Case Manager, RN
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Job Description
Remote RN case manager coordinating interdisciplinary care, insurance authorization, and discharge planning. Supporting patients across University of Miami’s academic health system.
Responsibilities:
- Coordinate the overall interdisciplinary plan of care for patients from admission to discharge
- Monitor care and act as a liaison between patients/families, healthcare personnel, and insurers
- Evaluate patient needs and available resources
- Recommend and facilitate plans for the best patient outcomes
- Develop discharge plans using available resources and encouraging compliance with medical advice
- Identify patient care issues and suggest revisions or new clinical pathways to improve quality of care
- Identify patient risk factors, obstacles to care, and discharge/readmission risks
- Evaluate plans of care through chart review and patient interviews
- Collaborate with the medical team to facilitate patient movement through the system
- Educate patients and families on the progression of care
- Promote quality care and appropriate services, status, and stay standards
- Facilitate ongoing insurance authorization for continued stay
- Facilitate regulatory notifications and patient signatures per policy
- Maintain knowledge of insurance reimbursement policies
- Plan and facilitate discharge and transition plans meeting patients’ physical, social, and emotional needs
- Adhere to University and unit-level policies and procedures and safeguard University assets
Requirements:
- Bachelor’s Degree
- Registered Nurse Licensing (RN)
- Minimum 2 years of relevant experience
- Ability to communicate effectively in both oral and written form
- Ability to recognize, analyze, and solve a variety of problems
- Ability to analyze, organize and prioritize work under pressure while meeting deadlines
- Ability to maintain effective interpersonal relationships
Benefits:
- Competitive salaries
- Medical insurance
- Dental insurance
- Tuition remission
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