Experienced RN Case Manager – Patient-Centered Care Coordination and Healthcare Navigation Specialist

Introduction to Monument Health

Imagine being part of a dynamic and compassionate healthcare team that makes a difference in the lives of patients and families every day. At Monument Health, our mission is built on a foundation of heart, teamwork, professionalism, and mutual respect. We are dedicated to providing high-quality, patient-focused care that exceeds expectations and changes lives. As a trusted healthcare provider, we are committed to fostering a culture of inclusivity, empathy, and excellence. If you share our vision and values, we invite you to join our team as an experienced RN Case Manager.

Job Summary

As an RN Case Manager at Monument Health, you will play a vital role in coordinating medical staff, patients, families, and the healthcare team to assess, facilitate, plan, and advocate for the health needs of patients. Your expertise will help drive quality, cost-effective outcomes and ensure that patients receive seamless care transitions. You will be responsible for establishing goals and priorities that align with our mission and vision, working collaboratively with interdisciplinary teams, and providing patient-centered care that addresses the unique needs of our communities.

Key Responsibilities

• Coordinate services for hospitalized patients with diverse care needs, from observation to emergent/urgent transitions, including facilitation of payer authorization and transportation.
• Conduct patient triage to ensure smooth transitions to appropriate settings, such as post-acute care or acute care transitions.
• Utilize critical thinking skills to assist providers in developing plan of care recommendations for hospitalized patients.
• Partner with providers, Physician Advisors, and Medical Directors to escalate complex cases for review, ensuring compliance with Conditions of Participation and Escalation standards.
• Optimize care coordination with hospital, ER, nursing homes, assisted living facilities, physicians, and community resources to facilitate planning for patient/family needs.
• Support the Medical Staff Quality Review process by identifying issues related to quality indicators and collaborating with the healthcare team to address these concerns.
• Create and update individualized Plans of Care (POC) that reflect patient/family-centered goals, interventions, and changing needs.
• Maintain a working knowledge of community resources, payer benefits, and regulatory guidelines to facilitate appropriate reimbursement, education, and guidance for patients, families, and the healthcare team.
• Evaluate current treatment plans to identify barriers, determine realistic goals, and seek potential alternatives in conjunction with the medical staff.
• Coordinate team efforts with support services departments to ensure smooth discharge transitions and high-quality patient care.

Essential Qualifications

To be successful in this role, you will need:

• Completion of a nursing education program approved by a board of nursing.
• Current Registered Nurse (RN) licensure in South Dakota.
• Strong communication, critical thinking, and problem-solving skills.
• Ability to work collaboratively in a fast-paced, dynamic environment.
• Proficiency in electronic medical records and other healthcare software applications.

Preferred Qualifications

While not required, the following qualifications are preferred:

• Bachelor's degree in Nursing.
• 2+ years of acute care experience and 2+ years of registered nursing experience.
• Commission for Case Management Certification (CCMC) or willingness to obtain.
• Experience with care coordination, case management, or healthcare navigation.

Skills and Competencies

To excel in this role, you will need to possess:

• Strong patient assessment and care planning skills.
• Excellent communication, interpersonal, and teamwork skills.
• Ability to work independently and as part of a multidisciplinary team.
• Strong problem-solving and critical thinking skills.
• Proficiency in time management, organization, and prioritization.
• Ability to maintain confidentiality and handle sensitive information with discretion.

Career Growth and Learning Benefits

At Monument Health, we are committed to supporting the growth and development of our employees. As an RN Case Manager, you will have access to:

• Competitive wages and benefits packages.
• Opportunities for professional development and continuing education.
• Tuition assistance and reimbursement programs.
• Mentorship and coaching from experienced healthcare professionals.
• Cross-training and rotation opportunities to expand your skill set.

Work Environment and Company Culture

Our work environment is built on a foundation of respect, empathy, and inclusivity. As an RN Case Manager, you will be part of a dynamic team that values:

• Collaboration and teamwork.
• Open communication and transparency.
• Patient-centered care and compassion.
• Professional growth and development.
• Work-life balance and flexibility.

Compensation, Perks, and Benefits

We offer a comprehensive compensation package that includes:

• Competitive salary range: $32.40 - $40.50 per hour (depending on experience).
• Medical, vision, and dental coverage.
• Retirement plans, health savings account, and flexible spending account.
• Instant pay options for qualifying positions.
• Paid time off accrual bank and flexible scheduling.
• Opportunities for growth and advancement.
• Tuition assistance and reimbursement programs.
• Excellent pay differentials for evening, night, or weekend shifts.

Conclusion

If you are a compassionate and experienced RN Case Manager looking for a new challenge, we encourage you to apply for this exciting opportunity. Join our team at Monument Health and make a difference in the lives of patients and families every day. Apply now and take the first step towards a rewarding and fulfilling career in healthcare navigation and case management.