Case Management - Case Manager, RN PRN

Lake Butler Hospital

1h

About The Position

Lake Butler Hospital is a critical access hospital in North Florida providing 24-hour emergency services, inpatient hospitalization, swing bed program, rehabilitation services, outpatient laboratory, and outpatient radiology (X-ray, ultrasound, and CT Scan) services to Union County and the surrounding counties. We are devoted to providing all members of our community with premier-quality health care in a compassionate and inviting environment.

We are seeking a knowledgeable Case Manager to join our team!

Job Summary:
The Case Manager monitors referral source systems for patients who meet criteria to be admitted to LBH, and if accepted, creates an account, gets authorization for admission, arranges transportation, and get updates/relays information to team about patients expected arrival time. The Case Manager is responsible for compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning including implementation and annual review of the Utilization Management Plan and assisting with the coordination of the Utilization Management Committee. The Case Manager follows the hospital’s Case Management/Utilization Program that integrates the functions of utilization review, discharge planning, and resource management into a singular effort to ensure, based on patient assessment, care is provided in the most appropriate setting utilizing medically indicated resources. The hospital’s case management model outlines a collaborative practice to improve quality through coordination of care impacting length of stay, minimizing cost, and ensuring optimum outcomes.

Requirements

• Education: Associates degree in healthcare or related field required. Bachelor’s Degree in nursing preferred. Must be a Registered Nurse in the state of Florida.
• Experience: Minimum of five (5) years acute hospital nursing experience or three (3) to five (5) years acute hospital Case Management experience.
• Skills: Strong organizational and interpersonal skills.
• Knowledge: Knowledge of criteria for Medicare, Medicaid, HMO, and private insurance coverage. Knowledge of the continuum of care and utilization process.
• Abilities: Ability to work independently, be attentive to detail, maintain a positive attitude, maintain confidentiality, complete work assignments timely, communicate effectively, be proactive, handle difficult situations in a professional manner and be able to document Case Management plans in a clear and concise manner. Ability to operate a computer and associated peripheral equipment.

Nice To Haves

• Bachelor’s Degree in nursing

Responsibilities

• Facilitate team meetings that foster interdepartmental collaboration with the patient and their family as deemed necessary, including multidisciplinary meetings and Utilization Review/Case Management meetings.
• Provides input in such meetings regarding utilization management and discharge planning and ensures appropriate documentation of completion.
• Responsible for evaluating and screening potential admissions to the facility when appropriate.
• Knowledgeable of criteria for Medicare, Medicaid, HMO, and private insurance coverage.
• Communicate daily with admissions personnel and ancillary staff regarding admissions and discharges to various units.
• Initiate ongoing communication with the patient and patient’s family to assess discharge needs.

What This Job Offers

• Education Level: Associate degree