RN - Case Manager
Company: Baptist Health Care
Posted on: November 19, 2022
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.
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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