Judit Inc. is seeking a Registered Nurse (RN) Case Management for a nursing job in Gainesville, Florida.
Job Description & Requirements
- Specialty: Case Management
- Discipline: RN
- Duration: Ongoing
- 36 hours per week
- Shift: 12 hours, days, evenings
- Employment Type: Staff
The Observation RN CM is responsible for progressing the care for Observation patient and ensures progression of care by reviewing the case promptly and applying IP IQ criteria. The Observation RN CM adheres to HCA standards regarding observation management. In addition, the Observation RN CM will be responsible for adhering to the 2 Midnight Process. The Observation RN CM works closely with the physician by monitoring the case and keeping the physician abreast of findings so appropriate and timely decisions can be made to admit or discharge the patient. When the observation CM identifies barriers that prevent progression, the Observation RN CM will directly intervene to remove the barrier. If the Observation RN CM cannot remove the barrier, the Observation RN CM will escalate the situation to the facility Director of Case Management who will advise on next steps (e.g., contact CMO, CNO, PA). The Observation RN CM is responsible for identification of observation patients with discharge planning needs that could lead to poor outcomes or a return to the hospital. If the Observation RN CM encounters such a patient, the Observation RN CM assumes responsibility for referring to the inpatient RN CM/Social Worker, who will complete a discharge planning evaluation and/or a psychosocial assessment and assume the transition of care. The Observation RN CM coordinates activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization.
What you will do in this role:
Provides case management services for both inpatient and observation patients as assigned.
Identifies patients who are at risk for adverse outcomes during the transition from one level of care/setting to another.
Performs a comprehensive assessment of psychosocial, medical and discharge needs of patients/family along with an assessment of resources appropriate and available to the patient/family.
Reassesses the patient's clinical condition as indicated. Considers patient's readmission status or risk of readmission and develops strategies to mitigate, including education on appropriately accessing healthcare resources, preventative education, and community-based resources.
Coordinates the plan of care and drives the discharge plan by collaborating with the multidisciplinary health care team and with the patient's physician to facilitate a successful care transition.
Partners with Social Services to ensure the post-acute medical needs and level of care are appropriate.
Assumes responsibility for timely referral to Social Services when risk factors for psychosocial determinants of health are identified.
Involves patient and family/responsible/significant others in identifying and clarifying needs and expectations to develop mutual and realistic goals.
Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established chain of command.
Makes appropriate referrals to third party payer and disease and case management programs for recurring patients and patients with chronic disease states.
Facilitates patient throughput with an ongoing focus on an effective care transition, quality, and efficiency.
Documents professional recommendations, discharge plan, care coordination interventions, and case management activities to effectively communicate to all members of the health care team.
Aligns patient needs with available resources to ensure a safe discharge/transition.
Acts as a liaison through effective and professional communications between and with physicians, patient/family, hospital staff, and outside agencies.
Seeks ways to control costs without compromising patient safety, quality of care, or the services delivered.
Functions in a manner to promote quality patient care and assure a positive patient experience.
Directs activities to identify and provide for the needs of the under-resourced patient population, including patient education activities, patient assistance programs, and community-based resources,
Participates in performance improvement activities, including identifying, documenting, and intervening when avoidable days occur.
Adheres to established policy and procedure and standards of care; escalates issues promptly through the established chain of command.
Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives.
Serves as an advocate for patient's rights, needs, and values; ensures that patients' ethnic, cultural, or religious values, beliefs, preferences, and needs are considered and aligned.
Performs other duties as assigned.
Practices and adheres to the "Code of Conduct" and "Mission and Value Statement."
What qualifications you will need:
Looking for 1+ years of Case Management Interqual experience. This candidate could have worked as an RN Case Manager for an insurance company and would do well in this role.
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 start
Associate Degree in Nursing required
Bachelor's Degree in Nursing preferred
InterQual experience required
Strong Utilization experience preferred
Judit Inc. Job ID .
About Judit Inc.
Judit Inc. is a trusted, women-owned leader in healthcare staffing with over 17
years of experience connecting top-tier professionals with rewarding
opportunities. Our commitment to successful outcomes ensures you are
matched with roles where your expertise makes a difference in patient care.
With access to a robust network of healthcare facilities and positions, we
specialize in placing clinical and non-clinical talent across diverse settings,
including hospitals, specialty care centers, and virtual facilities. Our precision-
driven recruiting process ensures that your skills and goals align with
opportunities that allow you to thrive professionally.
At Judit, we value your contributions and are dedicated to supporting your
growth while helping you deliver exceptional care. Join us to advance your
career and make a lasting impact in the healthcare industry.
Benefits