Case Manager RN

What You'll Do as a Case Manager RN

You'll facilitate the plan for moving patients from Med/Surg and medical ICU acute areas to the next appropriate level of care. It's about making sure the transition is orderly and safe. You'll work closely with physicians and payors to make sure fiscal resources are used the right way. And you'll serve as a liaison between providers and staff to keep continuity going strong throughout a patient's stay.

Here's what the day to day looks like:

• Provide customer service and communicate in a courteous manner that aligns with service excellence principles. Your goal is to keep patients, families, and physicians satisfied.
• Maintain collaborative relationships with providers, staff, facility liaisons, and outside community agencies. This includes giving medical updates to outside facilities during a patient's hospitalization and at discharge.
• Work with physician groups and monitor documentation to make sure patients of all age groups are getting evidence based care efficiently throughout their entire hospitalization.
• Complete medical record documentation thoroughly and on time.
• Stay current on what services are covered by managed care organizations, private insurances, and government payers.
• Coordinate discharges for acute to acute transfers, transfers to tertiary care centers, skilled nursing facilities, long term care facilities, assisted living facilities, inpatient rehabilitation centers, long term acute care facilities, group homes, hospice, prisons, and more. You can also assist with discharges to hospital related programs like behavioral health services or the hospital at home program.
• Arrange transportation services for acute to acute transfers or transfers to a tertiary care center.
• Help coordinate services like home health care, outpatient dialysis, outpatient/home infusions, durable medical equipment, oxygen supplies, wound care supplies and appointments, outpatient therapy services, and NICU care programs.
• Coordinate and participate in daily and weekly multidisciplinary rounds and any patient care conferences that come up.
• Communicate with Patient Advocate Services to help patients access financial resources.
• Talk with the logistics department about potential transfer back candidates for local community hospitals.
• Complete state required paperwork and documentation for skilled nursing or long term care facilities.
• Work with state officials on patients who are difficult to place.
• Assist with the Important Medicare Message on discharges for all Medicare patients. You'll also complete appeal process paperwork if it's needed.
• Serve as a resource for developing standard operating procedures and standards of care that meet regulatory and participation standards.
• Help collect and maintain records for the Medical Support Services department, Joint Commission, OSHA, or as required by law.

What You Need to Bring

You need a Registered Nurse (RN) license that's active in the state where you'll practice. You need to have that license upon hire.

We'd also prefer if you have:

• Case Management Nurse certification (CMGT BC) from the American Nurses Credentialing Center (ANCC)
• 4 to 6 years of hospital experience or training, or an equivalent mix of education and experience

You should be able to work the hours specified for this role. You'll need enough visual acuity to do the job duties and the ability to communicate effectively with others, hear, understand, and distinguish speech and other sounds. If you need a reasonable accommodation to perform the essential job functions, we'll work with you as long as it doesn't cause undue hardship.

Expectations and Standards

This role asks for a real commitment to Avera's mission, vision, core values, and social principles every day. You'll promote values like compassion, hospitality, and stewardship. You'll uphold Avera's standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. You'll maintain confidentiality. And you'll work effectively in a team environment, coordinating workflow with other team members.

Schedule

This is a day shift position at Avera McKennan Hospital in Sioux Falls, SD.

Pay

The pay range for this role is $34.50 to $51.50 per hour. Your actual pay rate will depend on your experience.