RN Case Manager, Health Plan (North Dakota or South Dakota)
Company: Sanford Health
Location: Sioux Falls
Posted on: April 25, 2024
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Job Description:
Careers With Purpose
Sanford Health is one of the largest and fastest-growing
not-for-profit health systems in the United States. We're proud to
offer many development and advancement opportunities to our nearly
50,000 members of the Sanford Family who are dedicated to the work
of health and healing across our broad footprint.
Facility: Cherapa Place Building
Location: Sioux Falls, SD
Address: 300 N Cherapa Pl, Sioux Falls, SD 57103, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40. 00
Salary Range: $29.00 - $46.50
Department Details
Registered Nurse Case Manager position available on our Care
Management team. Core hours M-F, 8 to 5. No weekends or holidays
with potential flexible scheduling once criteria met. Work with
members to improve and better manage their health through
education, goal setting and coordination of care.
Job Summary
The case manager provides case management and care coordination for
designated Health Plan members. Develops a care plan that includes
managing and directing members to appropriate resources, services
and programs. Evaluates for comprehensive coordination of care and
health services to manage members across the continuum, creates
action plans for members and helps them track toward program
graduation. Collaborates with the integrated team and partners in
order to provide a seamless exchange of information between
providers, members and caregivers with the ultimate outcome to
improve quality, reduce costs and enhance the member
experience.
Conducts member assessments, identifies gaps and interventions, and
coordinates ongoing care with physician and integrated team.
Coordinate with facilities to assist with discharge planning,
aftercare follow-up appointments and transition of care as
appropriate. Coordinates and manages medical/behavioral health
needs of members across the continuum of care. May perform
authorizations for services as indicated for specialty case
management. Provides educational resources to member based on
medical and behavioral health needs. Serve as a consult on cases
for their clinical expertise when they are not the lead case
manager. Supports a successful self-management of their long-term
health status. Uses internal and external resources to provide
quality and cost-efficiency care. Utilizes motivational techniques
to promote member engagement.
Possesses strong clinical knowledge and skills. Collaborates with
team members both internally and externally to ensure care is
coordinated and appropriate based on evidence based medicine. Must
be self-motivated with the ability to work independently, a problem
solver and fiscally responsible.
Ability to work independently or as a member of a team. Ability to
multitask and work with little direction. Works primarily day
hours. Works primarily telephonically in an office environment and
onsite as needed. Travel may be required as necessary.
Qualifications
Depending on area of focus, education, experience and licensure
differs.
Bachelor's degree in nursing required.
Graduate from a nationally accredited nursing program preferred,
including, but not limited to, Commission on Collegiate Nursing
Education (CCNE). Accreditation Commission for Education in Nursing
(ACEN), and National League for Nursing Commission for Nursing
Education Accreditation (NLN CNEA) is strongly preferred.
Will consider applicant with significant background in case
management, transplant services and/or other utilization review
experience. Minimum of three years nursing experience is
required.
Currently licensed with the applicable state nursing board and/or
possess multistate licensure privileges as required by position.
Current Commission for Case Manager Certification (CCMC) is
preferred or is to be obtained within two years of employment.
Benefits
Sanford Health offers an attractive benefits package for qualifying
full-time and part-time employees. Depending on eligibility, a
variety of benefits include health insurance, dental insurance,
vision insurance, life insurance, a 401(k) retirement plan,
work/life balance benefits, and a generous time off package to
maintain a healthy home-work balance. For more information about
Total Rewards, visit https://sanfordcareers.com/benefits .
Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an
individual with a disability and would like to request an
accommodation for help with your online application, please call
1-877-673-0854 or send an email to talent@sanfordhealth.org .
Sanford Health has a Drug Free Workplace Policy. An accepted offer
will require a drug screen and pre-employment background screening
as a condition of employment.
Req Number: R-0177724
Job Function: Health Plan
Featured: No
Keywords: Sanford Health, Sioux Falls , RN Case Manager, Health Plan (North Dakota or South Dakota), Executive , Sioux Falls, South Dakota
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