Conducts thorough and objective assessment of the client's current status, including a situational analysis and functional assessment covering various elements. Facilitates coordination of comprehensive, individualized plan of care, in collaboration with patient, family and interdisciplinary team.
Acts in accordance with legal principles of consent, healthcare proxies, and advanced medical care initiatives. Positively impacts financial outcomes through management of a case plan. Actively seeks alternatives and contingency plans in cases where resources are not available. Performs reviews in QRS utilizing all of the modules (i.e. lab, dx, auth).
Focus on accountability for quality care and cost/benefit to clients consistent with payer, provider, and consumer expectations. Is knowledgeable and up to date on resource availability, service costs, limitations of coverage and budgetary parameters. Is fiscally responsible to the patient, the hospital and outside referrals when carrying out all discharge planning.
Current Registered Nursing license in the state of Florida, certification in Utilization Review, or a degree in a related field is mandatory. Certification in Case Management is preferred.
Job: Case Management/Home Health
Primary Location: Miami, Florida
Facility: North Shore Medical Center
Job Type: PT2Y
Shift Type: Days
Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
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