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Job Description
| NURSE CASE MANAGER, RISK MANAGEMENT |
Job Code: 2676
Pay Grade: 017
FLSA Status: Exempt
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| General Functions |
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Performs professional nursing case management in compliance with the Florida Nurse Practice Act and regulatory agencies. Assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual’s health needs. Knowledge and skills related to utilization review, discharge planning and social service is an integral part of this position.
Work is performed with considerable latitude allowed for skilled judgment and initiative. Performance is reviewed through the observation of the total results and routine operation of the nursing and/or medical case management unit.
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| Representative Duties /Assignments |
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- Coordinates and assures optimum care delivery to an identified patient caseload.
- Assesses clinical information to develop treatment plans through communication with patient care coordinators, direct nursing caregivers, physicians, and other members of the health care team, and TPA telephonic nurse case managers.
- Establishes treatment goals that meet the patient’s health care needs and the requirements of referral sources.
- Provides nursing and discharge planning expertise in collaboration with other health care professionals, especially the primary care physician and specialist, if required.
- Applies advanced problem solving techniques in planning, assessing, implementing and evaluating patient care.
- Collaborates with appropriate disciplines and members of the health care team to prioritize program needs and develop plans for care, clinical protocols and patient education materials.
- Provides oversight and direction of TPA telephonic case manager.
- Performs other related as required.
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| Minimum Qualifications |
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Bachelor’s degree in Nursing and two years experience in nursing case management; or an equivalent combination of relevant education, training or experience.
Must possess and maintain current licensure from the State of Florida as a Registered Nurse.
Excellent interpersonal, verbal and written communication skills.
Computer literacy in word processing, spreadsheets and database functions.
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| Preferences |
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Strong financial analysis, delegation, coordination, evaluation, planning, and clinical assessment skills.
Credential in Case Management
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2/2/2005
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