Gulf Coast Regional Medical
Center is a 216-bed acute care hospital proudly serving Bay County and surrounding communities for 40 years. The hospital was recently named a Joint Commission Top Performer on Key Quality Measures® - heart failure , heart attack , pneumonia, surgical care , and perinatal care - for the fourth consecutive year and has achieved certifications for its stroke and wound care .
Located in Panama City, Florida, its team of more than 450 providers and 1,000 employees work to ensure patients receive the highest quality of care every day. With the areas only designated Pediatric ER , four-bed Pediatric ICU and 28-bed NICU , the hospital is ready to care for our youngest residents. The hospital has the only Accredited Chest Pain Center with Primary PCI as recognized by the Society of Cardiovascular Patient Care. Additionally, the hospital's cancer program is accredited by the Commission on Cancer and the National Accreditation Program for Breast Centers (NAPBC). It is also an affiliate of the University of Alabama at Birmingham (UAB) Cancer Care Network. These designations enhance the hospital's quality of care and demonstrate its commitment to higher, measurable standards of care. POSITION SUMMARY:
The primary purpose of the RN Case Manager is to serve as principal liaison between medical staff, administration, finance, health information management and other ancillary departments to ensure that patient care needs are met and treatment plans are executed in the most appropriate and efficient level of the health care continuum. ESSENTIAL FUNCTIONS:
Qualifications: EDUCATION REQUIRED AND/OR PREFERRED:
- Performs initial screening of identified patients for appropriate level of care, priority, payer status and high risk criteria.
- Collaborates with physicians and Health care team in planning the care of patients and families within the acute setting and along the healthcare continuum.
- Reviews patient population for appropriate disposition and communicates with ED/primary physician.
- Involves the physician, patient and family in planning care and the discharge plan.
- Identifies and transmits system issues impacting patient care to Case Management Director/CFO/UR committee, as appropriate
- Ensures the appropriate status is declared at the time admitting orders are written
- Collaborates with Bachelor's Social Worker in cases where their intervention is indicated.
- Monitors plan of care to ensure timely and cost-effective use of resources.
- Monitors patient's progress along the plan of care and intervenes appropriately on variances when identified.
- Maintains liaison with hospital department managers and other individuals to ensure continuity of care and effective communication of plan of care.
- Provides decision support to the admitting office, registration and nursing supervisor as well as physicians' office staff regarding appropriateness of admission, as needed.
- Coordinates with and corresponds to appropriate agencies and third party payers regarding pre-admission screening, concurrent, outpatient and retrospective review process as it relates to federal and commercial insurance plans to maximize positive financial outcomes.
- Coordinates and assists with Baker Act placements.
- Arranges appropriate after care needs (i.e. HHC, SNF, hospice, etc)
- Reports abuse as per guidelines.
- Provides community resources for unfunded patients.
- Ensures staff abides by government regulations in transferring acutely ill patients to higher or lower level of care.
- Associate Degree, Diploma in Nursing required from an accredited institution
- BSN from an accredited institution preferred
EXPERIENCE REQUIRED OR PREFERRED:
- Current Registered Nurse License in State of Florida required
- Five (5) years case management experience preferred
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A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom