Quality Case Management Rn

CHI St. Alexius Health Dickinson part of CommonSpirit Heath a national nonprofit health system based in Englewood Colorado. The faith-based system operates in 18 states and includes 103 hospitals. Additional services offered within the system are: long-term care assisted and residential living communities community health services organizations home health agencies and numerous outpatient facilities.

As our RN Qualitly Case Manager at CHI St. Alexius Health Dickinson, now part of CommonSpirit Health formed between Catholic Health Initiatives and Dignity Health, you’ll oversee the day-to-day operations of the Quality Management staff and lead quality improvement and risk management efforts across the organization. You will be accountable for hospital issues of quality including risk management, utilization management, regulatory compliance and accreditation standards. 

To thrive in this role, you must be competent and confident. Utilizing your excellent communication skills one-on-one and in front of groups, you lead and monitor quality improvement efforts, while supporting the mission, vision and values of the organization.. Every interaction is an opportunity to share your knowledge with others and improve their understanding of regulatory compliance and accreditation standards of the organization.

1.Completes and documents a discharge planning assessment on those patients identified by the designated
screening process, or upon request. Reassess the patient as appropriate and update the plan accordingly.
2. Facilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members,
the patient and/or patient representative and post acute care providers in accordance with the patients clinical
or psychosocial needs, choices and available resources.
3. Oversees and evaluates the implementation of the discharge plan.
4. Collaborates with the multidisciplinary team to ensure progression of care and appropriate utilization of
inpatient resources using established evidence based guidelines/criteria.
5. Collaborates with the healthcare team and post-acute service providers to ensure timely and smooth transitions
to the most appropriate type and setting of post-acute services based upon patients clinical needs.
6. Identifies risk for readmission and implements interventions to mitigate those risks for at least a 30-day period.
7. Responsible for delivery of appropriate patient notifications and related documentation
8. Responsible for patient education and advocacy.

Required Education and Experience

Required
● Minimum two (2) years of acute hospital clinical experience
or a Masters degree in Case Management or Nursing field in
lieu of 1 year experience.
Preferred
● Graduate of an accredited school of nursing (Bachelors
Degree in Nursing (BSN)) or related healthcare field.
● At least five (5) years of nursing experience.

Required Licensure and Certifications

Required
● RN license in the state(s) covered is required.
Preferred
● Certified Case Manager (CCM), Accredited Case Manager
(ACM-RN), or UM Certification preferred

Required Minimum Knowledge, Skills, Abilities and
Training

● BLS required within 3 months of hiring if located within
hospital
● Ability to pass annual Inter-rater reliability test for Utilization
Review product(s) used.
● Able to apply clinical guidelines to ensure progression of
care.
● Knowledge of managed care and payer environment
preferred.
● Must have critical thinking and problem-solving skills.
● Collaborate effectively with multiple stakeholders
● Professional communication skills.
● Understand how utilization management and case
management programs integrate.
● Ability to work as a team player and assist other members of
the team where needed.
● Thrive in a fast paced, self-directed environment.
● Knowledge of CMS standards and requirements.
● Proficient in prioritizing work and delegating where
indicated.
● Highly organized with excellent time management skills.