Case Manager

Monument Health
flexible benefit account, paid time off
United States, South Dakota, Rapid City
677 Cathedral Drive (Show on map)
Nov 10, 2024
Current Employees: If you are a current employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career"icon on your homepage. Primary Location Rapid City, SD USA Department RCH Care Management Scheduled Weekly Hours 40 Starting Pay Rate Range $28.17 - $35.21 (Determined by the knowledge, skills, and experience of the applicant.) Job Summary The Case Manager MSW is a hospital based professional that coordinates and evaluates care options for patients and are responsible for assessing the needs, partnering with the multidisciplinary team and patient / family to develop a plan that aligns with patient goals and access to resources. Coordinates, plans, and delivers the appropriate intervention related to the patients' biopsychosocial needs. Responsible for working with a multidisciplinary team and providing expertise related to the field while balancing regulatory guidelines related to Utilization Review and Conditions of Participation for Discharge Planning 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: Stays current with the provider aspect of federal/state organization regulations to ensure compliance with guidelines and reports / tracks internal metrics accordingly such as Potentially Avoidable Hospital Days, appropriate disposition codes and facilitates notices of non-coverage as appropriate. Support the patient, family, and involved caregiver to understand, accept and follow medical recommendations and provide services planned to assist in achieving the optimum social, spiritual, and health adjustment within their capacity and level of health literacy. This role serves as a resource for the MDT, patient/family and community partners related to their field. Display competence in motivational interviewing, social competence and promote empowerment among a population of hospitalized individuals. Identifies psychosocial, historical, financial, cultural and spiritual needs that guide the planning process with the patient to attain optimal outcomes in conjunction with the MDT. Evaluates current treatment plan to identify barriers, determine realistic goals and objectives, and seek potential alternatives in conjunction with the medical staff. Coordinates team efforts with support service departments to ensure appropriate care and smooth discharge transitions. Partners with providers and Physician Advisors /Medical Directors to escalate cases for review on complex cases in compliance with Conditions of Participation and Escalation standards. Completes an evaluation of hospitalized patients and customizes their plan based on their social determinants of health, MDT plan of care recommendations, access to services and the patient / family goals. Maintains a working knowledge and relationship with community resources and payer benefits that link the individual with the most appropriate resources. Assist by maintaining expertise on benefits, reimbursement, and contract/regulation changes per payer guidelines to provide education to assist the healthcare team and patient/family in decision making. Adheres to federal/state and regulatory standards related to scope of practice per SD Board of Social Work, Joint Commission requirements for Conditions of Participation: Discharge Planning / Utilization Review and the Standards of Practice / Scope of Services from the American Case Management Association. Assist patients to maintain their sense of competency, identity and autonomy and prepares the patient to deal with the changes and the family to support the patient including education on Surrogate Decision Makers / Living Wills and Power of Attorney All other duties as assigned. Additional Requirements Required: Education - Masters degree in Social Services Certification - Certified Social Work (CSW) - South Dakota Department of Social Services Preferred: Experience - 3+ years of Healthcare Experience Physical Requirements: Light work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. Job Category Patient Services Job Family Care Coordination Shift Employee Type Regular 10 Monument Health Rapid City Hospital, Inc. Make a difference. Every day. MonumentHealthis 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.