RN Case Manager

HCA•Pensacola, FL

34d

About The Position

The RN Case Manager will facilitate the interdisciplinary plan of care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care, and resource management. Responsible for coordinating activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. Identify potential barriers to patient throughput and quality outcomes and will facilitate appropriate discharge plans. Performs a comprehensive assessment of psychosocial and medical needs of assigned patients. Develops a case management plan of care to include identified clinical, psychosocial, discharge needs, and coordinates plan of care. Ensures plan is documented in the medical record and plan is communicated to appropriate clinical disciplines. Assumes a leadership role with the interdisciplinary team to manage care, through criteria driven processes, for the appropriate level of care, patient status, and resource utilization. Conducts interdisciplinary team meetings to provide a mechanism for all clinical disciplines to collaborate, plan, implement, and assess the plan of are. Patient selection should be based on criteria and interventions will be documented. Evaluates admissions for medical necessity using approved criteria at defined intervals throughout the episode of care.Escalates medical necessity and admission status issues through established chain of command. Performsutilizationmanagement reviews and communicatestothird party payors. Acts as a liaison through effective and professional communications between and with physicians,patient, family, hospital colleagues, and outside agencies. Documents professional recommendations, care coordination interventions, and case management activities toeffectivecommunicatetoall members of the healthcare team. Promotes and displays a positivecustomer orienteddemeanor to patients, visitors, staff, and physicians. Actively seeks ways to control costs without compromising patient safety, quality of care, or the services delivered. Demonstrates knowledge ofthe occurrence reporting system. Uses system to report potential patient safety issues. Uses Performance Improvement Plan to improve patient safety. Other duties as assigned.

Requirements

(RN) Registered Nurse
Associate Degree
Bachelors in Nursing
1+ year of prior case management experience
Registered Nurse - Currently licensed as a registered professional nurse in the state in which he or she practice, in accordance with law and regulation. State of Florida license or appropriate compact licensure.

Nice To Haves

Certified Case Manager preferred

Responsibilities

Performs a comprehensive assessment of psychosocial and medical needs of assigned patients.
Develops a case management plan of care to include identified clinical, psychosocial, discharge needs, and coordinates plan of care. Ensures plan is documented in the medical record and plan is communicated to appropriate clinical disciplines.
Assumes a leadership role with the interdisciplinary team to manage care, through criteria driven processes, for the appropriate level of care, patient status, and resource utilization.
Conducts interdisciplinary team meetings to provide a mechanism for all clinical disciplines to collaborate, plan, implement, and assess the plan of are. Patient selection should be based on criteria and interventions will be documented.
Evaluates admissions for medical necessity using approved criteria at defined intervals throughout the episode of care.Escalates medical necessity and admission status issues through established chain of command.
Performsutilizationmanagement reviews and communicatestothird party payors.
Acts as a liaison through effective and professional communications between and with physicians,patient, family, hospital colleagues, and outside agencies.
Documents professional recommendations, care coordination interventions, and case management activities toeffectivecommunicatetoall members of the healthcare team.
Promotes and displays a positivecustomer orienteddemeanor to patients, visitors, staff, and physicians.
Actively seeks ways to control costs without compromising patient safety, quality of care, or the services delivered.
Demonstrates knowledge ofthe occurrence reporting system. Uses system to report potential patient safety issues.
Uses Performance Improvement Plan to improve patient safety.
Other duties as assigned.

Benefits

Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.