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Job Posting

Care Manager
The RN Care Manager is responsible for the growth and maintenance of the care coordination program, which includes recruitment and maintenance of patients enrolled in care management services; assurance of the completion of the annual wellness visit and follow-up on all elements of the preventative plan of care; and discussing advance care planning with patients. These responsibilities will be completed by providing outreach, disease management/care management, care coordination/health promotion, education/training, and motivational support to patients, referral sources, and the community. This position will work to improve the quality of life of patients enrolled through supporting quality outcomes, smooth care transitions, coordination of care across the health continuum, and encouraging healthy lifestyle choices to reduce the long-term effects of chronic illness. This position is accountable for working with and representing our clinics across multiple constituents.

Desired Education, Certifications and/or Experience
• Associates of Science in Nursing
• 1-3 years of experience in Discharge Planning, Utilization Review, and general Case Management.
• Wyoming RN License

• Care Management Certification
Responsibilities / Functional Job Description
General: Performance Expectations
1. Responsible - works independently, in a safe and appropriate manner. Demonstrates both problem-solving and problem-prevention skills.
2. Sensitive - displays sensitivity to the needs of patients and co-workers. Demonstrates good communication skills and empathy.
3. Timely - recognizes time as a customer's most valuable resource and responds promptly to patients' and co-workers' needs.
4. Accurate - works carefully and precisely, with attention to detail.
5. Coordinated - organizes and delivers service in the proper order. Displays good organizational skills and utilizes resources wisely.
6. Thorough - meets all the requirements of his/her position. Is able to evaluate and follow up on his/her services.

General: Standards of Behavior
1. Demonstrates a commitment to living the SLHD standards of behavior through exemplifying in action, a commitment to the values of SLHD, namely:
A. Innovation – continually seeking the latest advances in cost-effective healthcare and customer service.
B. Compassion – concern for the individual, empathy for the situation, action to provide service
C. Integrity – doing the right thing; always.
D. Community – supporting, giving and acting to improve where we live, serve, and work.
E. Passion for Healthcare – fervently, avidly, and zealously seeking the improvement of human health
2. Displays this commitment to the standards of behavior through actions and words by demonstrating the following behavior traits:
A. Adaptability – Responding resourcefully to changes in direction, priorities, schedules, approaches and responsibilities for the good of everyone. Maintaining a positive attitude when faced with a difficult or challenging situation and providing an uplifting and realistic outlook on the opportunities the future may present.
B. Communication – Listening attentively and seeking clarification, being friendly in words and actions, and responding to others in a timely manner to ensure satisfaction, comfort, and quality care. Utilizing AIDET and the promise to explain the experience the patient can expect and communicate how the patient will receive excellent and timely care.
C. Professional Conduct and Attitude- Keeping personal conversations to an appropriate volume for the area I am working in, treating everyone in a courteous manner – rudeness is never acceptable, addressing conflict with others privately and respectfully and utilizing the appropriate chain of command. Doing the right thing, even when no one is watching, keeping frustration separate from patent care and professional activities, and recognize that patients are not an interruption, they are our reason for being here.
