RN Case Manager

Company: HCA Florida North Florida Hospital
Location: Gainesville
Posted on: April 6, 2025

Job Description:

Description

Sign-on Bonus Available Introduction

Do you have the career opportunities as a(an) RN Case Manager you want in your current role? We invest in what matters most to nurses like you - at home, at work, and at every stage in your career. We have an exciting opportunity for you to join HCA Florida North Florida Hospital which is a part of the nation's leading provider of healthcare services, HCA Healthcare.

Benefits HCA Florida North Florida Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more
• Consumer discounts through Abenity and Consumer Discounts
• Retirement readiness, rollover assistance services and preferred banking partnerships
• Education assistance (tuition, student loan, certification support, dependent scholarships)
• Colleague recognition program
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits
  
  Note: Eligibility for benefits may vary by location.
  
  Do you want to work where you have a voice? Nurses are at the forefront of our commitment to the care and improvement of human life. At HCA Healthcare, there are many ways for nurses to have a voice through professional practice councils, advisory councils, vital voices surveys, and units of distinction. We learn from our multi-generational nursing family. We partner with our Nurses at HCA Florida North Florida Hospital!
  
  Job Summary and Qualifications
  
  We are seeking a dynamic Case Management RN to join our team. The RN Case Manager f acilitates the interdisciplinary plan of care with a focus on evaluating the appropriateness of medical necessity, admission status, level of care, and discharge planning. Coordinates activities that promote quality outcomes and patient throughput. Identifies potential barriers to patient throughput and quality outcomes and facilitates appropriate discharge plans
  
  WHAT YOU WILL DO IN THIS ROLE:
  • Conducts initial and ongoing assessment of each individual patient with respect to clinical condition, level of care, and plan of care.
  • Reviews admission, pre-op orders for all components necessary for preadmission, admission process.
  • Assist the physician offices in obtaining necessary assessments prior to surgery, procedures, and/or admission.
  • Includes patient and family in care facilitation and education activities.
  • Assist in the development and implementation of critical pathways.
  • Utilizes computer support and physician advisor to determine potential outliers (length of stay and changes in condition) in continued hospital stay.
  • Communicates the benefits and changes in the various benefit plans, both in the terms of health management and financial implications to physicians and patients and families as appropriate.
  • Assists in management of payor denials; issues hospital-initiated notices of non-coverage (HINN's)
  • Distinguishes between the levels of care available and interacts with the various benefit plans and their delivery systems to coordinate this care across the continuum.
  • Defines desired clinical outcomes, sets target dates, and establishes a plan for required services and care, addressing all needs (i.e., physical, psycho-social, financial).
  • Participates in IDT rounds,
  • Conducts utilization review, evaluates clinical information, and communicates findings to physicians and payors on a timely basis in accordance with the NFRMC Utilization Review Plan and managed care contractual agreements.
  • Submits clinical information to insurance companies to ensure all days are authorized and notifies director of continued stay denials.
  • Applies decision support criteria (e.g. Interqual) appropriately.
  • Maintains accurate, up-to-date documentation in MIDAS.
  • Is cross-trained to function in any of the assigned Case Manager areas.
  • Promotes close alignment with medical and ancillary staff to facilitate appropriate patient care delivery, including alternative level of care opportunities.
  • Completes required documentation for transfer to next level of care. Coordinates with physician for optimal information related throughout the continuum.
  • Assists with patient/family/significant other's learning needs, abilities and readiness to learn. Identifies barriers to learning, such as language or culture. Integrates this information into the patient's plan of care.
  • Identifies and documents patient/family/SO's education needs in collaboration with other disciplines and implements an on-going education relevant to these needs.
  • Documents patient teaching on appropriate teaching tool for each teaching episode.
  • Ensures patient/family/SO understand discharge instructions.
    Requirements:
    
    Florida RN license and/or approved multistate RN license required. Compact license holders have 60 days to obtain the Florida license after relocation.
    BLS-AHA Provider issued card required within 30 days of start3 years of RN experience in an acute care setting is required
    Graduate of an accredited school of nursing as an RN. BSN preferred.
    2 years of Case Management experience or 3 years of nursing experience required. Case management experience preferred.
    Certification in Case Management, Nursing or Utilization Review is preferred
    
    HCA Florida North Florida Hospital is a 523-bed, full-service medical and surgical acute care center. For over 49 years, we have served North Central Florida. We offer comprehensive cardiovascular care, oncology, orthopedics, and neurosciences. We offer minimally-invasive laparoscopic and robotic surgery, weight loss surgery and treatment. Other services that we provide include women's health and wound therapy. We are fully accredited by the Joint Commission and certified as a Comprehensive Stroke Center. Our hospital has an Accredited Chest Pain Center by ACC (American College of Cardiology) and is designated as a Blue Distinction Center for Spine Surgery and Bariatric Surgery. We are committed to patient safety and quality of care. We have received the highest scores available in recognition of this commitment.
    
    HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
    
    "Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
    HCA Healthcare Co-Founder If this opportunity is your next step in your career path, we encourage you to apply for our RN Case Manager opening. We review all applications. Qualified candidates will be contacted by a member of our team. We are interviewing apply today!
    
    We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
    
    

Keywords: HCA Florida North Florida Hospital, Orlando , RN Case Manager, Executive , Gainesville, Florida