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Starting Pay Rate Range
$29.20
to
$36.50
(Determined by the knowledge, skills, and experience of the applicant.)
Job Summary
The Ambulatory Case Manager (ACM) supports patient care coordination in the primary care ambulatory clinic setting. The ACM primary responsibility provides clinical evidence-based care management support to assist the delivery of effective education, self-management and timely health care delivery to high risk and rising risk patients associated with the assigned ambulatory clinic. The ACM works collaboratively with the multidisciplinary care team to deliver seamless transitions through the continuum of care by guiding the patient through the healthcare system in an efficient and fiscally responsible manner to achieve desired outcomes. The ACM facilitates alliance between the health care team, patients, family/caregivers by assessing, planning, and advocating for health care needs of an individual for quality, cost-effective outcomes. The registered nurse will demonstrate performance consistent with nursing and case management professional standards of practice, care, and the Nurse Practice Act.
Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:
• Supportive work culture
• Medical, Vision and Dental Coverage
• Retirement Plans, Health Savings Account, and Flexible Spending Account
• Instant pay is available for qualifying positions
• Paid Time Off Accrual Bank
• Opportunities for growth and advancement
• Tuition assistance/reimbursement
• Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)
• Flexible scheduling
Job Description
Essential Functions:
• Optimize care coordination with hospital, ER, consulting physicians, and community resources as necessary. Collaborates with physicians, providers, and practice caregivers to identify appropriate patients for care management
• Utilize evidence-based materials related to coordination of care and health transitions to facilitate identification of appropriate interventions for improvement and maintenance of health.
• Maintains a working knowledge and relationship with community resources and payer benefits that link the individual with the most appropriate resources. Assists by maintaining expertise on benefits, reimbursement and contract/regulation changes per payer guidelines, Medicare and Medicaid to facilitate appropriate reimbursement, education and guidance to assist the Healthcare team and patient/family in decision making.
• Collaborate with the interprofessional health team across health care settings to effectively implement coordination plans while maintaining fiscal accountability and individual patient advocacy.
• Collaborate with the patient and multidisciplinary team in evaluating change readiness, assessing patient needs, developing plan of care, designing teaching plans/programs, and evaluating the patient’s progress toward health care goals and attaining expected outcomes.
• Educates the patient and the patient’s family/caregiver about self-management tasks they can undertake to gain greater control of their health status through patient involvement in activities to improve their health, encourage wellness, avoid preventable hospital admissions, and address advance care planning where applicable. Identifies potential barriers to learning and/or care delivery and makes appropriate suggestions for change.
• Responsible for the collaborative development and monitoring of identified outcomes measures. Conducts current and retrospective clinical reviews for the purposes of determining best practice patient care outcomes including most cost effective, appropriate care for the patient, and the effectiveness of care coordination.
• Anticipates the needs of this patient population, seeing that necessary documentation and pre-visit planning is completed or requested before patient visit. Utilizes available resources efficiently and takes cost-effectiveness into account when assisting patients in scheduling medical services.
• Stays informed of the latest developments, trends and changes in healthcare; regularly attends continuing education and training opportunities in case management field.
• All other duties as assigned.
Additional Requirements
Required:
Education – Completion of a nursing education program that is approved by a board of nursing
Certifications – Basic Life Support (BLS) Certification – American Heart Association (AHA); Registered Nurse (RN) – South Dakota Board of Nursing
Preferred:
Education – Bachelors degree in Nursing
Certification – Commission for Case Management Certification (CCMC) – Accredited University or accredited training professionals
Physical Requirements:
Medium work – Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.
Job Category
Nursing
Job Family
Ambulatory Nursing
Department
MHMC-SP 10th St. Primary Care
Scheduled Weekly Hours
36
Shift
Employee Type
Regular
62 Monument Health Spearfish Hospital
Make a difference. Every day.
Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.
