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The RN Care Manager is knowledgeable of post-hospital care and services available to the patient including, but not limited to the following: Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, Transitions of Care Clinics, Transitional Care supportive programs and clinics, follow up appointments, Skilled Nursing Facilities, Rehabilitation Services and Facilities and Community-based Organizations.
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Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing.
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Related experience may include hospice and palliative care; family medicine; internal medicine; geriatrics, oncology; home health care; medical surgical. More importantly we are proud to be a community based, not for profit hospice & palliative care provider.
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Facilitate bi-directional communication to enhance the handover of care from one setting and arrange/ensure all elements of the transition plan are implemented and communicated to key stakeholders including, not limited to, the health care team, patient/family/caregiver, payers, and post-acute providers.
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JOB SUMMARYThe RN Case Manager serves as a patient advocate to support, guide and coordinate care for patients, families, and caregivers as they navigate their health and wellness journeys.
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NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
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Arranges services among community agencies, provider, patient/family/caregivers, and others involved in the plan of care. The RN Case Manager is responsible for participating in the development of the patient's plan of care and facilitating efficient throughput, ensuring appropriate utilization of resources, identifying needs, and establishing safe and appropriate discharge plans.
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Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
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Ensure the patient is in the appropriate status, level of care and length of stay for the patient’s clinical condition and participates in multidisciplinary rounds with the care team.
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Minimum of 1-2 years Discharge planning, case management, managed care, or Registered Nurse experience in a medical setting. · Actively collaborates with utilization review team to facilitate and meet organizational and department goals.
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Provide the clinical information necessary for the appeals process of cases for which a denial of care or services has been received. · Evaluates the patient’s/family's/caregiver’s level of understanding and engagement with the progress toward goals and incorporates findings into the plan of care.
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Identify available community resources/potential partners and advocate for resolution of gaps in the available resources and processes. · Educates patients/families/caregivers on the financial impact of their care options.
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Identify and address avoidable delay practice patterns that may require modification to support cost-effective care. · Develops a plan that is clinically appropriate and focused on the patient’s care needs and goals for care and treatment plan is consistent with patient choice and available resources.
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Provides patient/family/caregivers available tools/ resources including pertinent quality measures to make informed choices. · Screen all patients for clinical, psychosocial, financial, and other factors that may affect the progression of care and collaborate with patients/families/caregivers in goal setting that is reflective of the patient’s needs.
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We are committed to care and believe there's always more at NCH - for you and every person we serve together. · Licensed as a Registered Nurse (RN) in the state of Florida. · Case Management Certification preferred.
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family care team community health jobs Title: rn case manager in Raleigh, West Virginia
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