Case Manager Registered Nurse FT Days

Top Reasons to Work at AdventHealth Lake Wales

• A historic community with a hometown family feel; voted “friendliest small town in FL”
• Surrounded by golf courses, beautiful lakes, and outdoor adventures
• The facility is just 20 minutes away from LEGOLAND Florida
• Faith-based work environment
• Great benefits

• M-F

• Eagerly assists in conducting an effective   Utilization Management program.
• Accurately identifies through chart review of SI/IS for admit and continued stay.
• Efficiently refers cases to the Physician advisor/representative of UM comm not meeting criteria.
• Correctly identifies avoidable days and maintains a system to communicate effectively to UM committee.
• Accurately identifies relevant information that is appropriate to present to UM committee
• Distinctively establishes and maintains criteria or identifies resolutions of problems associated with utilization Review functions for committee
• Competently coordinates the overall discharges planning and social services function ensuring compliance with federal and state laws and Joint Commission of Accreditation of Hospital.
• Enthusiastically accepts client referrals and responds accordingly

• Current Florida RN license
• Minimum of three years nursing experience
• Prior experience in UR or Case management (Preferred)
• RN with three years’ experience in case management or utilization management (Preferred)

The Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of Utilization Review and Discharge Planning.  Including but not limited to daily review of medical records to determine appropriateness and medical necessity of admission, continued hospital stay and use of ancillary services.