Utilization Review Nurse Salary in Billings, MT

May be eligible for a sign on incentive, tuition loan repayment, and relocation assistanceThe Therapist/Social Worker is an integral part of a multidisciplinary team working with patients in an acute inpatient mental health setting. While promoting the health and wellness of patients, Therapist/Social Work staff provide comprehensive services, which include therapy (individual, group and family), discharge planning, case management, care coordination, crisis intervention as well as addressing psychosocial and other needs of patients and their families.Under the direction of department leadership, therapist/social work staff provides services consisting of therapy, comprehensive case management, care coordination, continuing care services, and clinical social work services including crisis intervention. In addition, the Therapist/Social Worker is responsible for providing education addressing physical, psychosocial, financial, environmental and other needs of patients and families and/or significant others. The Therapist/Social Worker is part of an interdisciplinary team who promotes health and addresses medical and non medical barriers.Essential Job Functions• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service. • Assesses patient medical records for treatment plan, identifies actual and potential discharge needs at the time of admission for assigned patients. • Identifies, screens and assess patients, families and/or significant others who require therapy/social work services in a timely manner. • Integrates social work plan into overall patient care plan through participation in interdisciplinary team collaboration may include RN care management, physicians, nurses and other members of the health care team as service area dictates. Promotes collaboration and communication among team members. • Provides patient, family, significant other education, and emotional support utilizing individual, family and group modalities (care conferences). • Meets with patient, family, significant other as appropriate to develop plan of care taking into consideration choice, support network(s), resource needs (financial, housing, transportation, etc.), and appropriate level of care. • Provides crisis intervention, therapeutic support and coping skills on adjustment to illness/disability. • Identifies physical, psychosocial, and spiritual needs and incorporates them into the plan of care. • Demonstrates sensitivity and awareness about population specific needs or special issues related to culture, race, gender, age religion, sexual orientation, etc. • Demonstrates the ability to identify symptoms/indicators of abuse, neglect, and exploitation in specific patient populations and provide appropriate interventions, including mandated reporting. • Assess and responds to legal issues such as Living Wills, Durable Power of Attorney, guardianship, etc. • Supports patients to ensure they can function to the best of their ability and maintain optimal health related to their medical condition. Provide education and information to patient's identified support systems. • Supports patients to stabilization using individual and group therapy techniques. • Utilizes interviews and patient medical record reviews to identify actual or potential barriers and care needs. • Interacts with patients, support systems, healthcare professionals, 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 from a medical/psychosocial/financial perspective, assesses the needs of patients and support systems. • Discusses evaluations, goals and treatments with patients and support systems to enhance patient and support system engagement. • Collaborates with the multidisciplinary team to identify needs of patients and their support systems. • Understands and utilizes hospital and community based financial resources and entitlements such as SSD, SSI, Medicaid, charity care, mental health, HCFS, Patient Financial Representatives, Public Health and other outside resources as needed. • Coordinates and implements discharge/transitional planning activities within expected length of stay in collaboration with the multidisciplinary team. • Accountable for appropriate and patient focused discharge planning; including placement in alternative living environments. • Advocates on behalf of patients and takes a lead role assisting patients with complex psychosocial needs. • Keeps supervisor informed of barriers to discharge, patient/family dissatisfaction, and/or agency conflicts. • Coordinates with referral agencies as indicated to ensure services are in place before discharge. This includes providing necessary paperwork in a timely manner to process the referral and enhancing positive working relationships with community agencies. • Demonstrates and utilizes knowledge of internal and external agency services/resources related to the needs of specific patient populations and the ability to be creative in coordinating services. • Refers patients, families, and significant others to appropriate services to ensure continuity and quality of care (information and referral). • Monitors the need for revisions in the care plan and makes recommendations to physician(s) and interdisciplinary team when indicated. Demonstrates resourcefulness when collaborating with the interdisciplinary team. • Modifies treatment plans to reflect changes in patients or their support system status and needs. • Demonstrates the ability to evaluate compliance with medical/psychiatric treatment protocols and intervene to address barriers. • Helps navigate patient through the healthcare system. • Provides timely referral and coordinates with agencies/facilities to ensure services are in place to meet the patient's and organizational needs to achieve continuity and quality of care. • Demonstrates and utilizes knowledge of services/resources related to the needs of specific patient populations. • Maintains current knowledge regarding insurance benefit reimbursement, community resource and ancillary clinical services to meet the needs of internal and external customers. • Serves as a resource to staff on psychosocial needs of patients and families, resources, and discharge/transitional planning. • Documents care management interventions in medical record including patient, family and/or significant other communication, discharge/transition plan, support system and disposition status. • Documentation is timely, reflects professional practice and is consistent with departmental/organizational policy. • Monitors, evaluates and documents patient progress related to the plan of care. • Maintains data and reporting information as required by department and other programs. • Provides utilization review functions as required by the department. • Identifies service gaps and participates in hospital and departmental programs to address and improve quality of care. • Adheres to department and organizational policies addressing confidentiality, infection control, patient rights, medical ethics, advance directives, disaster protocols and safety. • Maintain competency in organizational and departmental policies/processes relevant to job performance. • Adheres to regulatory, legal, compliance, and professional licensure/certification requirements in day-to-day practice. • Participates in continuing education, department planning, work teams, and process improvement activities. • Demonstrates the ability to be flexible, open minded and adaptable to change • Maintain competency in organizational and departmental policies/processes relevant to job performance. • Performs other duties as assigned or needed to meet the needs of the department/organization.

