Case Management - Case Manager, RN Part Time

Lake Butler Hospital•Lake Butler, FL

1d•Onsite

About The Position

Lake Butler Hospital is a critical access hospital in North Florida providing emergency, inpatient, rehabilitation, swing bed, laboratory, and radiology services. The hospital seeks a knowledgeable Case Manager to support its Case Management/Utilization Program, which integrates utilization review, discharge planning, and resource management. The program aims to ensure care is provided in the most appropriate setting using medically indicated resources, improve quality through coordinated care, affect length of stay, minimize cost, and ensure optimum outcomes. The Case Manager monitors referral systems for patients who may meet admission criteria. For accepted patients, the role creates an account, obtains admission authorization, arranges transportation, and communicates expected arrival updates to the team. The position supports compliance with CMS Conditions of Participation concerning utilization review and discharge planning, including implementing and annually reviewing the Utilization Management Plan and assisting with coordination of the Utilization Management Committee.

Requirements

Associate degree in healthcare or a related field required.
Must be a Registered Nurse in the state of Florida.
Minimum of five years of acute hospital nursing experience or three to five years of acute hospital Case Management experience.
Strong organizational and interpersonal skills.
Knowledge of criteria for Medicare, Medicaid, HMO, and private insurance coverage.
Knowledge of the continuum of care and utilization process.
Ability to work independently, pay attention to detail, maintain a positive attitude and confidentiality, complete assignments in a timely manner, communicate effectively, be proactive, handle difficult situations professionally, and document Case Management plans clearly and concisely.
Ability to operate a computer and associated peripheral equipment.

Nice To Haves

Bachelor’s degree in nursing preferred.

Responsibilities

Facilitate team meetings that foster interdepartmental collaboration with patients and families as appropriate, including multidisciplinary and Utilization Review/Case Management meetings.
Provide input on utilization management and discharge planning during meetings and ensure appropriate documentation of completion.
Evaluate and screen potential admissions to the facility when appropriate.
Communicate daily with admissions personnel and ancillary staff about admissions and discharges to various units.
Initiate ongoing communication with patients and their families to assess discharge needs.
Monitor referral source systems for prospective patients who meet admission criteria.
For accepted patients, create an account, obtain admission authorization, arrange transportation, and update the team about expected arrival times.
Support compliance with CMS Conditions of Participation related to utilization review and discharge planning.
Implement and annually review the Utilization Management Plan and assist with coordination of the Utilization Management Committee.
Follow the hospital’s Case Management/Utilization Program, integrating utilization review, discharge planning, and resource management.