Readmission Prevention Case Manager RN - Orlando/Remote

What are the Key Responsibilities:

• Meet with members, (and/or their caregivers) who are at high risk for readmission, post discharge, in person, if at all possible, if not by phone, within 2 business days of discharge.
• Perform an assessment of members current health status, including potential knowledge deficits, environment, care giver(s) and others supports, creating a care plan identifying problems, goals and interventions, based on member's responses, conditions, needs and priorities, as appropriate.
• Conduct Comprehensive Medication Reconciliation process, including education, identification of potential medication concerns, document and address any possible issues with the ordering physician, pharmacy, etc. and provide CMR report to PCP
• Validate the initiation of planned care and services, reinforce understanding of discharge instructions utilizing teach back methods, answer questions as appropriate and address concerns.
• Coordinate/assign necessary interventions including any available community resources, enhanced benefits or flex benefit to overcome potential barriers to care, e.g. meals, transportation, etc.
• Facilitate appropriate practitioner office follow-up visit within 7-14 days of discharge. Follow-up with member and practitioner to confirm appointment was kept.
• Provide continuing telephonic support/follow up for at least 30 days post facility discharge.

What is Required:

• 2+ years' experience recent clinical acute, home care and/or case management experience
• Current Florida RN - Registered Nurse Licensure And/Or Compact State Licensure Without Restriction
• Hands-on experience with Mircrosoft suite of products, including Word, Outlook, PowerPoint, etc as well as navigating through multiple systems such as electronic medical records
• Ability to drive your own vehicle to and from home assessment visits, and/or in clinical settings, within Orange County (Orlando area), FL approximately 20-40% of work time
• Current and valid state driver's license
• Associate's degree in Nursing

What is Preferred:

• CCM - Certified Case Manager Certification
• Home care Experience
• Bilingual English/Spanish
• Bachelor's degree in Nursing

General Physical Demands

Medium work: Exerting up to 50 pounds of force occasionally and/or up to 20 pounds of force frequently to move objects.

Physical/Environmental Activities

Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Frequently May be exposed to outdoor weather conditions of cold, heat, wet, and humidity. Occasionally Must be able to ascend and descend ladders, stairs, or other equipment. Occasionally

What We Offer:

As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

• Medical, dental, vision, life and global travel health insurance;
• Income protection benefits: life insurance, Short- and long-term disability programs;
• Leave programs to support personal circumstances;
• Retirement Savings Plan includes employer contribution and employer match;
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits available; and
• A comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Typical Annualized Hiring Range: $68,100 - $85,100, within an annualized full salary range of $68,100 - $110,600

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.

At GuideWell, we are committed to making diversity, equity and inclusion part of everything we do. We believe in hiring people who represent the communities we serve while creating a workplace that encourages a sense of belonging for everyone, no matter who you are or where you come from.

From students to former military to seasoned professionals, our family of mission-based companies are stronger because of the unique talents and skills of our employees. We believe everyone's contribution has the power to help people and communities achieve better health. Find your new team today.

Florida Blue, A GuideWell Company, has been providing health insurance to residents of Florida for 75 years. Driven by its mission of helping people and communicating to achieve better health, the company serves more than five million health care members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting the members first.