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About Us
Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group practice and a 304-bed hospital. Learn more about Billings Clinic (our organization, history, mission, leadership and regional locations) and how we are recognized nationally for our exceptional quality.
Your Benefits
We provide a comprehensive and competitive benefits package to all full-time employees (minimum of 24 hours/week), including Medical, Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more. Click here for more information or download the 2021 Employee Benefits Guide.
Magnet: Commitment to Nursing Excellence
Billings Clinic is proud to be recognized for nursing excellence as a Magnet®-designated organization, joining only 97 other organizations worldwide that have achieved this honor four times. The re-designation process happens every four years. Click here to learn more!
RN Care Manager (Full-time/Billings)
CARE MANAGEMENT (Billings Clinic Main Campus)
req7906
Shift: Day
Schedule: M-F 7:30-4:00, will include some weekend shifts.
Employment Status: Full-Time (.75 or greater)
Hours per Pay Period: 1.00 = 80 hours (Non-Exempt)
Starting Wage DOE: $38.96 - $48.71 per hour
Under the direction of department
leadership, the Care Manager provides services consisting of comprehensive care
management, care coordination and care continuing care services. The Care
Manager is accountable for a designated patient caseload/population and plans
effectively in order to meet patient needs. The Care Manager is a support to
providers and the multidisciplinary in facilitating patient care. The Care
Manager strives to enhance the quality of clinical outcomes and patient
satisfaction while managing the cost of care.
Essential Job Functions
• Supports and models behaviors
consistent with Billings Clinic’s mission, vision, values, code of business
conduct and service expectations. Meets all mandatory organizational and
departmental requirements. Maintains competency in all organizational, departmental,
and outside agency standards as it relates to the environment, employee,
patient safety or job performance.
• Conducts initial and ongoing
assessments and chart reviews of each assigned patient to identify potential
and or actual barriers and care needs.
• Proactively screens and assesses
the acuity and transitional needs of each assigned patient.
• Engages and collaborates with
patients, support systems and the multidisciplinary/healthcare team to
establish a plan of care that addresses the mutually identified needs of the
patient.
• Demonstrates the ability to
interpret clinical information and understand health care treatment and
systems.
• Supports patients to ensure they
can function to the best of their ability and maintain optimal health related
to their medical condition(s). Identifies and addresses gaps in
knowledge/understanding/education related to disease management.
• Participates in the patient’s
plan of care by interacting/collaborating with patients, support systems,
healthcare professionals and community and state agencies. Serves as a liaison
between hospital, clinic, and community agencies to facilitate the exchange of
clinical and referral information.
• Identifies high-risk patients
through risk stratification tools and ongoing assessments including ED
utilization and hospitalizations to address the medical/psychosocial/financial
needs of patients and their support systems in both hospital and ambulatory
settings.
• Reinforces goals of care and
treatment plans with patients and support systems in order to enhance patient
and support system engagement.
• Coordinates care conferences to
support effective communication as needed.
• Helps navigate the patient
throughout the continuum of care.
• Effectively collaborates and
coordinates care with the Social Services Care Manager.
• Maintains current knowledge of
community resources and ancillary clinical services to meet the needs of
hospital, clinic, and regional customers.
• Provides information about
available resources to patients and their support systems.
• Partners with the
multidisciplinary/healthcare team and the Social Services Care Manager to
guide/advocate placement to the appropriate Acute rehab, LTACH, SNF, long-term
care facility, assisted living facility, or Home Health Care, in-home services,
hospice, ancillary OP services and/or DME as clinically 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.
• Maintains working knowledge of
CMS requirements and readmission penalties.
• Maintains working knowledge of
insurance/payer benefits.
• Monitors the need for revisions
in the plan of care and makes recommendations to the
multidisciplinary/healthcare team when indicated. Modifies the plan of
care/goals to reflect changes in patient or their support system status and
needs.
• Monitors, evaluates, and
documents patient progress related to plan of care.
• Documents accurately and in a
timely manner in the Electronic Medical Record per program guidelines.
• Utilizes standards of
professional practice in all documentation and communication consistent with
organization/department policy as well as the Board of Nursing and ethical
guidelines established and universally supported by the nursing profession.