The incumbent in this position acts as an advocate for patients serving as the primary point of contact and is responsible for coordinating the care and services of the identified patient populations for an extended period of time across the continuum of care for outpatient services; promoting effective resource utilization; assuming a leadership role with the multidisciplinary team to achieve an optimal clinical outcome.Operational aspects include but are not limited to schedule coordination, follow-up communication with patients, outside care facilities, and referring providers, documentation and record maintenance for necessary records for accreditation and continued care needs.Supply an exceptional patient and family entry and journey through the healthcare system. Help providers by coordinating patient visits, provision of proper records as applicable, and aid in coordinating proper supplementary service visits as applicable. Navigation will ideally begin before the patient comes for their first visit, continue during the first phases of consultation and care plan generation, and often during a course of therapy. Navigation will often be a 'go to' when patients or family have question, concerns, or confusion. They will supply skills and knowledge to effectively arrange patient centered cancer care through leadership of the interdepartmental team.The oncology nurse navigator will provide effective communication to patient and families regarding disease process, treatment plan review, next steps in care. ONN will translate medical terminology into information that patients can use to improve their understanding of their cancer journey. Ancillary services offered in the cancer center -Social work, palliative care team, financial counseling, dietician, support groups will be discussed and encouraged with the patient and family. Coordination of care provides timely access to cancer care by addressing patient barriers and providing interventions.Essential Job Functions• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service.• Facilitates the coordination of patient care services to assure excellence in patient care and patient flow; includes coordinating care, treatment and communication among the medical team• Follows patient through the care continuum/experience, eliminating operational (such as scheduling, test results, etc.) barriers to services.• Works closely with other healthcare disciplines to ensure timely appointments, results reporting, financial need referrals, communication, patient care and follow-up• Coordination of care: The oncology nurse navigator will receive referral for cancer patients from outside providers, departments in the Billings Clinic and faxed referrals.• The nurse navigator will then start the process of obtaining records if applicable. This includes but not limited to provider notes, labs, pathology report, imaging report and imaging.• After patient records are obtained in a prompt matter; the nurse will start the process of scheduling the patient with proper provider and multidisciplinary team in the clinic. The nurse will notify cancer research team of patient.• The nurse navigator will contact the patient/caregiver within one business day of scheduling patient. • The navigator will supply education on the rationale of the multidisciplinary team/appointments and need for further imaging or testing. Location, date, and time will be provided to the patient. • Appointment notification will be mailed to home address, along with navigator business card. The navigator will explain the role and supply contact information to the patient/caregivers.• The nurse navigators will attend patient first consult in medical and radiation oncology. Navigation may be present in multidisciplinary appointments inside the Billings Clinic.• Nurse navigation schedule further appointments, imaging, lab draw, etc. as directed by providers. • These appointments will be communicated to the patient/caregiver's day of and or within one business day.• Nurse navigation will notify/schedule patient with supplementary appointments, such as symptom management team, oncology social workers, physical therapists, dietician, breast boutique, financial counselors, oral oncology pharmacist, site specific and/or general tumor board.• When patient presents for the first consults the nurse navigator will provide patient/family with Billings Clinic Cancer Center resources, contact numbers for staff, education resources on cancer, staging, treatment from reputable sources. (NCCN, ACOS, ACS)• The nurse navigator will supply education to the patient. Navigation will assess patient education needs by assessing barriers to care (literacy, language, cultural influences, and comorbidities). Resources will be offered such as web, printed materials, and verbal education.• The nurse navigator will supply and reinforce education to the patient, families, and caregivers about diagnosis, treatment, post treatment care and survivorship. (Treatment summary when applicable.)• The nurse navigator will schedule patient for their first treatment, they will provide calendars to the patient and review times, dates, and providers with them to expedite the plan of care and continuity of care.• The nurse navigator will schedule patients for follow up in the cancer center when actively navigating patient.• The nurse navigator will provide anticipatory guidance and manage expectations to aid patient/caregivers/families in coping with cancer diagnosis, potential or expected outcomes.• The nurse navigator will support a smooth transition of patients from active/initial treatment into survivorship, chronic cancer management or end of life care.