RN Care Manager, Acute

Position Summary Opening Summer 2026 at 4000 Lakeland Highlands Road, Lakeland, FL. The Orlando Health System of Care includes award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities that span Florida’s east to west coasts, Central Alabama and Puerto Rico. Collectively, our dedicated team members honor our over 100-year legacy by providing professional and compassionate care to the patients, families and communities we serve. Join us! Combining the strengths of Orlando Health and the high-quality physicians at Watson Clinic, we are expanding access to award-winning specialty care for patients in Polk County and beyond. Opening in Summer 2026, Orlando Health Watson Clinic Lakeland Highlands Hospital – a state‑of‑the‑art, seven‑story, multi‑specialty hospital – will serve as a vital 550,000 square‑foot healthcare hub offering: 300+ inpatient beds and 69 emergency and observation beds 11 operating rooms and four cardiac interventional suites Dedicated labor and delivery services, including a neonatal intensive care unit (NICU) that will debut shortly after the hospital opens Comprehensive cardiovascular, neurology, and oncology services Advanced surgical procedures Join us in shaping the future of healthcare in Polk County as part of the opening team and share in the privilege of saying you were there from the very beginning. Benefits Beyond the Expected Orlando Health is committed to providing you with benefits that go beyond the expected, with career‑growing free education programs and well‑being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say; it’s our promise to you. Benefits that begin on day 1 Four (4) weeks paid parental leave Debt‑free degrees through our Preferred Education Program Tuition reimbursement and loan repayment programs Back‑up childcare and elder care Fertility benefits and adoption assistance NCLEX reimbursement Free NCPDs for RN license Free Kaplan review courses Dedicated RN career counselor and GN coordinators to develop you Specialty certifications reimbursement And more! Shift: Second Shift 2pm‑10pm Responsibilities Initially, and concurrently, assess all patients within assigned population, including accurate medical necessity screening and submission for Physician Advisor review. Provide care coordination that includes admitting diagnosis, medical history, current treatments, age, payment source, resources, support systems, anticipated needs, expected length of stay, appropriate level of service, special/personal needs, and other relevant information. Assign initial DRG to determine GMLOS, while monitoring and managing LOS and transition planning as appropriate through assessment and reassessment with InterQual guidelines. Lead and facilitate multidisciplinary patient care conferences. Manage concurrent disputes. Make appropriate referrals to other departments. Identify and refer complex patients to Social Work Services. Communicate with patients and families about the plan of care. Lead and facilitate Complex Case Review. Identify and document potentially avoidable days. Identify and report over‑ and under‑utilization. Ensure compliance with all regulatory standards including Federal, State, Local and Joint Commission with review requirements for Managed Contracts, Medicare, Medicaid, and campus related to admission and continued stay approval. Adhere to Utilization Management Plan. Integrate national standards for care management scope of services, including utilization management, transition management, care coordination, and education for physicians, patients, families, and caregivers. Communicate appropriately and timely with the interdisciplinary team and third‑party payers. Prioritize activities in assigned areas to focus on high‑risk, high‑cost, and problem‑prone areas. Develop collaborative relationships with patient business, nursing, physicians, and patient/family to facilitate efficient movement through the continuum of care. Monitor and evaluate data, fiscal outcomes, and other relevant information to develop and implement strategies for improvement. Forward identified quality and/or risk issues appropriately. Maintain positive relationships with outside/onsite reviewers and other payer representatives. Identify cultural, socio‑economic, religious, and other factors that may impact treatment. Involve patient’s family in the development of the treatment plan as appropriate while explaining procedures, therapies, system treatment plans, and discharge plans in age/developmental/educational specific terms to patient/family. Review patient’s discharge plan at multidisciplinary meetings and/or staffing to facilitate communication with other healthcare team members. Prioritize workload to manage multiple priorities while using problem‑solving skills to meet goals. Enhance professional growth by participating in educational programs, current literature and/or workshops. Possess excellent interpersonal skills and ability to work in a team environment. Respect the rights and privacy of others and hold staff member information in strict confidence. Maintain reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards. Maintain compliance with all Orlando Health policies and procedures. Maintain records and documentation of work performed in an organized and easily retrievable fashion while maintaining confidentiality of data and patient information. Review current literature regularly, maintain reference materials and update as required, and keep abreast of relevant reimbursement information. Actively serve on committees and task forces to promote quality, cost‑effective care for patient population. Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast‑paced environment, critical thinking and problem‑solving skills, and computer literacy. Perform other duties as assigned or required. Qualifications Graduate of an approved school of nursing. Three (3) years of experience in chronic disease management, care management, care coordination, utilization management, or acute clinical care. Must hold and maintain a current Florida RN license. Handle with Care (HWC) Certification is required for the Behavioral Health Unit within 90 days of hire; the Handle with Care training and education will be provided onsite to all team members. #J-18808-Ljbffr Orlando Health