Nurse Case Manager II - Transition OD Care Registered Nurse

SGS Consulting
Florida

Job Responsibilities:

  • Complete at least 10 NF member assessments weekly
  • Support the Health Plan Rebalancing Initiative goal of successful transitions: Assess, identify, screen and transition NH members into the community
  • Follow up on CM referrals and visit current NH members in-person at least twice a week to complete the rebalancing events and screening assessments.
  • Complete telephone or in-person contact to assess the home prior to discharge and identify any environmental support needed to support transition (i.e. ramp, DME installation etc.).
  • Conduct an in-person Significant Change Visit with members and Rep if applicable, within 5 days of transition. Coordinate provision of services as needed, establish Plan of Care, and document all actions taken.
  • Contact facility’s Business Office once a week to follow-up on members census and will coordinate with Social Services and CM to facilitate discharge.
  • Work collaboratively with case managers to identify high risk community members and implement appropriate interventions to prevent lapses or coordinate safe transition (Upon receiving referral)
  • Drive enhanced value of health care to increase member satisfaction and retention and drive new membership growth.
  • Be involved in at least two community relations events per year
  • Engage in building strong relationships that contribute towards member satisfaction and retention

Skills:

  • Experience Needed: Candidate must reside in FL and area of coverage
  • Minimum 2 years of clinical experience
  • Bi-Lingual Spanish/ English required
  • Willing and able to travel 75% of their time to meet members face to face and surrounding counties/areas

Education/Experience:

  • Education/Licensure: Active, unrestricted and good standing RN license in the state of Florida.
  • Associate Degree Required and BSN preferred.
Posted 2025-11-14

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