Join our team at Cleveland Clinic Indian RiverHospital andexperience world-class healthcare at its best. Cleveland Clinic Indian River has been recognized as one of the top regional hospitals in South Florida. Indian River Hospital is in sunny Florida’s Treasure Coast where it is committed to providingoptimalfamily-centric and community-focused care. At Indian River Hospital, you will be part of a collaborative, compassionate, and innovative team of caregivers. You will work withstate-of-the-arttechnology and will build a rewarding career with one of the most respected healthcare organizations in the world.
Indian River Hospital is looking to add an RN Care Manager to its compassionate nursing team.As an RN Care Manager, you will work collaboratively with multidisciplinary care team staff across the continuum of care forhigh-riskpatients.You will provide coordination of care and disease management longitudinally to patients with chronic condition(s) or episodic care of a surgical population, focusing your efforts on patient outreach, achievingoptimaloutcomes, promotingwellnessand decreasing preventable Emergency Department visits and readmissions.This opportunity will not only provide you with plenty of hands-onlearning butcan also lead you to becoming certified in Care Management.
A caregiver in this position worksdays from 8:00AM – 4:30PM, including rotating Saturdays.
A caregiver who excels in this role will:
Identifywhich patients in the specialty care practice have ongoing carecoordination needs for their specialty condition.
Outline the nature and duration of involvement needed by the specialty careteamand specialty care coordinator andidentifythe primary care team involved.
Utilize assessment skills and risk assessment tools toidentifypatients with actual or potential care needs that would require care coordination.
Conduct targeted outreach to a defined panel ofhigh-riskpatients (chronic illness, lack of social support, readmissions, ED visits, surgical episodes, etc.) to ensuretimelyand efficient care delivery across the continuum of care.
Utilize technological tools (registries, patient lists, care teamtab, etc.) to manage populations.
Conduct comprehensive clinical assessments that include disease-specific, age-specific, medical, behavioral pharmacy, social andend-of-lifeneeds of each patient.
Inform the patient,familyand healthcare teamregardingcoordination of their care
Develop goals and plan interventions to maximize patient outcomes.
Monitorpatient compliance withplanof care.
Perform reassessmentsregardingpatient progress toward goals and update plan of care asappropriate.
Ensure care gaps are closed around specialty disease/chronic disease/surgical episodes.
Serve as primary patient contact for team related to condition/surgical episode andfacilitateaccess to services.
Coordinate members of the patient care team.
Serve as the liaison between patients, families,physiciansand clinical staff by advocating forpatientand families.
Respond to andfacilitateresolution of patient and family questions and concerns.
Assistin managing transitions of care across caresetting.
Identifybarriers to receiving care andfacilitatesolutions.
Define andensurecompliance with disease-specific care paths for specialty care or chronic disease.
Work with the patient and family to assess current knowledge, healthliteracyand readiness to change.
Coach and educatepatientand family on self-management support andmanaginga specialty or surgical condition.
Minimum qualifications for the ideal future caregiver include:
Graduate from an accredited school of professional Nursing (Diploma,ADNor BSN program)
Current state licensure as a Registered Nurse (RN)
Basic Cardiac Life Support (BLS)
Three to five years of nursing experience
Preferred qualifications for the ideal
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