SD - RN Case Manager - Rapid City
About The Position
The hospital-based RN Case Manager at Monument Health collaborates with medical staff, patients, families, and the healthcare team to assess, facilitate, plan, and advocate for patient health needs, supporting quality and cost-effective outcomes. The role establishes goals and priorities consistent with Monument Health’s mission and supports individualized plans of care for patients in the community. The Case Manager coordinates patient services and transitions across levels and settings of care, supports care planning and discharge coordination, and works with providers and community resources. The position also helps ensure compliance with applicable regulations, payer requirements, quality processes, and organizational standards. A sign-on bonus of up to $20,000 is available for qualified candidates.
Requirements
- Completion of a nursing education program approved by a board of nursing.
- Registered Nurse (RN) certification through the South Dakota Board of Nursing.
Nice To Haves
- Bachelor’s degree in Nursing.
- At least 2 years of acute experience.
- At least 2 years of Registered Nurse experience.
- Commission for Case Management Certification (CCMC) from an accredited university or accredited training professionals.
Responsibilities
- Coordinate services for hospitalized patients, including payer authorization and transportation for transitions from observation care to higher levels of care.
- Triage hospitalized patients to support transitions to appropriate settings, including post-acute and acute care.
- Use critical thinking to assist providers in establishing plan-of-care recommendations.
- Partner with providers and Physician Advisors or Medical Directors to escalate complex cases for review in compliance with Conditions of Participation and escalation standards.
- Coordinate care with hospitals, emergency departments, nursing homes, assisted living facilities, physicians, and community resources.
- Plan for patient and family needs to support smooth transitions across the continuum of care.
- Coordinate provider-related functions under federal and state requirements, including Conditions of Participation and other applicable regulations.
- Support the Medical Staff Quality Review process by identifying issues related to established quality indicators.
- Create and update patient- and family-centered Plans of Care, including goals and interventions that reflect changing needs and preferences.
- Maintain knowledge of community resources and payer benefits to connect individuals with appropriate resources.
- Maintain expertise regarding benefits, reimbursement, and payer, Medicare, and Medicaid contract or regulatory changes to support reimbursement and informed decision-making.
- Guide patients and families on funding applications, guardianship, and charity care programs when needed.
- Evaluate treatment plans to identify barriers, establish realistic goals and objectives, and consider alternatives with medical staff.
- Coordinate with support services departments to ensure appropriate care and smooth discharge transitions.
- Serve as a visible unit resource and coordinate interdisciplinary team huddles and communication, communicating patient needs according to best-practice standards and applicable policies, regulatory guidelines, and True North metrics.
- Perform other duties as assigned.
Benefits
- Up to $20,000 sign-on bonus for qualified candidates.
- Competitive wages.
- Medical, vision, and dental coverage.
- Retirement plans.
- Health Savings Account and Flexible Spending Account.
- Instant pay for qualifying positions.
- Paid Time Off Accrual Bank.
- Opportunities for growth and advancement.
- Tuition assistance or reimbursement.
- Pay differentials for qualifying positions.
- Flexible scheduling.
- Supportive work culture.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
