Avera Health

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Registered Nurse Case Manager (RN)|MCK Pharm Specialty (PRN)

Clinical OperationsClinical OperationsFull TimeRemoteLeadTeam 1

Location

United States

Posted

2 days ago

Salary

$31 - $46 / hour

Seniority

Lead

NursingPatient AssessmentCare CoordinationHealth EducationInsurance AuthorizationDocumentationCase ManagementClinical ProtocolsPatient AdvocacyElectronic Health Records

Job Description

Location:

Integrated Services Center

Worker Type:

PRN

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$31.00 - $46.25

Position Highlights

The specialty pharmacy case manager facilitates the pharmacy plan of care by working closely with the clinical pharmacist, physicians and payors to assure proper use of specialty medications in order to manage patient adherence, clinical outcomes and payor requirements. Performs scheduled assessments with patients according to applicable therapy management protocol and collaborates with the interdisciplinary care team to encourage the best possible patient outcome. Serves as a liaison with physicians and other referral sources to assure continuity of care.

**Bachelor's degree in Nursing preferred**

**This position does require a Minnesota Nursing license 90 days from hire**

**This position is remote to Specialty Pharmacy after 4 weeks orientation**

Varied Shifts, Monday-Friday, 8:00am - 5:30pm

**This position requires to live within 100 radius of Sioux Falls**

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.


A Brief Overview

​​​​Collaborates with the multidisciplinary care team to bring together an established plan for patient treatments, assists with the transitions between levels of care, to promote the best possible patient outcome. The case manager facilitates efficient utilization of resources and identifies patient care needs throughout the continuum of care.

What you will do

  • Acts as liaison with hospitals and other health care service to provide treatment advice and lobby on behalf of the patients to various payor sources.
  • Identifies community resources which can provide assistance with non-covered benefits such as, medications, nutritional supplements, transportation or durable medical equipment.
  • Provides patient care and assisting provider as needed.
  • Completes documentation, obtain insurance prior authorizations, and coordinates scheduling of procedures, testing and treatments.
  • Performs and assists with medical treatment teaching and follow-up care with patients and their families regarding their healthcare needs.
  • Assists with updating all policies and procedures pertinent to the area of responsibility.
  • Assists with the review and development of education materials offered to patient.
  • May attend discharge planning meetings to facilitate and coordinate the post procedure needs of all discharged patients.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Required Education, License/Certification, or Work Experience:

  • Registered Nurse (RN) - Board of Nursing An active license in the state of practice Upon Hire

Preferred Education, License/Certification, or Work Experience:

  • Specialty Certification - Area of Nursing Practice - Certification Board Upon Hire
  • 1-3 years

Expectations and Standards

  • Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
  • Promote Avera’s values of compassion, hospitality, and stewardship.
  • Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
  • Maintain confidentiality.
  • Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
  • Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Job Requirements

  • Bachelor's degree in Nursing preferred.
  • Registered Nurse (RN) - Board of Nursing An active license in the state of practice upon hire.
  • Specialty Certification - Area of Nursing Practice - Certification Board upon hire (preferred).
  • 1-3 years of experience (preferred).
  • Acts as liaison with hospitals and other health care services to provide treatment advice and lobby on behalf of patients to various payor sources.
  • Identifies community resources which can provide assistance with non-covered benefits such as medications, nutritional supplements, transportation, or durable medical equipment.
  • Provides patient care and assists provider as needed.
  • Completes documentation, obtains insurance prior authorizations, and coordinates scheduling of procedures, testing, and treatments.
  • Performs and assists with medical treatment teaching and follow-up care with patients and their families regarding their healthcare needs.
  • Assists with updating all policies and procedures pertinent to the area of responsibility.
  • Assists with the review and development of education materials offered to patients.
  • May attend discharge planning meetings to facilitate and coordinate the post-procedure needs of all discharged patients.
  • Expectations and Standards
  • Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
  • Promote Avera’s values of compassion, hospitality, and stewardship.
  • Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
  • Maintain confidentiality.
  • Work effectively in a team environment, coordinating workflow with other team members and ensuring a productive and efficient environment.
  • Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

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