Hca Utilization Review Jobs in Florida (NOW HIRING)

Perm Staff Jobs is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in Gainesville, Florida.

Job Description & Requirements

• Specialty: Utilization Review
• Discipline: RN
• Duration: Ongoing
• Employment Type: Staff

RN Patient Safety Coordinator

Do you want to join an organization that invests in you as an RN Patient Safety Coordinator? At HCA Florida North Florida Hospital, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Job Summary and Qualifications

The RN Patient Safety Coordinator will be responsible for risk/CMS data management, claims management, education components of the facility’s risk management program, and ensuring claims and compliance with regulatory and accreditation agency risk management standards are met. In an effort to increase patient satisfaction and reduce liabilities and exposures for the facility, this position will establish, coordinate and manage Patient Safety education initiatives which include, but are not limited to, new employees in orientation, current employees, visitors and students doing clinical rotations in the facility. This role will collaborate with all facility leadership and work as a liaison to the appropriate committees to address complaints, grievances and concerns to identify patient satisfaction opportunities.

• Assists with development of Hospital Risk Management Program and correlate with facility Strategic plan.
• Assists with clinical risk assessments and analysis.
• Assists with an annual evaluation of the effectiveness of the Risk Management Program and develops/modifies goals as indicated.
• Assists with an analysis plan for data management.
• Assists in analyzing incidents/occurrences and identifies patterns as evidence for decision-making and process improvement.
• Analyzes, investigates and responds to Quality of Care Concerns.
• Investigates incidents that could lead to professional/general liability claims; makes adjustments to patient accounts as needed and approves payment for lost items.
• Collaborates with staff, physicians, patients/families and visitors where appropriate to resolve outstanding issues within the guidelines approved by facility administration.
• Assists in developing policies and procedures to implement the Risk Management Program and annual risk management plan. Coordinates the tracking and trending of occurrence reports.
• Assists in working closely with the Ethics and Compliance Officer and the Director Quality to ensure compliance with statutory mandates, regulatory requirements and accreditation standards of professional organizations such as the Agency for Health Care Administration, TJC. (Statutory and regulatory requirements include but are not limited to the following: FDA, OSHA, EPA, EMTALA, Medicare and Medicaid provisions of the Social Security Act.)
• Assists in disseminating information and research related to changes in regulatory requirements and clinical research pertinent to potential liability exposures and risk issues.
• Assists with Code 15 investigations and annual reports to the State per statutory requirements.
• Maintains current knowledge and education in risk management through educational materials, seminars and pertinent information and research.
• Serves as a member of select committees, as assigned, critical to the effectiveness of the Risk Management and Patient Safety Program.
• Assists appropriate medical staff and nursing committees in the resolution of peer review, medical quality of care and nursing quality of care issues posing clinical risk exposure.
• Analyzes, interprets and facilitates distribution of patient information to Leadership. Incorporates complaints, grievances and compliments to guide daily process improvement.
• Assists in the development of improvement strategies that direct the patient experience, identifies barriers to improvement and develops effective mitigation strategies.
• Assists with developing and/or providing education to hospital staff on patient safety and other issues.
• Produces thorough, accurate, well-designed and appropriate documents.
• Performs other functions as assigned.

What qualifications you will need:

• RN Diploma required. Bachelor’s Degree or significant experience beyond the required minimum preferred. 
• 2 years related clinical and/or risk management/patient safety experience required. 
• Currently licensed as a registered professional nurse in the state(s) of practice and/or has an active compact license, in accordance with law and regulation. Certified Professional in Patient Safety (CPPS) or Certified Professional in Healthcare Quality (CPHQ) certification to be achieved within 1 year of hire.

Benefits

HCA Florida North Florida Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

HCA Florida North Florida Hospital is a 523-bed, full-service medical and surgical acute care center. For over 49 years, we have served North Central Florida. We offer comprehensive cardiovascular care, oncology, orthopedics, and neurosciences. We offer minimally-invasive laparoscopic and robotic surgery, weight loss surgery and treatment. Other services that we provide include women’s health and wound therapy. We are fully accredited by the Joint Commission and certified as a Comprehensive Stroke Center. Our hospital has an Accredited Chest Pain Center by ACC (American College of Cardiology) and is designated as a Blue Distinction Center for Spine Surgery and Bariatric Surgery. We are committed to patient safety and quality of care. We have received the highest scores available in recognition of this commitment.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our RN Patient Safety Coordinator opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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