RN / Case Management Job in Kissimmee, Florida / Hospital
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Description
Standard Qualifications: Poinciana Medical Center is a four-story, 150,000 square foot hospital with 70 private beds and a six-private bed ICU. Poinciana Medical Center provides a full range of acute care services including emergency services, diagnostic imaging, inpatient and outpatient surgery, cardiac catheterization, laboratory, pharmacy, and a full range of support services. The Emergency Department is approximately 14,500 square feet and consists of 22 private treatment spaces, an EMS entrance and a helicopter pad. Poinciana Medical Center is located at 325 Cypress Parkway in Kissimmee, serving the communities of Osceola and Polk counties. POSITION SUMMARY: Provides ongoing support and expertise through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction to promote continuity of care and cost effectiveness through the integration of case management, utilization review management and discharge planning. ESSENTIAL FUNCTIONS: Ensures all admissions and continued stays meet clinical criteria for appropriateness and medical necessity. Assesses discharge planning needs and coordinates the delivery of care to meet these needs. Develops, initiates, and coordinates individual patient case management plans to ensure appropriate level of care across the continuum. Ensures plan meets patient's clinical, psychological and discharge needs in collaboration with the attending physician and interdisciplinary team. Assesses the health status of assigned patients by collecting and analyzing patient and family data, and expedites and coordinates the delivery of services to facilitate patient's progression through the healthcare system. Performs admission certification screening for patients in accordance with Utilization Plan using ISD criteria, and performs concurrent stay reviews at least every 72 hours for medical necessity using ISD criteria. Maintains documentation on discharge planning notes and charts on patient's record. Evaluates patients' educational needs concerning continuum of care and available services and provides information and materials regarding community resources, discharge options, and pre and post treatment options and costs to patient and patient families. Acts as an educational resource and provides consultation to hospital medical personnel regarding discharge planning process and applicable federal, state and local regulations; identify benefits, implications and limitations of home care as appropriate. Monitors and controls the use of healthcare resources to achieve desired patient outcomes, decrease length of stay, and decrease resource utilization. Identifies and documents delays in care and services and reports findings to department director. Tracks and trends barriers to care; makes recommendations and develops action plans to improve processes and systems.
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