Case Manager
2 days ago
At Monument Health, we are committed to delivering exceptional patient care and creating a culture of teamwork, professionalism, and mutual respect. As a Case Manager, you will play a vital role in ensuring the seamless transition of patients across the continuum of care.
Key Responsibilities:- Coordinate services for hospitalized patients, facilitating payer authorization and transportation as needed.
- Provide patient triage to ensure smooth transitions to other appropriate settings, including post-acute care and acute care.
- Utilize critical thinking skills to assist providers in establishing plan of care recommendations for hospitalized patients.
- Partner with providers and Physician Advisors/Medical Directors to escalate complex cases for review and ensure compliance with Conditions of Participation and Escalation standards.
- Optimize care coordination with hospital, ER, nursing homes, assisted living facilities, physicians, and community resources to ensure a smooth transition for patients.
- Support the Medical Staff Quality Review process by identifying issues related to quality indicators set forth by the Medical Staff.
- Create and update the Plan of Care (POC) to include patient/family-centered goals with interventions that reflect the changing needs of the patient/family unit.
- Maintain a working knowledge of community resources and payer benefits to link individuals with the most appropriate resources.
- Facilitate planning for patient/family needs to ensure a smooth transition for patients, including offering guidance on applications for funding, guardianship, and charity care programs as needed.
- Evaluate current treatment plans to identify barriers, determine realistic goals and objectives, and seek potential alternatives in conjunction with the medical staff.
- Coordinate team efforts with support services departments to ensure appropriate care and smooth discharge transitions.
- Education: Completion of a nursing education program approved by a board of nursing.
- Certification: Registered Nurse (RN) - South Dakota Board of Nursing.
- Preferred: Bachelors in Nursing, 5+ years of Acute Experience, 5+ years of Registered Nurse Experience, Commission for Case Management Certification (CCMC).
Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.
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