Job Description

Medix is currently hiring for Transitional Care Nurse - Hybrid for a Health Plan in FL. It's remote but a bit of travel if necessary - doing TOC reviews.

Location - The hires would need to be in the Treasure Coast, Tampa, Citrus, Northeast Florida, or Orlando area.

Schedule - Monday - Friday 8a-5p

Job Overview

Acute Transitional Care Nurse (RN), Telecommuter, working in the Comprehensive Clinical Management Department. Responsible for ensuring the transition of care in both the inpatient and outpatient setting utilizing the appropriate resources within the parameters of established contracts and patients’ health plan benefits. Facilitates continuum of patients’ care utilizing advanced nursing knowledge, experience, and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs continuity of care clinic support functions on-site or telephonically per member care delivery needs. Works in conjunction with the PCP and care team in an active leadership role. Ensures evaluation is in alignment with site-based goals.

ESSENTIAL FUNCTIONS:

• Prioritizes patient care needs upon initial patient/family encounter and addresses emerging issues.
• Meets with patients, patients’ family, and caregivers to discuss care and treatment per member care delivery needs.
• Identifies and assists with the patient follow-up in acute care settings, skilled nursing facilities, custodial and ambulatory settings.
• Uses established protocols, pathways, clinical support resources, to optimize clinical outcomes.
• Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., to maintain continuity of care.
• Maintains effective communication with the physicians, hospitalists, care teams, extended care facilities, patients, and families.
• Demonstrates a thorough understanding of the cost consequences resulting from care delivery decisions through utilization of reports and systems such as Health Plan Benefits, utilization of metrics and associated care delivery reports.
• Consults with physician and other team members to ensure that plan of care is successfully implemented.
• Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management.
• Works in coordination with the care team and demonstrates accountability with patient management and outcome.

REQUIRED QUALIFICATIONS:

• Bachelor’s degree in nursing (associate degree in nursing with four or more years of experience).
• Nurse with an active and unrestricted license to practice in the state of Florida.
• Minimum 2 years applicable clinical experience in a physician’s office, clinical or hospital setting.

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