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 standards 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.
• 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 and goals of Monument Health.
• Support compliance with Utilization Review and regulatory guidelines.
• Create and update the Plan of Care (POC) with patient/family-centered goals.
• Maintain knowledge of community resources and payer benefits to assist patients.
• Evaluate treatment plans to identify barriers and determine realistic goals.
• Coordinate interdisciplinary team huddles and communication regarding patient needs.

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 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