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RN Case Manager

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Care Coordination
  • Uses and documents levels of care criteria for all assigned patients throughout the patient’s hospitalization.
  • Evaluates each patient for appropriate level of care.
  • Ensures hospital reimbursement for services.
  • In collaboration with the interdisciplinary team (IDT), creates and implements an appropriate plan of care for each patient.
  • Identifies obstacles to patient care goals and throughput; intervenes to overcome or eliminate these.
Advocacy
  • Demonstrates caring and involved behaviors to patient/family members and is an active and engaged advocate to achieve positive outcomes.
  • Negotiates with payers and healthcare agencies for services; identifies internal and/or external resources and refers appropriately to meet patient needs.
  • Identifies patients who may benefit from Palliative Care and is an active member of the Palliative Care Team for assigned patients.
  • Educates patients and families about payer issues and coverage including appropriate governmental rules and regulations.
Discharge Planning/Psycho-social Services
  • Performs initial discharge planning assessment. In conjunction with other members of the IDT and the patient and /or patient representative and family develops a discharge plan. Continuously monitors appropriateness of plan and ensures timely implementation.
  • Ensures patient, family, members of the IDT and post-discharges provider are educated about the discharge plan.
  • Ensures continuity of patient care between hospital and post discharge providers.
  • Collaborates with Department Social Workers regarding patient clinical condition, discharge planning and psychosocial issues. Refers complicated discharge planning arrangements, guardianship and conservator questions and as appropriate psychosocial issues to Social Workers.

  • Current MT RN license or ability to obtain upon hire.
  • Previous experience as a case manager, or minimum 3 years current clinical hospital experience or nursing management experience, or current experience working within the St. Vincent Healthcare Care Management Department.
  • Current BLS certification
  • Current case manager certification; preferred.
  • Ability to communicate effectively and diplomatically within an interdisciplinary team.
  • Strong organizational skills.
  • Ability to successfully function in a fast paced, service oriented environment.
  • Computer experience.
Organization: St. Vincent Healthcare, Billings, MT
Primary Location: MT-Billings/Surrounding Areas-Billings
Department: SVB-Utilization Review
Schedule: Full-time
Shift: Variable Shift
FTE: 1.0
Job Number: 17009992
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