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Registered Nurse-Case Manager (RN) | Case Management

Registered Nurse-Case Manager (RN) | Case Management

Avera HealthSioux Falls, SD, USA
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Registered Nurse-Case Manager (RN) | Case Management at Avera Health summary :

The Registered Nurse-Case Manager (RN) facilitates patient transitions from acute care settings to appropriate levels of care while collaborating with a multidisciplinary team. This role involves coordinating discharges, communicating with external facilities, and ensuring continuity of care for patients, aligning with healthcare regulations and standards. The position requires strong customer service skills and expertise in managed care resources to optimize patient outcomes.

Location :

Avera McKennan Hospital

Worker Type : Regular

Work Shift :

Day Shift (United States of America)

Pay Range :

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$34.00 - $51.00

Position Highlights

Varied Shifts, Monday-Friday, 7 : 30am-4 : 00pm – can be flexible, occas wknd (6 / 7 weekends / year, no evening / nights)

  • This position may be eligible for a sign-on bonus up to $15,000

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

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.

What you will do

  • 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.
  • Essential Qualifications

    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.

    Required Education, License / Certification, or Work Experience :

  • Registered Nurse (RN) - Board of Nursing An active license in the state of practice Upon Hire
  • Preferred Education, License / Certification, or Work Experience :

  • 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
  • Expectations and Standards

  • Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
  • Promote Avera’s values of compassion, hospitality, and stewardship.
  • Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
  • Maintain confidentiality.
  • Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
  • Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.
  • Benefits You Need & Then Some

    Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

    PTO available day 1 for eligible hires.

    Free health insurance options, for full-time single coverage on Avera High Deductible Health Plan

    Up to 5% employer matching contribution for retirement

    Career development guided by hands-on training and mentorship

    Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org .

    Keywords :

    Registered Nurse, Case Manager, Patient Transition, Healthcare Coordination, Discharge Planning, Managed Care, Multidisciplinary Team, Patient Advocacy, Care Continuity, Hospital Nursing

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    Rn Case Management • Sioux Falls, SD, USA

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