• Documentation and patient
information shall be secured and maintained in accordance with Billings Clinic
policy, HIPPA, state and federal guidelines.
• Identifies service gaps and
participates in hospital and department programs to address and improve quality
of care.
• Advocates for marginalized or
vulnerable populations by identifying cases of abuse and neglect and
appropriately involving risk management and regulatory agencies.
• Participates in continuing
education, department planning, work teams and process 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/processes relevant to job performance.
• Utilizes standards of
professional practice in all communication with patients, support systems and
colleagues consistent with the Board of Nursing and ethical guidelines
established and universally supported by the nursing profession.
• Performs all other duties as assigned or as needed to meet the needs of
the department/organization.
• Collaborates with post-acute
services, Ambulatory Care Managers and PCP’s to ensure successful transition
back to the home environment. Makes appropriate Ambulatory Care Management
referrals. Anticipates those patients who may require more support after
hospital discharge and communicates these concerns.
• Utilizes length of hospital
stay, past utilization of resources and risk stratification to identify
patients at high risk for readmission.
• Interfaces effectively with the
Utilization Review department to stay current on patient’s eligibility for
admission, continuing stay, or readiness for discharge.
• Communicates with medical staff,
coordination team and nursing staff regarding appropriateness of admission,
need for continued stay and discharge plans.
• Identifies and records episodes
of avoidable days.
• Evaluates the appropriateness of
care delivery in the inpatient setting and communicates any discrepancies with
the medical team.
• In addition to the above Care
Managers in the Emergency Department will also be responsible for the following
duties:
• Screens ED admissions using
established criteria for specific payer populations
• Understands insurance/payer
policy language, benefits, and authorization requirements for admission
• Discuss payor criteria and
issues on a case-by-case basis with clinical staff
• Ensures that the patient is in
the appropriate “status” and level of care for the clinical condition.
Utilizing screening criteria and physician advisor, per department standards
• Outpatient Care Management
Specific
• Receives referrals on patients
being seen in the clinic (Primary Care, SDC, specialty office, ancillary
departments). Coordinates services for medical and non-medical care
coordination needs that are episodic or longitudinal.
• Receives referrals for elective
procedure patients who would benefit from pre-discharge planning assessments
and resource coordination.
• Assists patients through care
transitions from hospital to home, SNF to home/assisted living, or alternate
setting per program guidelines.
• Manages a panel of high-risk
patients that require longitudinal education and support.
• Effectively collaborates with
Inpatient Care Managers and Social Service Care Managers to address the needs
of shared patients.
• Able to function effectively as
a part of a team. Utilizing shared knowledge to address complex patient needs.
• Supports Billings Clinic and
community-based programs to advance the role of Outpatient Care Management,
strengthen partnerships and meet department and patient needs.
Minimum Qualifications
Education
• 4 Year Bachelor of Science in
Nursing (BSN) or Bachelor of Arts in Nursing (BAN) preferred
Experience
• Five (5) years of professional
nursing (one within the Billings Clinic) in a related cardiac care area such as
critical care, ambulatory telemetry unit, or emergency services
License and Certification
• Healthcare Provider and ACLS CPR
certifications
• National Institutes of Health
Stroke Scale (NIHSS) certification required or to be obtained within first year
of employment Within 1 year of hire
• Current Registered Nurse license
in the state of Montana
Billings Clinic is Montana’s largest health system serving Montana, Wyoming and the western Dakotas. A not-for-profit organization led by a physician CEO, the health system is governed by a board of community members, nurses and physicians. Billings Clinic includes an integrated multi-specialty group practice, tertiary care hospital and trauma center, based in Billings, Montana. Learn more at www.billingsclinic.com/aboutus
Billings Clinic is committed to the principles of Equal Employment Opportunity. All policies and processes are designed toward achieving fair and equitable treatment of all employees and job applicants. Employees are encouraged to discuss any concerns they have in this regard with their immediate supervisor and/or the Vice President People Resources. All employees and job applicants will be provided the same treatment in all aspects of the employment relationship, regardless of race, color, creed, religion, national origin, gender, gender identity, sexual orientation, age, marital status, genetic information or disability.