RN- Case Manager w/ Utilization Review Experience!

MedCadre Inc; Bozeman (MT); On-site; USD 60,000 - 90,000; Full time

Job summary

A leading healthcare company is seeking a Registered Nurse Case Manager with utilization review experience in Bozeman, MT. This role involves developing patient care plans, conducting assessments, and ensuring continuity of care. The successful candidate will work collaboratively with healthcare teams to achieve optimal outcomes for patients. Strong interpersonal and communication skills are necessary for this position.

Qualifications

• Minimum of 2 years of nursing experience required.
• Must have utilization review experience.
• Strong judgment and communication skills are essential.

Responsibilities

• Develops and implements a case management plan with interdisciplinary team.
• Completes comprehensive assessments and monitors care plans.
• Identifies and resolves barriers to patient care.

Skills

Interpersonal Skills

Communication Skills

Judgment

Organization

Computer Applications

Education

Montana Licensure (Registered Nurse)

Bachelor's Degree in Nursing

Tools

EMR (EPIC)

MS Office

Job description

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Job Description

Position Summary:

The Registered Nurse Non-Certified Case Manager works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records. Identifies and resolves barriers that hinder effective patient care. Actively involved in discharge planning process.

Required

Minimum Qualifications:

Montana Licensure (Registered Nurse)

American Heart Association BLS

Minimum Of 2 Years Of Nursing Experience

MUST HAVE UTILIZATION REVIEW EXPERIENCE

Preferred

Bachelor s Degree in Nursing

2 years of acute care hospital experience as a case manager

Essential Job Functions

In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.

Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment.

Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.

Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.

Maintains ongoing member case load for regular outreach and management.

Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for members.

Knowledge, Skills, And Abilities

Demonstrates sound judgement, patience, and maintains a professional demeanor at all times

Ability to work in a busy and stressful environment

Strong interpersonal, verbal and written communication skills

Exercises tact, discretion, sensitivity and maintains confidentiality

Computer applications, MS Office, EMR, internet applications and standard office equipment

Ability to analyze, organize and prioritize work while meeting multiple deadlines

Strong emotional intelligence, interpersonal and teamwork skills

Schedule Requirements

This role requires regular and sustained attendance.

The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.

On-call work may be required to respond promptly to organizational, patient, or employee needs.

Physical Requirements

Lifting (Repeatedly 50 pounds): Exerting force occasionally and/or using a negligible amount of force to lift, carry, push, pull, or otherwise move objects or people.

Sit (Occasionally): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain.

Stand (Repeatedly): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain.

Walk (Repeatedly): Walking and moving around within the work area requires good balance and coordination.

Climb (Rarely): Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like using feet and legs; may also use hands and arms.

Twist/Bend/Stoop/Kneel (Repeatedly): Twisting, bending, and stooping require flexibility and a wide range of motion in the spine and joints.

Reach Above Shoulder Level (Repeatedly): Lifting, carrying, pushing, or pulling objects as necessary above the shoulder, requiring strength and stability.

Push/Pull (Repeatedly): Using the upper extremities to press or exert force against something with steady force to thrust forward, downward, or outward.

Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling.

Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials.

Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow.

Exposures (Continuously): Bloodborne pathogens, such as blood, bodily fluids, or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances. Infectious diseases are caused by contact with patients in areas that may have contagious illnesses. Emotionally challenging situations, such as dealing with distressed patients or difficult family interactions.

Position Urgency

Normal

Shifts

Day Shift. 730am -430pm, Weekend Rotations

State License Details

Must Be Currently Active

Minimum Years Of Experience

2

Minimum Guaranteed Hours

40

Specialty Type

Nursing

Sub Specialty

Care Manager, Med-surg Adult

Bilingual

No

EMR Used

EPIC

Vacation Coverage Required

Yes

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Business Consulting and Services and Hospitals and Health Care

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