Case Manager

2 days ago

Rapid City, South Dakota, United States Monument Health Full time
Job Summary

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.
Requirements:
  • 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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