D. Commitment to Team Members/Patients – Assist patients in finding their destinations, walking with them when possible, interacting constructively with team members and supporting a blame-free environment, recognizing there is no place for “it’s not my job”, finding the right person to support a patient or coworker if I am unable to support or help them. I will not spread negativity; being positive starts with me.
E. Personal and Career Development – Demonstrating a curiosity toward learning and practicing self-development. Supporting co-workers by sharing knowledge, expertise and encouragement to help them be successful in their role. Finding ways to improve the quality of my work even when things are going well. Seeking creative solutions to problems and encouraging creativity in others.
F. Sense of Ownership – Admitting and correcting mistakes, taking personal responsibility to help the organization to succeed. Ensuring cleanliness by maintaining a clutter free environment. Refraining from behavior or conversations that undermine the confidence of the community in our facility. Utilizing resources effectively and maintaining financial responsibility.
Role Specific: Care Coordinator Work role responsibilities include, but are not limited to:
1. Exhibit competence in the Seven Domains of Care Coordination in the primary care setting:
a. Population Health Management,
b. Comprehensive Assessment and Care Planning,
c. Interpersonal Communication,
d. Education/Coaching,
e. Health Insurance and Benefits knowledge,
f. Community Resource knowledge and
g. Research and Evaluation skills.
2. Provide outreach, disease management, education and other needed clinically based activities to patients managing various chronic health conditions and to referral sources and community.
3. Assess and identify participants’ readiness, willingness, and ability to change.
4. Identify patient coaching, support, and educational needs by focusing on what is important to their quality of life.
5. Determine and connect with relevant community and/or health care resources to support solutions; provide educational tools to promote self-management.
6. Collaborate with the patient to develop interventions and set goals for behavioral modification within the scope of nursing practice.
7. Conduct health and wellness coaching sessions to assist participants in making lasting changes to their health and wellness.
8. Monitor and document the patient’s progress toward his or her optimal level of wellness.
9. Promote wellness and provides education regarding preventative care measures.
10. Act as a liaison between referral sources, facilities, and outside entities to prevent and/or resolve continuum-of-care issues
11. Communicate with service delivery partners, providers, and other health professionals to provide care coordination to ensure the plan of care facilitates the efficient use of health care resources.
12. Demonstrate skills in effectively coordinating and monitoring care to promote quality and cost-effective outcomes.
13. Proactively follow up with patients discharged from all hospitals, rehab facilities, and emergency rooms to recruit patients into the care management services to ensure the patient has an appointment with their provider and reviews any unmet needs prior to the upcoming appointment.
14. Analyzes clinical data generated from EHR/Registry system and identifies patients who have gaps in care, and utilizes risk stratification intervention metrics for care coordination recruitment purposes.
15. Remains current on industry trends, best practice operational models, and changing patient and provider needs.
1. Adhere to departmental policies, procedures, and objectives; ongoing quality improvement objectives; and safety, environmental, and infection control standards.
2. Maintain patient confidentiality and comply with all federal and state health information privacy laws.
3. Perform other duties as assigned.

