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RN - Case Manager

Company: Baptist Health Care
Location: Pensacola
Posted on: November 19, 2022

Job Description:

Job Description

Under the general supervision of the case management director, case manager acts as a patient advocate/case manager to hospital clients. An autonomous role that coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost efficient patient outcomes. Looks for opportunities to reduce cost while ensuring the highest quality of care is maintained. Applies review criteria to determine medical necessity for admission and continued stay. Provides clinically based case management, discharge planning, and care coordination to facilitate the delivery of cost-effective quality healthcare and assists in the identification of appropriate utilization of resources across the continuum of care. The Case Manager assists the patients throughout their hospital experience to insure the right care is provided at the right time every time by focusing on the person and family and ensures the patient's active participation and decision making in their care. Works collaboratively with interdisciplinary staff internal and external to the organization. Participates in quality improvement and evaluation processes related to the management of patient care. The case manager is on-site and available seven days a week, as well as holidays and, therefore, is required to work a weekend rotation and an occasional holiday.

The person in this position works under general supervision, is responsible for various shifts, may be subject to over 40 hours per week and/or callback as required, and may also be required to remain on campus immediately before, during, and after severe weather and/or disasters.


"Directs, coordinates, and provides case management to patients in caseload. Responsible for preventing delayed discharges of observation patients. Participates in case finding and preadmission evaluation screening to ensure a safe discharge plan. Completes case management assessment of patients and support systems in order to facilitate the most appropriate and timely transition plan. Interacts, communicates, and intervenes with multidisciplinary healthcare team in a purposeful, goal-directed fashion. Works proactively to maximize the effectiveness of resource utilization. Anticipates, initiates, and facilitates problem resolution around issues of resource use and continued hospitalization and discharge planning. Consistently maintains a professional commitment to institutions and department's goals and objectives. Demonstrates flexibility to the department's needs in relation to floor and work schedule and any other internal and external demands on the department. Continually shows commitment to the department by extending one's self when the need arises. Maintains current knowledge of case management, , and discharge planning, as specified by federal, state, and private insurance guidelines.Assist in other duties as assigned to support the operational needs of the department and organization. May be required to remain on campus immediately before, during, and after severe weather and/or disasters."


  • Must have ASN degree or Nursing Diploma.
  • Four (4) years broad based nursing experience is required.
  • Current RN Licensure in the State of Florida required.
  • Demonstrated skills in the areas of negotiation, communication (verbal and written), conflict, interdisciplinary collaboration, management, creative problem solving, and critical thinking.; Knowledge of healthcare financing, community and organizational resources, patient care processes, and data analysis; Knowledge of utilization management as it relates to third-party payers; Knowledge of post-acute care community resources; Excellent verbal and written communication skills required; Demonstrates flexibility via an ability to adapt to changing priorities and regulations; Basic computer skills required.

    About Us

    Baptist Health Care is a not-for-profit health care system committed to improving the quality of life for people and communities in northwest Florida and south Alabama. The organization includes three hospitals, four medical parks, Andrews Institute for Orthopaedic & Sports Medicine, and an extensive primary and specialty care provider network. With more than 4,000 team members, Baptist Health Care is one of the largest non-governmental employers in northwest Florida.

Keywords: Baptist Health Care, Pensacola , RN - Case Manager, Executive , Pensacola, Florida

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