Registered Nurse Manager - Case Management - Full Time

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This position functions as Manager of the Case Managers and Utilization Review for all inpatient UMHC facilities under the direction of the Director of Case Management, to include all inpatient CM areas for UMHC-Bascom Palmer, Sylvester and UHealth Tower.

This position analyzes and distributes daily Case Manager assignments, coordination of monthly schedules, daily report management, denial management, creates action plans for continuous improvement, maintains and creates reports for the Utilization Management Committee Meetings.

The manager will assume the oversight of the department in the absence of the director for all 3 facilities and other manager and or supervisors;

this position will also be responsible to complete direct report annual evaluations and make recommendations regarding employee discipline.

The person in this position will be available to assist Case Managers and Social Workers when experiencing family / physician issues and attempt to resolve such issues.

In addition to the above administrative responsibilities, the manager may be responsible to function as a Case Manager as well.

This position will assist the director with physician, patient and family issues, multidisciplinary treatment team, Managed Care plans, and when indicated, legal representative(s).

Facilitates delivery of clinical and community services to patients and families through effective utilization of available resources.

Manage the observation patient process, assist the Admitting department with bed assignment and appropriate placement, conduct InterQual® reviews, EQ Health reviews, coordinate monthly statistics for data reporting-Avoidable data, denial data and Physician Advisor reviews, HINN Data.

Ensures the appropriateness and cost effectiveness of treatment as well as generating all the letters to the physicians from the Utilization Management Committee Meeting.

Proactively works with physician(s) regarding medical necessity for hospital services.

Facilitates decision making in establishing an evaluation program, an interdisciplinary treatment plan, and an assessment of the patient's status and need for provision of continuing care.

Work weekends if and when necessary.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

MINIMUM QUALIFICATIONS :

Education :

Graduate from an accredited school of nursing, Bachelor’s degree (BSN).

Experience :

Minimum of five years in Hospital Case / Care Management / nursing and 1 year of management.

Certification and Licensing :

Valid Florida Registered Nurse License, BLS certification from the American Heart Association required.

Knowledge, Skills and Attitudes :

Knowledge of business and management principles.

Ability to direct, manage, implement, and evaluate department operations.

Ability to establish department goals, and objectives that support the strategic plan.

Ability to effectively plan, delegate and / or supervise the work of others.

Ability to lead, motivate, develop and train others.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine.

As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year.

Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination.

Failure to meet this requirement will result in rescinding or termination of employment.

The University of Miami is an Equal Opportunity Employer - Females / Minorities / Protected Veterans / Individuals with Disabilities are encouraged to apply.

Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status : Full time

Full time

Employee Type : Staff

Staff

Pay Grade :