RN Case Manager PRN Days

Position Summary

Baptist Health Princeton Hospital

Serving our neighbors for more than a century, Baptist Health Princeton Hospital in Birmingham is a 505-bed facility dedicated to a patient-first approach.

A recognized leader in aortic valve surgery, COPD, heart attack, heart failure and stroke, we provide fast, lifesaving response times for patients with chest pain or stroke symptoms. Our full range of services includes comprehensive emergency room care; cardiovascular care, including structural heart and valve care; orthopedics, including rehabilitation; a comprehensive sleep center; a comprehensive bariatrics center, providing surgical and nonsurgical weight-loss procedures; and women's care for all stages of life.

We have achieved Primary Stroke Center certification from The Joint Commission and accreditation from the American College of Surgeons Commission on Cancer and from the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). At Baptist Health Princeton Hospital, we are committed to contributing to the future of healthcare through our clinical research and medical residency program.

Baptist Health Princeton Hospital offers great NEW competitive pay and benefits!

• Medical, Dental, Vision
• 403(b) Retirement Savings Plan w/matching
• Health Savings Account (HSA)
• Flexible Spending Account (FSA)
• Paid Time Off (up to 5 weeks to start)
• Life Insurance
• Extended Leave Plan (ELP)
• Family Care (childcare, elder care, pet care)
• Educational Benefits including tuition reimbursement & monthly payments to help pay down any graduated school debt

ALL benefits start on day one!

Position Summary


Promotes and facilitates effective use of hospital resources. Assists with planning an individual comprehensive case management plan addressing patient/family needs and transition to the next appropriate level of care.

Responsibilities

Essential Functions:

Initially and concurrently assesses all patients within assigned population to include but not limited to admitting diagnosis/medical
history, current treatments/therapies, age, payment source, criteria compliance, resources, support systems, anticipated needs,
expected length of stay, appropriate level of service, special/personal needs, and other relevant information.
Assigns working DRG and GMLOS, while concurrently monitoring and managing LOS, as appropriate (determined by medical
necessity using Interqual guidelines).
Develops collaborative relationships with patient/family, patient business, nursing staff/leadership, physicians, social workers, care
coordinators, and ancillary services to facilitate optimal patient outcomes and efficient movement through the continuum of care.
Prioritizes activities in assigned areas to focus on high risk, high cost, and problem prone areas.
Acts as an advocate for patient's health care needs.
Performs admission and concurrent utilization review in compliance with review requirements for Managed Care contracts,
governmental payors (i.e. Medicare, Medicaid, and Champus) and departmental review policies; adheres to Utilization
Management Plan.
Communicates in an appropriate and timely manner with interdisciplinary team to coordinate/evaluate plan of care.
Communicates with third party payers and external care team as appropriate/necessary.
Monitors and evaluates data, fiscal outcomes, and other relevant information to develop and implement strategies for process
improvements related to case management activities.
Maintains positive relationships with peers, collaborative team, outside reviewers, and post-acute providers.
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal,
state, and local standards.
Maintains compliance with all Orlando Health policies and procedures.
Other Related Functions
Demonstrates awareness of medical/ legal issues, patient rights and compliance with standards of regulatory and accrediting
agencies.
Serves as a facilitator to physician, nursing staff/leadership and ancillary services (physical therapy, respiratory therapy, clinical
social work, care coordination, etc.).
Maintains records and documentation of work performed in a timely, organized, and easily retrievable fashion.
Reviews current literature on a regular basis; stays current on changes in policies/procedures, maintains reference materials and
updates as required, and keeps abreast of relevant reimbursement information.
Assumes responsibility as a self-directed professional for ongoing education, based on individual identified needs.
Actively serves on committees and task force teams to promote quality, cost-effective care for patient population.
Maintains positive relationships with outside reviewers and other payer representatives.
Forwards identified quality and/or risk issues to appropriate person.

Qualifications

Education/Training
Must have one of the following to be in this role:
o Bachelor of Science in Nursing degree (BSN)
o Associate of Science in Nursing (ASN)
o Be a Diploma Nurse with 5 or more years of applicable/related experience.