Hospital Risk Management Jobs in Montana (NOW HIRING)

Under the direction of department leadership, the RN CareManager provides services consisting of comprehensive care management, carecoordination and care continuing care services. Accountable for a designatedpatient caseload/population and plans effectively in order to meet patientneeds. Supports providers and the multidisciplinary in facilitating patientcare. Strives to enhance the quality of clinical outcomes and patientsatisfaction while managing the cost of care.

Essential Job Functions
Assessment
 Conducts initial and ongoing assessments and chart reviews of eachassigned patient to identify potential and or actual barriers and care needs.
 Proactively screens and assesses the acuity and transitional needs ofeach assigned patient.
 Engages and collaborates with patients, support systems andthe multidisciplinary/healthcare team to establish a plan of care thataddresses the  mutually identified needs of the patient.
Interventions and Care Coordination
 Demonstrates the ability to interpret clinical information andunderstand health care treatment and systems.
 Supports patients to ensure they can function to the best of theirability and maintain optimal health related to their medical condition(s).Identifies and addresses gaps in knowledge/understanding/education related todisease management.
 Participates in the patient's plan of care by interacting/collaboratingwith patients, support systems, healthcare professionals and community andstate agencies. Serves as a liaison between hospital, clinic and communityagencies to facilitate the exchange of clinical and referral information.
 Identifies high-risk patients through risk stratification tools andongoing assessments including ED utilization and hospitalizations to addressthe medical/psychosocial/financial needs of patients and their support systemsin both hospital and ambulatory settings.
 Reinforces goals of care and treatment plans with patients and supportsystems in order to enhance patient and support system engagement.
 Coordinates care conferences to support effective communication asneeded.
 Helps navigate the patient throughout the continuum of care.
 Effectively collaborates and coordinates care with the Social ServicesCare Manager.
 Maintains current knowledge of community resources and ancillaryclinical services to meet the needs of hospital, clinic and regional customers.
 Provides information about available resources to patients and theirsupport systems.
 Partners with the multidisciplinary/healthcare team and the SocialServices Care Manager to guide/advocate placement to the appropriate Acuterehab, LTACH, SNF, long-term care facility, assisted living facility, or HomeHealth Care, in-home services, hospice, ancillary OP services and/or DME asclinically appropriate.
 Acts as a clinical resource to the Social Services Care Manager.
 Understands consultative disciplines and their role in patient care.
 Maintains respectful and professional communication skills.
Insurance and Utilization Management
Maintains working knowledge of CMS requirements and readmission penalties.
Maintains working knowledge of insurance/payer benefits.

Evaluation
Monitors the need for revisions in the plan of care and makes recommendationsto the multidisciplinary/healthcare team when indicated. Modifies the plan ofcare/goals to reflect changes in patient or their support system status andneeds.
Monitors, evaluates and documents patient progress related to plan of care.

Documentation
 Documents accurately and in a timely manner in the Electronic MedicalRecord per  program guidelines.
 Utilizes standards of professional practice in all documentation andcommunication c  consistent with organization/department policy as well asthe Board of Nursing and  ethical guidelines established and universallysupported by the nursing profession.
 Documentation and patient information shall be secured and maintainedin      accordance with Billings Clinic policy, HIPPA, state andfederal guidelines.

Safety/Quality Assurance/Risk Management
 Identifies service gaps and participates in hospital and departmentprograms to  address and improve quality of care.
 Advocates for marginalized or vulnerable populations by identifyingcases of abuse  and neglect and appropriately involving risk managementand regulatory agencies
Professional Accountabilities
Participates in continuing education, department planning, work teams andprocess  improvement activities.
Maintains current Licensure.
Adheres to department and organizational policies addressing confidentiality,infection  control, patient rights, medical ethics, advance directives,disaster protocols and  safety.
Demonstrates the ability to be flexible, open minded and adaptable to change.
Maintains competency in organizational and departmental policies/processesrelevant to job performance.
Utilizes standards of professional practice in all communication withpatients, support systems and colleagues consistent with the Board of Nursingand ethical guidelines established and universally supported by the nursingprofession.
Minimum Qualifications
Education
 2 Year / Associate Degree Associate Degree in Nursingconsidered with commitment  to complete BSN.
 4 Year / Bachelors Degree BSN required for candidateswith fewer then 5 years registered nursing experience

Experience
 2 - 4 years of successful professionalnursing experience.
 1 Successful inpatient nursing experience, preferred.
 1 Experience working in Billings Clinic, preferred.

License and Certification     
Current Registered Nurse license in the state of Montana,at hire