All the benefits and perks you need for you and your family:

Benefits from Day One

Paid Days Off from Day One

Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)

Nursing Clinical Ladder Program

Our promise to you:

Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind, and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full

The role youll contribute:

Under minimal supervision and reporting to the Chief Nursing Officer the Director Care Management Women and Childrens develops and coordinates implementation of complex hospital operational strategies and length of stay management, involving physicians and multiple hospital departments, to assure appropriate utilization of hospital resources, appropriate level of care for patients, and appropriate discharge planning.

Responsible for assuring appropriateness of patient admissions based on severity of illness/intensity of service criteria. Facilitates case reviews based on medical screening criteria to ensure optimum reimbursement. Responsible for case management, social worker/discharge planning processes and length of stay management for all AdventHealth CFD South Women's and Children's Care Management business units. Leads and directs Women's and Children's Care Management leaders to achieve positive care management outcomes.

Responsible for building and maintaining positive working relationships with medical staff, external agencies (ECF's, sub-acute facilities, Home Care, Hospice, DCF, etc.). Provide direct oversight of Care Management billing reconciliation and accounts payable. Responsible for on-going operations, short- term and long-term planning and development of the outcome's management service area of Women's and Children's Care Management.

Responsible for overseeing research, development, and implementation of educational materials and training, responsible for designing integrated leadership development programs to drive growth and accountability across the Women's and Childrens Care Management service line through the Central Florida Region. Oversees Care Management CMS and regulatory compliance.

Develops and implements state-of-the-art performance improvement and outcomes management programs that enhance the operational, financial, and clinical performance of the organization.

Implements and oversees the maintenance and use of databases and systems for measuring, monitoring, and tracking utilization and performance changes. Works closely with physicians and the campus leadership team on utilization/case management issues.

Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

The value youll bring to the team:

Contributes to the design and development of Care Management programs in coordination with hospital, division, and corporate leadership.

Serves as a change agent to re-structure or improve hospital clinical and operational monitoring activities to reflect the philosophy of the evidence-based medicine/disease management/clinical programs initiatives.

Assumes implementation responsibilities for change activities required to re-engineer hospital clinical processes to address resource consumption issues.

Educates Medical Staff and hospital administrative staff concerning current trends in cost/resource management.

Identifies clinical topics for review and analysis by medical staff monitoring committees, based on consistent monitoring of clinical practice patterns, feedback from clinicians and physicians and retrospective data analyses of quality, resource consumption and cost reports at a DRG and physician-specific level.

Develops an active, collaborative, interface, and structure with AdventHealth Medical Staff

Organizes process improvement/resource consumption committees on a clinical or product line basis to address quality/resource consumption opportunities. Provides staff support services to such committees

Assures that process improvement/resource consumption/utilization management committees receive data as required to perform target/goal setting, benchmarking/comparative analyses and monitoring activities and to formulate their process improvement recommendations

Assures that data documenting the results of patient care processes and variations in clinical practice are collected on a concurrent basis in an effective format

Qualifications

The expertise and experiences youll need to succeed :

KNOWLEDGE AND SKILLS REQUIRED :

Understanding of medical necessity for appropriate patient status and level of care

Understanding of Care Management best practices

Ability to research and reason best practices to support process improvement

Strong verbal and electronic communication skills

Ability to analyze, evaluate and monitor data in addition to provide action plans

Supports positive employee relations and customer experience

Understanding of Microsoft Office Products and other appropriate software platforms

Understanding of CMS Conditions of Participation for Discharge Planning

Understanding of Managed Care and Value Based Programs

Ability to work autonomously with self-direction

Ability to work as a collaborative partner of a diverse leadership team

Ability to lead and sustain change

Knowledge of change management principles, methodologies, and tools

KNOWLEDGE AND SKILLS PREFERRED :

5 yeas of Care management leadership

5 years in acute care

EDUCATION AND EXPERIENCE REQUIRED :

Graduate of a school of nursing

EDUCATION AND EXPERIENCE PREFERRED :

Bachelors degree in Nursing

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIRED :

Current valid State of Florida or multi state license as a Registered Nurse

Basic Life Support (BLS) certification

Advanced life support certification (ACLS, PALS, NRP) per specialty/unit requirements

For Radiology/Imaging, PALS required only for cost centers 4220,7211,6236

LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED :

Professional certification

ACLS, PALS, NRP (based on patient population; See document EKG and Advanced Life Support Requirements)

LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED :

FASPR (Fellow of Association of Staff Physician Recruiters) highly preferred

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

Category: Case Management

Organization: AdventHealth Orlando

Schedule: Full-time

Shift: 1 - Day

Req ID: 25028821

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.