RN Care Manager

Job Description

Summary:

The Staff Pad is proud to collaborate with a non-profit healthcare system in Helena, Montana, dedicated to providing exceptional care and a strong community commitment. We are currently seeking a RN Care Manager to join their team.

Job Description:

The Case Management/Utilization Review RN works with patients, families, physicians, and the interdisciplinary team to ensure efficient and cost-effective care from the Emergency Room through discharge. Responsibilities include implementing evidence-based protocols, facilitating patient navigation, and advocating for patients and families throughout their care journey.

Aptitudes:

1. Strong communication and negotiation skills.
2. Knowledge of community and system resources.
3. Excellent organizational and time management abilities.
4. Ability to work independently.
5. Experience with Word, Excel, and Meditech preferred.

Responsibilities:

Access Management/ED Coordination:

1. Collaborate with medical staff to confirm admission status and treatment goals.
2. Meet with patients and families to assess navigation and transition needs.
3. Coordinate timely reviews and follow-ups with E.H.R. physician consultants.
4. Identify financial barriers and refer to appropriate services.
5. Utilize high-risk screens to identify patients needing focused management.
6. Confirm admission diagnosis and related quality measures.

Progression of Care:

1. Work with physicians and staff for initial assessments and resource management.
2. Encourage adherence to clinical protocols and evidence-based interventions.
3. Provide coaching for documentation improvement and safety indicators.
4. Suggest treatment alternatives to reduce resource consumption.
5. Initiate referrals for home health, hospice, and other services.
6. Consult with the Medical Advisor to resolve barriers.
7. Communicate proactively to influence care progression.
8. Participate in daily staffing meetings to support the team.

Transition/Discharge:

1. Identify patients with complex needs and refer to Social Worker Counselor.
2. Collaborate with Social Worker Counselor on discharge plans.
3. Facilitate patient movement to alternate care levels as needed.
4. Communicate care plans to receiving case managers if unable to follow patients.

Additional Performance Expectations:

1. Function as a member of a self-directed Care Management team.
2. Participate in departmental committees and performance improvement activities.
3. Assist in the orientation of new employees.
4. Prepare monthly updates on work accomplishments.
5. Promote efficient delivery of services to patients and physicians.
6. Complete required educational offerings annually.
7. Manage time and coordinate departmental functions effectively.
8. Perform other assigned duties as needed.
9. Provide weekend and holiday coverage as required.

Qualifications:

Knowledge/Experience:

1. 3-5 years of acute care experience required.

Education:

1. Registered Nurse required; Baccalaureate degree preferred.

Licensure/Certification: Must be licensed in Montana; certification in Case Management and/or Utilization Review is desired.