Lead RN Case Manager

Jointhe Cleveland Clinic Florida team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.The Lead RN Case Manager acts as the key information and education resource for the interdisciplinary team and works to develop organization-wide approaches to problem solving.Using your effective communication and interpersonal skills, youwill help to prepare a plan of care that is patient specific and coordinate with post-acute providers to ensure continuity of care after discharge.This is a very hands-on team who feel valued in the work they do each day knowing that they have a direct impacton the patient.A caregiver in this position works days from 8:00AM - 4:30PM, with on-calland rotating weekend and holidayrequirements.A caregiver who excels in this role will:Promote the achievement ofoptimalclinical and resource outcomes.Facilitate pre-certification and payer authorization processes.Facilitate the collaborative management of patient care across the continuum, proactivelyidentifyand effectively address barriers foridentifiedpatient populations.Identify,developand apply process improvement methodologies in evaluating and improving outcomes of care.Act as the expert involved in the clinical documentation efforts and serving as a clinical resource for coders and staff ensuring that documentation accurately reflects severity of illness and intensity of service.Beutilizedas a sought-out expert with physician relations and communications.Support and act as a role model for the compliance of team members ensuring regulatory requirements are met.Work with leadership to align goals and visions.Minimum qualifications for the ideal future caregiver include:Registered Nurseand aBachelor’s of Sciencein Nursing (BSN)ORBachelor'sin HealthcarefieldCurrent and valid license to practice as a Registered Nurse (RN) in FloridaCase Manager Certification (CCM)requiredwithin one year of eligibilitySix years of experience in Care Management,UtilizationReviewor Discharge Planning in a Healthcare settingExcellent interpersonal communication and negotiation skillsDemonstrated leadership skillsStrong analytical, datamanagementand PC skillsCurrent working knowledge of discharge planning,utilizationmanagement, Care Management, performanceimprovementand managed care reimbursementUnderstanding ofpre-acute and post-acute venues of care and post-acute community resourcesStrong organizational and time management skillsCan work independently and exercise sound judgment in interactions with physicians,payors andpatients and their familiesPreferred qualifications for the ideal future caregiver include:Master’sof Science in Nursing (MSN)orMaster's in Healthcarerelated fieldPhysical Requirements:Requires direct patient care.Requires extensive walking, telephone use, bending, reaching, and lifting items weighing twenty pounds or less.Must be able to work well under pressure and maintain professional demeanor under adverse conditions.Extensive reading, writing, use of pagers, fax machines, computers, and copiers.Sedentary Work - Exerting up to 10 pounds of force occasionally (Occasionally: active or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body.Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time.Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.Personal Protective Equipment:Follows standard precautions using personal protective equipment as required.Pay RangeSalaries [which may be] shown on independent job search websites reflect various market averages and do not represent information obtained directly from The Cleveland Clinic. Because we value each individual candidate, we invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process.

Created: 2026-01-16