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Mount Sinai Medical Center

Care Manager PD

Mount Sinai Medical Center, Kapolei, Hawaii, us, 96709

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As Mount Sinai grows, so does our legacy in high‑quality health care.

Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami‑Dade (including our 674‑bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care and more. Mount Sinai takes pride in being South Florida’s largest private independent not‑for‑profit hospital, dedicated to continuing the training of the next generation of medical pioneers.

Culture of Caring: The Sinai Way Our hardworking, tight‑knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Department CC017410 Care Management

Job Description Summary Position Responsibilities

Proactively identifies patients/individuals in need of care management services/intervention

Gathers information about assigned populations and prioritizes workload appropriately to meet desired outcomes

Responds to referral requests in a timely manner and offers possible alternatives for assistance if referral is not appropriate for care management intervention

Conducts/documents admissions assessments in a complete and timely manner in accordance with department standards

Conducts/documents utilization reviews in a complete and timely manner

Utilizes InterQual criteria and communicates outcomes as indicated/warranted to appropriate parties

Maintains a holistic view of the patient and his/her needs

Develops and documents a plan to address identified barriers to care collaboratively with the patient/family, physician, and interdisciplinary team

Documents the discharge plan in a complete and timely manner

Updates the discharge plan as warranted/patient condition changes

Appropriately addresses any identified issues that may put a patient at risk for readmission

Discusses transitions of care and discharge planning with patients and families (HCAHPS)

Documents discharge disposition and agencies/facilities related to post‑acute care as required by department standards

Completes and provides all required forms, including but not limited to: the Important Message from Medicare (IM), the Choice Letter, Hospital‑to‑Hospital transfer forms, SNF transfer forms, the PASRR

Demonstrates problem‑solving skills, critical thinking skills, effective communication, and an appropriate sense of urgency in providing service to avoid delays in progression of care

Reviews cases for over, under, or inappropriate utilization of resources (including but not limited to unnecessary ED/IP visits, greater than expected LOS, unplanned readmissions, unnecessary testing/treatment, etc.)

Develops, maintains, and utilizes skills and a network of resources both internal and external to the organization necessary to problem solve immediate needs of the customer; refers to care management leadership in timely manner if additional support is needed to help resolve/remove barriers

Participates effectively in multidisciplinary rounding

Supports patient transitions across the continuum through effective communication and interventions; demonstrates competency in coordinating key services for safe and effective transitions of care

Demonstrates appropriate referral to/collaboration with other members of interdisciplinary team or outside agencies as warranted; if patient transferred, communicates patient information to next care manager or outside agency in a timely manner

Refers to colleagues, such as social workers and care management specialists, and escalates cases to management appropriately

Develops and maintains knowledge of Medicare, Medicaid, and key payer benefits/reimbursement methodologies necessary to procure services for patients and serve as a resource to the interdisciplinary team on quality and cost‑effective care

Maintains understanding of, and articulates the regulatory requirements (CMS, TJC, etc.) regarding discharge planning/utilization review and/or care management services

Maintains a patient centered approach through ongoing communication with patient/family seeking their input and participation at all times

Communicates in a polite and professional manner to all patients, families, physicians, and colleagues at all times

Participates in weekend rotation and on‑call as required

Demonstrates sufficient computer skills to perform job function; checks voicemail and email as instructed by leadership and as warranted

Qualifications

License/Registration/Certification

Current RN FL license is required for nurses or a Medical Doctor’s degree for Foreign Medical Graduates (FMG)

Education

Bachelor’s Degree in Nursing preferred or proof of Medical Doctors Degree required for FMG.

Experience

Proof of RN licensure, Foreign Medical Graduate (FMG), or at least 2 years as a Care Manager in a hospital is required.

Benefits

Health benefits

Life insurance

Long‑term disability coverage

Healthcare spending accounts

Retirement plan

Paid time off

Pet Insurance

Tuition reimbursement

Employee assistance program

Wellness program

On‑site housing for select positions and more!

Seniority level

Mid‑Senior level

Employment type

Full‑time

Job function

Health Care Provider

Hospitals and Health Care

Office is located in Fort Lauderdale, FL. Salary range: $70,000‑$80,000.

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