RN Case Manager PRN

Fort Walton Beach Medical Center is a 257-bed top-performing quality hospital with over 200 of the most highly respected and qualified physicians in the area. It is the only acute care hospital in the Tri-County area that offers open heart surgery , an Advanced Primary Stroke Center accredited by the Joint Commission and an Accredited Chest Pain Center. An affiliate of the UAB Cancer Community Network , Fort Walton offers a Cancer Care Center that is accredited by the Commission on Cancer Commission on Cancer. Fort Walton Beach Medical Center also provides advanced care for critically ill patients, including cardiovascular and trauma injury care, and emergency services, including a main ER , Pediatric ER and Express ER . Fort Walton Beach Medical Center is in partnership with Twin Cities Hospital, located in Niceville. We are the parent company of the Destin Emergency Care Center (DECC) and the Rehabilitation Institute, both located on Airport Road in Destin.

Position Summary:
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. The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. The RN Case Manager will identify potential barriers to patient throughput and quality outcomes and will facilitate appropriate discharge plans.

Essential Job Functions:
  • Performs initial screening of all bedded patient for appropriate level of care, priority, payer status and high risk criteria.
  • Performs a comprehensive assessment of psychosocial and medical needs of assigned patients
  • Develops a case management plan of care to include identified clinical, psychosocial and discharge needs; coordinates plan of care; plan is documented in the medical record; 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 for assigned case load.
  • Conducts interdisciplinary team meetings to provide a mechanism for all clinical disciplines to collaborate, plan, implement, and assess the plan of care; patient selection should be criteria based 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 the established chain of command. Performs routine medical necessity reviews (daily for unit patients and care coordinated patients).
  • Evaluates and assess observation patients for appropriateness in observation status
  • Acts as a liaison through effective and professional communications between and with physicians, patient / family, hospital staff, and outside agencies
  • Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives; monitors self-compliance and implements process changes to ensure compliance to such regulations and quality initiatives as it relates to the provision of Case Management Services
  • Makes appropriate referrals to third party disease and case management programs for recurring patients and patients with chronic disease states
  • Documents professional recommendations, care coordination interventions, and case management activities to effectively communicate to all members of the health care team
  • Facilitates patient throughput with an ongoing focus on quality and efficiency
  • Tracks and trends barriers to care; makes recommendations and develops action plans to improve processes and systems

  • Associate Degree, Diploma in Nursing required
  • BSN preferred
  • Current Registered Nurse License in State of Florida required
  • BCLS-AHA Healthcare Provider certification required upon hire
  • Three (3) of acute care hospital direct patient care nursing experience required
  • One (1) year of hospital case management experience preferred
  • National Case Management Certification (CCM or ACM preferred)
  • Interqual competence required, certification preferred

An EEO/AA Employer M/F/V/D. Tobacco Free Campus

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