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  • 4 days ago

jobs description

Current Employees:

To apply for a job opening within the company, internal candidates must first log into their Workday account. Once logged in, click on the Career icon on your homepage to access the internal career site and begin the application process...

Starting Pay Rate Range

$34.00 - $42.50

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

Provides clinically based care management to ensure effective and efficient patient and family-centered care in an acute care hospital setting. Responsible for collaborating with medical staff, patients, families, and the healthcare team by assessing, facilitating, planning, and advocating for individual health needs to achieve quality, cost-effective outcomes. Sets realistic goals and coordinates efforts for smooth discharge planning and clear follow-up after discharge. Uses InterQual criteria guidelines to confirm medical necessity for admission and continued stay. Establishes goals and priorities aligned with Monument Health's mission and goals, and meets the requirements of JCAHO and other relevant federal, state, and local regulatory or accrediting bodies. Works with medical staff and the interdisciplinary team to promote quality patient outcomes and performs follow-up discharge calls within 48 hours

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:
• Supportive work culture
• Medical, Vision and Dental Coverage
• Retirement Plans, Health Savings Account, and Flexible Spending Account
• Instant pay is available for qualifying positions
• Paid Time Off Accrual Bank
• Opportunities for growth and advancement
• Tuition assistance/reimbursement
• Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)
• Flexible scheduling

Job Description

Essential Functions:
• Collaborating in the development of a comprehensive plan of care requires assistants to be well-versed in the most current information on reimbursement procedures, managed care contracts and patient status.
• Coordinates and manages provider-related matters, including compliance with regulatory requirements and ongoing quality assurance.
• By monitoring compliance with Utilization Review and regulatory standards, the assistant aids in identifying trends. Collaborating with hospital staff and external agencies is necessary to facilitate appropriate process adjustments.
• Assists the medical staff in assessing the quality review process by recognizing issues related to quality indicators established by the medical staff.
• Develops a Plan of Care (POC) that is patient-focused and includes interventions that are in line with the patient and their family's current needs and preferences.
• Maintains a thorough knowledge of Medicare and Medicaid regulations, which serves as a tool for providing patients/families with the necessary financial education and guidance required when making informed decisions that affect their healthcare.
• Aids in the development of a comprehensive plan for patient and family requirements, to facilitate a seamless transition across the care continuum.
• Realistic goals and objectives are established by evaluating the current treatment plan to identify any barriers to progress. The medical staff and support services work in tandem to ensure seamless discharge transition for the patient.
• The unit's resource is responsible for organizing and coordinating interdisciplinary team huddles and communication with internal and external providers to meet the patient's healthcare needs. The resource assesses the patient's needs based on the best practice standards, core measures, internal policies, regulatory guidelines, and True North metrics to ensure that the patient's communication and care requirements are met efficiently.
• All other duties as assigned.

Additional Requirements

Required:

Education - Completion of a nursing education program that is approved by a board of nursing

Certification - Registered Nurse (RN) - South Dakota Board of Nursing

Preferred:

Education - Bachelors in Nursing

Experience - 5+ years of Acute Experience; 5+ 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 Category

Patient Services

Job Family

Care Coordination

Department

RCH Care Management

Scheduled Weekly Hours

0

Shift

Employee Type

PRN

10 Monument Health Rapid City Hospital, Inc.

Make a difference. Every day.

Monument Health is an equal opportunity employer that offers employment opportunities to applicants regardless of their race, gender, religion, or national origin
Brainerd MN United States

salary-criteria

Apply - Lead Case Manager | Rapid City Hospital | PRN Brainerd