Case Manager

Job Summary

UP TO $20,000 FOR QUALIFIED CANDIDATES

It starts with heart. That is what you will do each day. As a Case Manager at Monument Health, you will be valued as an essential team member providing compassionate patient focused care. You will discover a culture of teamwork, professionalism, mutual respect, and— most importantly— a life-changing career. You will make a difference. Every day.

Essential Functions

• Coordination of services for hospitalized patients whose care needs range from observation level of care to emergent/urgent higher level of care transitions to include facilitation of payer authorization and transportation.
• Patient triage for hospitalized patients to ensure transitions to other appropriate settings which range from post-acute care to acute care transitions.
• Uses critical thinking skills to assist providers in establishing plan of care recommendations for hospitalized patients.
• Partners with providers and Physician Advisors/Medical Directors to escalate cases for review on complex cases in compliance with Conditions or Participation and Escalation standards.
• Optimize care coordination with hospital, ER, nursing homes, assisted living facilities, physicians and community resources as necessary.
• Facilitates planning for patient/family needs to ensure a smooth transition for the patient across the continuum of care.
• Supports the Medical Staff Quality Review process by identification of issues related to quality indicators set forth by the Medical Staff.
• Creates and updates the Plan of Care (POC) to include patient/family-centered goals with interventions that reflect the changing needs of the patient/family unit and is consistent with their current needs and desires.
• Maintains a working knowledge and relationship with community resources and payer benefits that link the individual with the most appropriate resources.
• Facilitates planning for patient/family needs to ensure a smooth transition for the patient across the continuum of care to include offering guidance to patients / families regarding applications for funding, guardianship and charity care programs as needed.
• Evaluates current treatment plan to identify barriers, determine realistic goals and objectives, and seek potential alternatives in conjunction with the medical staff.
• Captures and communicates the patient’s Healthcare needs based on the best practice standards to ensure care and communication needs are met in relation to both internal and external providers/services, ancillary department services, core measures, compliance with internal policies/regulatory guidelines and True North metrics.
• Coordinates team efforts with support services departments to ensure appropriate care and smooth discharge transition.
• Is a visible resource on the unit and coordinates interdisciplinary team huddles/communication.

Required Additional Requirements

• Education – Completion of nursing education program that is approved by a board of nursing or Bachelors/Masters Degree in Social Services
• Certification – Registered Nurse (RN) - South Dakota Board of Nursing or Certified Social Work (CSW) - South Dakota Department of Social Services
• Preferred Education - Bachelors in Nursing
• Experience - 2+ years of Acute Experience; 2+ years of Registered Nurse Experience
• Certification - Commission for Case Management Certification (CCMC) - Accredited University or accredited training professionals

Physical Requirements

• Medium work - Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.

Job Description

Job Summary: UP TO $20,000 FOR QUALIFIED CANDIDATES

It starts with heart. That is what you will do each day. As a Case Manager at Monument Health, you will be valued as an essential team member providing compassionate patient focused care. You will discover a culture of teamwork, professionalism, mutual respect, and— most importantly— a life-changing career. You will make a difference. Every day.

Job Category

Patient Services

Job Family

Care Coordination

Shift

Requires the ability to work assigned schedules and hours as determined by the department