RN - Case Manager - Case Management - Utilization Review

Job Description

The Case Manager acts as a patient advocate to hospital clients. This is an autonomous role that coordinates, negotiates, procures services, and resources for, and manages the care of patients throughout the continuum of care, which includes arranging post-acute services. The Case Manager is responsible for team building, educating, and consulting interdisciplinary team members. This position provides clinically based case management, therefore requiring someone with a strong clinical background, preferably in the acute care setting. This position requires someone that is flexible and willing to work in all and/or any areas of the hospital. Case Management requires an individual that is adaptable to change and can assume any assignment wherever the need may be. The Case Manager is responsible for discharge planning, and care coordination to facilitate the delivery of quality health care and assists in the identification of appropriate utilization of resources across the continuum of care.

Responsibilities

• 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.

Qualifications

Minimum Education

• Technical Diploma/Certificate Practical Nursing Required or
• Associates Degree Nursing Required or

Minimum Work Experience

• 3 years Acute Hospital Nursing Experience Preferred
• 1-3 years Case Mgmt in the Acute Care Setting Preferred

Licenses and Certifications

• Registered Nurse Licensed State of Florida or eligible compact license Upon Hire Required

Required Skills, Knowledge and Abilities

• Demonstrated skills in the areas of negotiation, communication (verbal and written), conflict, interdisciplinary collaboration, management, creative problem solving, and critical thinking. (High proficiency)
• Knowledge of healthcare financing, community and organizational resources, patient care processes, and data analysis. (Medium proficiency)
• Knowledge of post-acute care community resources. (Medium proficiency)
• Demonstrates flexibility via an ability to adapt to changing priorities and regulation. (High proficiency)
• Excellent verbal and written communication skills required. (Medium proficiency)
• Proficient computer skills required. (Medium proficiency)
• Ability to communicate effectively and document information accurately (High proficiency)
• Excellent communication and interpersonal skills. (High proficiency)
• Excellent organizational and multitasking skills. (High proficiency)
• Understanding the implications of new information for both current and future problem-solving and decision-making. (High proficiency)
• Ability to plan, organize and direct the activities of others. (High proficiency)

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.

Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC maintains and enforces a policy that prohibits discrimination against any workforce members or applicants for employment because of sex, race, age, color, disability, marital status, national origin, religion, genetic information, or other category protected by federal, state or local law.