Registered Nurse Care Manager

Inpatient Care Manager

InnovaCare Health operates more than 40 clinics throughout Florida and Texas and is recognized as a leader in transforming how care is delivered. Our physician-led model blends clinical expertise, advanced technology, and a commitment to personalized, coordinated care that puts patients at the center of every decision. Our impact extends beyond our clinic walls through public health education, outreach, and philanthropic efforts that strengthen the well-being of the communities we call home. As we continue to grow, we invite passionate individuals to explore opportunities with InnovaCare Health and join us in improving the lives of those we care for each day.

Job Summary

Inpatient Care Managers support patients throughout patient hospitalization/facility admission and ensure a smooth transition through discharge. They identify, track, and monitor patients from arrival at a healthcare facility through discharge- ensuring a smooth transition. Inpatient Care Managers review medical records to ensure appropriate utilization and that patients' needs are met for the discharge plan. They collaborate with the inpatient regional medical director, patient, hospital system, and multidisciplinary team in coordination of care to ensure the patient receives the appropriate services, at the appropriate level of care, at the appropriate time. The care manager identifies barriers and provides intervention at the guidance of the clinician to prevent avoidable hospital utilization and collaborates with the internal care management team to ensure continued support is provided. The Inpatient Care Manager is a vital asset to ensuring optimal care for InnovaCare health's patient population. This is a hybrid role that will be up to 50% onsite at the hospital setting and 50% remote work from home.

Essential Job Functions

• Provides utilization support and review by:
• Reviewing daily inpatient/observation status
• Participating in daily care management IP rounds
• Review medical records and coordinate with health plan and hospital for appropriate patient care
• Identify patient needs and risks for readmission
• Collaborate with office, care management team, and providers to support transition of care
• Follow up with other teams for pending tasks completeness
• Utilizes Electronic Medical Record (EMR), Excel, and InterQual daily
• Follows up on escalations and documents accurately
• Assists with required paperwork from hospitals. SNFs. LTAC, Home health
• Excellent communication skills with the ability to adapt to the audience/environment
• Establishes and maintains positive relationships with all internal and external partners
• Highly organized with ability to keep accurate notes and records

General Knowledge/Skills

• Must: Critical thinking and problem-solving skills.
• Preferred: Clinical knowledge of chronic conditions, management of high-risk patient populations and knowledge of available community resources.
• Strong knowledge of managed care concepts.
• Strong written and verbal skills with patients, physicians and other stakeholders including techniques in facilitating patient engagement in their healthcare.
• Demonstrate ability to timely assess and respond to patient and family needs.
• General knowledge of care (case) management practices, including familiarity with Medicare Advantage products, programs, and services.
• Experience in establishing professional and collaborative relationships with patients, providers, and insurance organizations.
• Basic computer skills, including working knowledge of the Microsoft Office suite.
• Not required, but preferred: Certification as a diabetes educator, nutritionist or social worker or other specialty.

Minimum Required Education, Experience & Skills

• Licensed and credentialed RN - Active, Unrestricted Florida License, BSN preferred.
• Minimum of 3 years' experience in a clinical setting- hospital preferred.
• Continuing education in Care (Case) Management and all other applicable professional licensure.
• CPR/BLS certification.
• Transitional care management/Discharge planning experience
• InterQual experience preferred
• Utilization review or hospital case management experience preferred
• Bilingual in English/Spanish preferred but not required

ENVIRONMENTAL AND WORKING CONDITIONS

In this position, the employee will work in an office/hospital setting that requires sitting, walking, talking, and listening. Position will require a valid driver's license and will travel approximately 30% of the time.

Physical & Mental Requirements :

• Required immunizations and vaccinations.
• Ability to lift to 50 pounds.
• Ability to push or pull heavy objects using up to 100 pounds of force.
• Ability to endure repetitive motions (i.e.; bending, stooping, reaching, pushing, pulling).
• Ability to stand or sit for extended periods of time.
• Ability to use fine motor skills to operate equipment and/or machinery.
• Ability to properly drive and operate a vehicle.
• Ability to receive and comprehend instructions verbally and/or in writing.
• Ability to use logical reasoning for simple and complex problem solving.
• Occasionally requires exposure to communicable diseases or bodily fluids.
• Ability to discriminate shades of color when reading a dipstick.
• Occasional travel for clinic activities may be required (ex. InnovaCare meetings or training).

The information listed above is not comprehensive of all duties/responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.

Innovacare participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.