Registered Nurse (RN) Case Manager | MCK Case Management

Avera•Sioux Falls, SD

19h•$35 - $52•Onsite

About The Position

Facilitates the plan for an orderly transition of patients from the Med/Surg and medical ICU acute area settings to the next appropriate level of care. Works closely with physicians and payors to assure proper use of fiscal resources. Serves as liaison with physicians and staff to assure on going continuity.

Requirements

The individual must be able to work the hours specified.
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.
Registered Nurse (RN) - Board of Nursing
An active license in the state of practice
Upon Hire

Nice To Haves

Case Management Nurse - Board Certified (CMGT-BC) - American Nurses Credentialing Center (ANCC)
4-6 years hospital experience and/or training; or equivalent of education and experience

Responsibilities

Provides customer service and communicates in a courteous manner consistent with principles of service excellence in order to achieve patient, family and physician satisfaction.
Maintains collaborative relationships with providers, staff, facility liaisons, and outside community agencies. This includes providing medical updates to any appropriate outside facility during hospitalization and at discharge to ensure continuity of care.
Works closely with physician groups and monitors documentation to assure that patients of all age groups are receiving evidence based care in an efficient manner throughout entirety of hospitalization.
Completes medical record documentation in a thorough and timely manner.
Maintains knowledge of services that are covered by managed care organizations, private insurances, and government payers.
Coordinates all 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, etc. Can assist in discharges to hospital related programs such as behavioral health services or the hospital at home program.
Case managers are responsible for arranging any transportation services needed for an acute to acute transfer or for a transfer to a tertiary care center.
Helps coordinate and arrange services such as home health care, outpatient dialysis, outpatient/home infusions, durable medical equipment, oxygen supplies, wound care supplies/appointments, outpatient therapy services, NICU care programs, etc.
Coordinates and participates in daily and weekly multidisciplinary rounds and any patient care conferences that are requested.
Communicates with Patient Advocate Services to facilitate financial resources for patients.
Communicates with logistics department for potential transfer back candidates to local community hospitals.
Coordinates and completes are state required paperwork and documentation required for skilled nursing or long term care facilities.
Works and coordinates with state officials for difficult to place patients.
Assists with the Important Medicare Message on discharges for all Medicare patients and will complete the appeal process paperwork if necessary.
Serves as a resource in the development of and complies with standard operating procedures and standards of care to meet regulatory and participation standards.
Assists with the collection and maintenance of records as needed by the Medical Support Services department, Joint Commission, OSHA, or as may be required by law.