Role Specific: Case Manager/Utilization Review Work role responsibilities
1. Provides direction to para and non-professional personnel to perform their duties in accordance with their level of expertise.
2. Has major responsibility for assessing, planning, implementing, and evaluating quality patient care which is consistent with the established hospital and nursing service policies and procedures.
3. Is responsible for teaching patients and others.
4. Responsible for initiating, developing, and coordinating a discharge plan with assigned patients in collaboration with the physician and other health care providers.
5. Responsible for maintaining the dignity and confidentiality of the patient and serving as a patient advocate at all times.
6. Is responsible for maintaining up-to-date knowledge of care trends and new developments in the healthcare field in order to promote optimal standards of care.
7. Utilizes effective human relations and communication skills in interfacing with hospital personnel, patients, and others.
8. Is responsible for making independent nursing decisions relating to patient care.
9. Interviews and counsels patients, families or significant others for options as related to discharge planning as indicated. Acts as a patient advocate.
10. Evaluates for and initiate referrals to appropriate agencies and interdepartmental services.
11. Includes patient, family, and significant others in assisting in establishing the discharge plan of care.
12. Is knowledgeable of resource information available and provides information to patients, families, staff, providers, and the community. Facilitates communication among all disciplines involved in the provision of care.
13. Maintains current knowledge of Federal and State regulatory guidelines.
14. Reviews patient data a minimum of once daily and as needed.
15. Assist with updating discharge planning/case management/ utilization review policies and procedures annually and as needed.
16. Completes screening tools as indicated to improve the quality of care.
17. Maintains current resources and knowledge of durable medical equipment services, rehabilitative options, home care services, and long-term care facilities.
18. Participates in community events as appropriate.
19. Actively participates in self-development by attending educational programs offered inside and outside the facility.
20. Contacts insurance companies for nursing follow-up.
21. Provides or arranges for financial counseling as indicated (i.e., HINN letters, BIPA notices, ABN/s payment plans).
22. Ensures continuity of care by communicating appropriate patient information to any healthcare organization or provider to which the patient is admitted, transferred or discharged.
23. Uses current utilization guidelines/criteria
24. Coordinates the evaluation of the severity of illness and intensity of service, discharge readiness, and outlier and co-morbidity issues.
25. Educates providers and other staff regarding necessary documentation to evidence medical necessity and continuing care plan.
26. Assists with tracking, trending, and displaying utilization data and making recommendations for improvement.
27. Performs other duties as assigned
28. Accountable for cost-effective patient care through monitoring the use of personnel, time supplies, and equipment
a. Attends work in a punctual and dependable manner
b. Manages time and uses supplies based on patient needs and medical/nursing plans of care.
c. Assures that charges are accounted for and are recorded to the patient billing system.
29. Accountable for coordinating patient care activities with patients, colleagues, other hospital personnel, and physicians.
30. Accountable for maintaining patient confidentiality.
a. Communicates effectively with patients and others
b. Understands patient rights and complies with confidentiality policies
c. Functions competently under stress
d. Communicates and solves problems with coworkers, physicians, and other hospital employees.
e. Demonstrates appropriate problem-solving ability and support of hospital philosophy and policies.
31. Performs other duties as assigned
Desired Knowledge, Skills & Abilities
1. Excellent interpersonal skills, including persuasion, customer care and service, and conflict resolution.
2. Above average Emotional Intelligence, with the ability to empathize with the emotional experience of others without taking on and agreeing with every communicated perspective.
3. Ability to memorize and coordinate several discrete sets of essential information.
4. Clear and concise communicative style, balancing the need to express complicated content while, at the same time, expressing support and understanding.
5. Powerful listening skills include the ability to sort through complex messages, retain several discrete and related details, and synthesize hierarchal meaning according to what is most important on the part of the person communicating.
6. Ability to follow a script while appropriately improvising and making the required message on one’s own.
7. Ability to skillfully coordinate competing priorities, ensuring the completion of all required tasks.
8. Skill in accuracy and attention to detail.
9. Knowledge of state and federal regulations, policies, and procedures governing accounting, medical billing, and financial recordkeeping.
10. Knowledge of general accounting principles and ability to produce, read and analyze financial reports
11. Knowledge of accounting and finance best practices and programs which enhance the financial success of the organization
12. Knowledge of financial/revenue cycle reporting and key performance indicators for measuring and benchmarking performance
13. Ability to operate various office equipment
14. Skill in accuracy and attention to detail
15. Ability to perform public relations and public speaking in a professional manner
16. Ability to develop strong relationships with team members.
17. Ability to maintain confidentiality.
18. Ability to read, write legibly and calculate mathematical figures.
19. Ability to solve practical problems and deal with a variety of variables.
20. Ability to effectively lead a team in a fast-paced and intense environment.
21. Ability to handle stressful situations and respond appropriately.
22. Ability to work and interact effectively and positively with other staff members to build and enhance teamwork across SLHD departments.
23. Ability to communicate to complete responsibilities effectively
24. Ability to see to use a computer efficiently and read computer reports and correspondence
25. High proficiency with Microsoft office products (excel, word, PowerPoint, etc.)
Equal Employment Opportunity
South Lincoln Medical Center will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability, marital status, parental status, sexual orientation, or any other category protected by law.
Americans with Disabilities Act (ADA) Statement
Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to stand; sit; use hands to finger, handle, or feel; reach with hands and arms, and talk or hear. The employee is occasionally required to walk, stoop, kneel, or crouch. The employee must regularly lift and/or move up to 50 pounds.

Additional Information
Position Type : Full Time
Shift : Day

Contact Information
Stephanie Raver - HR Business Partner
711 Onyx
Kemmerer, WY 83101
Phone: 13078008683

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