Pines, 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 RN Case Manager coordinates the care and service of patient populations from admission through discharge. The RN Case Manager, collaboratively with inter-disciplinary teams, works to build a comprehensive case management plan through effective care coordination and utilization of healthcare resources to achieve desired clinical and financial goals. Key responsibilities are to partner with the healthcare team to ensure all aspects of the patient’s needs, clinical, psychosocial, and financial are adequately addressed in the transition of the care plan and to manage the patient’s timely progression of care and safe transition to the next most appropriate level of care.

Responsibilities:

Collaborates with the Social Worker to proactively identify the need for team and/or patient and family conferences to facilitate discussion of the patient’s condition, discuss prognosis and determine an agreed upon transition of care plan.Consults with Physicians and multidisciplinary teams regularly to evaluate the patient's status and appropriateness of medical care, including admission, length of stay (LOS), transfer, and discharge.Performs ongoing chart review to identify actual or potential issues, which may include service delivery, patient outcomes, satisfaction, compliance, cost, and reimbursement.Actively coordinates progress and the patient’s care by monitoring the length of stay (LOS) of the patient’s hospitalization, leads and facilitates rounds, and proactively works to meet expected length of stay and clinical targets/indicators.Monitors patient and family satisfaction. Responds to questions and complaints from patients, family members, and payers regarding care.Performs duties in a manner that promotes quality patient care/satisfaction, while promoting safety, cost efficiency, and a commitment to the continuous quality improvement process.Addresses system-level issues impeding diagnostic or treatment progress with the healthcare team and reports unresolved opportunities for improvement through the organizational defined escalation process (chain-of-command structure). Proactively identifies and resolves barriers to timely discharge/transition and documents avoidable delays information in accordance with health system protocols.Conducts an in-depth case management assessment of a patient’s needs at the time of admission and throughout the patient’s stay. Obtains and confirms information necessary for the development of a comprehensive discharge/transition plan of care.Clinically assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs to facilitate a safe and timely discharge to the next appropriate post acute level of care.

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 critical thinking skills, effective communication, decisive judgment, and 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. Required Work Experience: Minimum one (1) year of experience in a hospital-based Case Management practice or five (5) years in Healthcare. Other Information: Additional Education Info: Graduate of an accredited Registered/Professional Nursing Program.Additional Credential Info: Basic Life Support (BLS) Healthcare Provider required upon hire.

Working Conditions and Physical Requirements:

  • Bending and Stooping = 0%
  •  Climbing = 0%
  •  Keyboard Entry = 80%
  •  Kneeling = 0%
  •  Lifting/Carrying Patients 35 Pounds or Greater = 40%
  •  Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
  •  Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
  •  Lifting or Carrying > 75 lbs Non-Patient = 0%
  •  Pushing or Pulling 0 - 25 lbs Non-Patient = 60%
  •  Pushing or Pulling 26 - 75 lbs Non-Patient = 60%
  •  Pushing or Pulling > 75 lbs Non-Patient = 0%
  •  Reaching = 60%
  •  Repetitive Movement Foot/Leg = 0%
  •  Repetitive Movement Hand/Arm = 80%
  •  Running = 0%
  •  Sitting = 80%
  •  Squatting = 0%
  •  Standing = 80%
  •  Walking = 80%
  •  Audible Speech = 80%
  •  Hearing Acuity = 80%
  •  Smelling Acuity = 0%
  •  Taste Discrimination = 0%
  •  Depth Perception = 80%
  •  Distinguish Color = 60%
  •  Seeing - Far = 80%
  •  Seeing - Near = 80%
  •  Bio hazardous Waste = 60%
  •  Biological Hazards - Respiratory = 60%
  •  Biological Hazards - Skin or Ingestion = 60%
  •  Blood and/or Bodily Fluids = 60%
  •  Communicable Diseases and/or Pathogens = 60%
  •  Asbestos = 0%
  •  Cytotoxic Chemicals = 0%
  •  Dust = 60%
  •  Gas/Vapors/Fumes = 60%
  •  Hazardous Chemicals = 60%
  •  Hazardous Medication = 40%
  •  Latex = 60%
  •  Computer Monitor = 80%
  •  Domestic Animals = 60%
  •  Extreme Heat/Cold = 0%
  •  Fire Risk = 0%
  •  Hazardous Noise = 0%
  •  Heating Devices = 0%
  •  Hypoxia = 0%
  •  Laser/High Intensity Lights = 0%
  •  Magnetic Fields = 0%
  •  Moving Mechanical Parts = 0%
  •  Needles/Sharp Objects = 60%
  •  Potential Electric Shock = 0%
  •  Potential for Physical Assault = 60%
  •  Radiation = 0%
  •  Sudden Decompression During Flights = 0%
  •  Unprotected Heights = 0%
  •  Wet or Slippery Surfaces = 60%

Shift:

Days

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing.

If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net

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Transitions of Care coordination and post-discharge support . Member and provider engagement with motivational interviewing . Regulatory compliance and documentation accuracy . Data interpretation and actionable reporting . Cross-functional collaboration and teamwork . Time management balancing administrative and outreach duties . Values & Mission Alignment: Demonstrate integrity, respect, and empathy in all interactions. Uphold the mission to improve health outcomes and member satisfaction through proactive, compassionate care. Champion continuous learning, innovation, and professional growth. Work Information: This role requires an in-center presence, involving daily commute to assigned clinic(s) and occasional (quarterly) travel within the market to alternative clinic(s) for strategic meetings. Workstyle: Clinic-based, in-center 5 days per week . Location: Must reside in designated market area, in reasonable commutable distance to assigned clinic(s) . Hours: Monday–Friday, 8:00 AM–5:00 PM; additional time may be required . TB Statement : This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Driving Statement : This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.