What are the responsibilities and job description for the CASE MANAGER position at Baptist Health Care?
Overview :
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 patients 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.
Qualifications :
- 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.
