Location:
Pembroke Pines, Florida

Summary:

Assumes 24-hour accountability for managing the functions of Access, Care Coordination, and Discharge Planning. With the Manager - Social Work, serves as the central resource to the Director - Case Management to develop strategies which are efficient, effective, timely, patient-centered, and support appropriate financial reimbursement. To meet accountabilities of the Care Management Dashboard, collaborates with all disciplines, departments, payers, system partners, vendors, and community agencies to optimize clinical outcomes within best practice, ethical, legal, and regulatory parameters.

Responsibilities:

Assists with the preparation and evaluation of departmental budgets, and ensures that the department operates in compliance with allocated funding. Coordinates and directs internal/external audits.Monitors staffing activities, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives. Completes annual and interim performance reviews for all staff and contributes to performance reviews of other professionals and support staff as requested.Manages and constantly evaluates staffing levels, assignments, skills, learning needs, and deployment of staff.Assists with the management and evaluation of department operations, including information technologies, service level determination and complaint management, to achieve performance and quality control objectives.May collect and assess data to identify quality trends or actual sources of risk to patients and employees. Collaborates with multi-disciplinary teams and committees with respect to quality outcomes.Participates in clinical performance improvement activities, including the development of clinical paths, patient/family education programs, collaborative practice groups, Six Sigma, and other quality initiatives.Assists with the development and implementation of Case Management goals, plans, and standards consistent with the clinical, administrative, regulatory, legal, and ethical requirements.

Competencies:

ACCOUNTABILITY, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION, HEALTHCARE REGULATORY ENVIRONMENT, LEADING BY COACHING, LEADING CHANGE INITIATIVES, MANAGING PEOPLE, PATIENT AND FAMILY CENTERED CARE, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR

Education and Certification Requirements:

Accredited Program: Nursing (Required)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: Responsible for day-to-day oversight and coordination of case management and discharge planning functions ensuring patient care meets quality and efficiency standards while aligning with regulatory requirements. This role requires an understanding of payer guidelines and working closely with multi-disciplinary teams to optimize patient flow. Requires critical thinking and effective communication (verbal and written) skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Knowledge of State and Federal regulations governing discharge planning conditions of participation, hospital information systems (e.g., logician and IDX), staff development techniques, and performance improvements processes. Strong background in clinical decision making, medical criteria, and discharge planning. Must be proficient with Interqual or Milliman guidelines and use. Proficient in process improvement, and performance monitoring.

Required Work Experience: Minimum of three (3) years of case management experience and, at least, two (2) years of leadership experience within case management.

Other Information: Additional Education Info: Graduate of an accredited Registered/Professional Nursing program or a Bachelor's degree in Nursing (BSN).Additional Certification Info: Certification in Case Management preferred.

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 = 80%
• Seeing - Far = 60%
• 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 = 40%
• 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:

Primarily for office workers - not eligible for shift differential

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.