Lead Case Manager | Community Health

$36,317 - $56,826/Yr

Monument Health Rapid City, SD - Rapid City, SD

Full-time - Mid Level

Rapid City, SD

11-50 employees

About the position

The Lead Case Manager at Monument Health is responsible for providing clinically based care management to ensure effective and efficient patient and family-centered care within the acute care hospital setting. This role involves collaboration with medical staff, patients, families, and the healthcare team to assess, facilitate, plan, and advocate for individual health needs, resulting in quality and cost-effective outcomes. The Lead Case Manager will also coordinate discharge planning and follow-up care, ensuring compliance with regulatory guidelines and promoting quality patient outcomes.

Responsibilities

• Provide clinically based care management to support patient and family-centered care.
• Collaborate with medical staff, patients, families, and the healthcare team to assess and facilitate care needs.
• Determine realistic goals and coordinate efforts for smooth discharge planning.
• Utilize InterQual criteria guidelines to confirm medical necessity for admission and continued stay.
• Establish goals and priorities consistent with the mission of Monument Health and regulatory requirements.
• Support compliance with Utilization Review and regulatory guidelines.
• Create and update the Plan of Care (POC) with patient/family-centered goals and interventions.
• Maintain knowledge of community resources and payer benefits to assist patients and families.
• Facilitate planning for patient/family needs to ensure smooth transitions across the continuum of care.
• Evaluate treatment plans to identify barriers and seek alternatives in conjunction with medical staff.

Requirements

• Completion of a nursing education program approved by a board of nursing.
• Registered Nurse (RN) certification from the South Dakota Board of Nursing.
• 5+ years of acute care experience.
• 5+ years of Registered Nurse experience.

Nice-to-haves

• Bachelor's degree in Nursing.
• Commission for Case Management Certification (CCMC) from an accredited university or training professionals.

Benefits

• Supportive work culture
• Medical, Vision and Dental Coverage
• Retirement Plans, Health Savings Account, and Flexible Spending Account
• Instant pay available for qualifying positions
• Paid Time Off Accrual Bank
• Opportunities for growth and advancement
• Tuition assistance/reimbursement
• Excellent pay differentials for evening, night, or weekend shifts
• Flexible scheduling