Inpatient Case Manager – Center for Behavioral Health - Orlando
Orlando seeks to hire Inpatient Case Manager who will embrace our mission to extend the healing ministry of Christ.
Located on a lush tropical campus, our flagship hospital, 1,107-bed Florida Hospital Orlando, serves as the major tertiary facility for much of the Southeast, the Caribbean and South America. Florida Hospital Orlando houses one of the largest Emergency Departments and largest cardiac catheterization labs in the country. We are already one of the busiest hospitals in the nation, providing service excellence to more than 32,000 inpatients and 125,000 outpatients each year.
The Utilization Review Department at Florida Hospital Center for Behavioral Health is a collaborative centered environment with targeted measures in providing excellent service delivery in a multi-disciplinary way to the patients, staff, and physicians by providing essential insurance information, education, and authorizations to encompass essential levels of care. The Utilization Review Department provides an additional measure of observation to specific federal and state guidelines quality measures, to meet enhanced quality care, and provides patients with home health referrals for continued outpatient treatment.
Monday – Friday; 8:00am – 5:00pm
The Inpatient Case Manager under the direct supervision of the Director or designee is responsible for the utilization review and case management process of patients within the Center for Behavioral Health. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
Excellent communication, negotiation and advocacy skills with staff, providers and health care team
Working knowledge of payer sources including PPO, HMO, Medicaid and Medicare
Working knowledge of diagnosis, assessment and treatment of psychiatric patients
Ability to organize and prioritize job duties in a timely and efficient manner
Registered Nurse, Licensed Clinical Social Worker or Licensed Mental Health Counselor
Bachelor's degree in Nursing (preferred)
Experience with acute care psychiatric nursing, leadership, utilization management, managed care and Medicaid/Medicare reimbursement
Licensure, Certification, or Registration Required:
Current active State of Florida license as a: Registered Nurse OR Licensed Clinical Social Worker OR Licensed Mental Health Counselor
Demonstrates through behavior Florida Hospital's Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork as outlined in the organization's Performance Excellence Program
Completes thorough and timely concurrent reviews daily for admissions and continued stays according to specified criteria by the Utilization/Case Management Department
Prepares daily census report with identification of patients' payer status, length of stay and approved days of coverage
Participates in coordinating and arranging second-level review
Prepares and maintains ongoing statistical data to monitor utilization and case review of all patients per payer source, length of stay and denied days
Maintains professional relationship with clinical staff to ensure continuity of care and assist with discharge plans
Participates in staff education as to Utilization Process and Clinical Documentation
Participates in developing Quality Indicators to assess effectiveness of services
Promotes case management and quality improvement ideas by participation in appropriate hospital committees
Participates on the interdisciplinary treatment team to provide input and assist in meeting patients' needs
Collaborates with Utilization Review Appeals Processor in achieving targeted outcomes
Performs additional duties as assigned or directed to ensure the smooth operation of the department
If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Inpatient Case Manager opportunity with Orlando and apply online today.
Florida Hospital is dedicated to improving lives not only in Central Florida, but also around the world. As a destination hospital, we are committed to serving the health care needs of our patients with a holistic approach to heal the mind, body and spirit. We strive to be the hospital of choice for patients, physicians and employees. Over the last 100 years, Florida Hospital’s mission remains unchanged: to extend the healing ministry of Christ.