• Facilitates the development, implementation and adherence to clinical and evidenced based guidelines, as appropriate, to ensure optimal clinical outcomes• Ensures follow-up on identified patient clinical and non-clinical care, facilitating communication and compliance to care plans (i.e., medication reconciliation, follow-up on care concerns/critical values/core measures, patient care conferences, etc.) Ensures follow up has occurred regarding patient clinical and non clinical care to include adherence to plans of care, resource utilization, and general progress utilizing care conferences as necessary.• Works in collaboration with the medical team to develop and implement clinical guidelines. Facilitates the adherence of the guidelines through regular evaluation and auditing of clinical practice.• Ensures follow-up in the outpatient setting on identified patient clinical and non-clinical care, facilitating communication and compliance to care plans (i.e., medication reconciliation, follow-up on care concerns/critical values/core measures, patient care conferences, etc.)• Demonstrates expertise in educational and resourcing services• Participates in educational activities related to patient/community, clinical operation and process issues on an ongoing basis• Collaborates with other health care providers in developing, implementing and evaluating educational materials for patients and their families• Facilitates intra-departmental relationships in an effort to provide necessary resources to and for the patient.• Interfaces with other members/disciplines within the healthcare teams for appropriate referrals/services• Aware of and assists with financial needs of the patients.• Identify and access appropriate social services, including resources to assist caregivers to support treatment• Contributes to an environment of quality and process improvement• Ensures accurate and timely data collection and entry into patient database as indicated by department guidelines• Directs and coordinates identified quality assessment and improvement activities to assure quality patient services are monthly provided through audits and reviews other identified evaluation tools• Ensures patient care activities for the department services are monitored monthly through audits and reviews• Ensures and enhances facility, safety, and regulatory outcomes• Complies with all applicable laws, regulations and accrediting agencies• Complies with all Billings Clinic policies• Works in collaboration with Leadership team to ensure departmental goals and objectives are met.• Contributes to community activities sponsored by the Cancer Center• Develops patient referral services by relationship-building strategies with physicians not related to the department.• Performs other duties as assigned or needed to meet the needs of the department/organization.• Works as an active team member and effective communicator• Demonstrates effective internal and external communication strategies, written and verbal, to assure a collaborative environment• Ensures appropriate and timely documentation in the EHR• Demonstrates a productive work ethic• Works consistently as an active team player, inter-and intra-departmentally• Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements.• Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.• Assists Mammography provider throughout imaging guidance breast biopsy procedures.Remove this line.• Identification and assistance for patients in potential benefit for genetic testing evaluation.• Organization and record maintenance of appropriate record needs required for accreditation purposes.• Performs other duties as assigned or needed to meet the needs of the department/organization.• Additional Duties for Breast Diagnostics• Facilitates the coordination of patient care services to assure excellence in patient care and patient flow.• Follows patient from abnormal mammogram through diagnosis.• Provides seamless patient flow from abnormal mammogram to diagnosis and referral to breast Patient Care Navigator• Facilitates breast biopsy scheduling• Facilitates breast biopsy education• Facilitates the development, implementation and adherence to clinical and research guidelines, as appropriate, to ensure optimal clinical outcomes• Ensures that each patient scheduled for a screening mammogram has had a clinical breast exam within acceptable time frame.• Demonstrates expertise in educational and resourcing services• Facilitates relationship between physicians, vendors, departments and the breast multidisciplinary program• Interfaces with finance and breast imaging services to meet the financial needs of the patients• Additional Duties for Regional Navigator• Collaborate with local individuals, agencies and organizations to facilitate the increased availability of community-based care services.• Facilitates research participation opportunities.• Facilitates increased utilization of telemedicine in connecting rural patients and providers to Billings Clinic resources.• Coordinate opportunities to increase prevention awareness and offer early-detection screening programs in outreach areas.• Develop and implement regional care protocols, resulting in reduced time to problem resolution and improved quality of care.• Interfaces with local and outreach providers in addressing care navigation concerns.• Identifies community support services in underserved and frontier areas and facilitates utilization of these services.• Advocates for the individual and collective needs of patients in rural and frontier areas.• Facilitates relationship-building between physicians, agencies, and organizations.• Interfaces with physicians, agencies, and organizations to meet the medical, social, and financial needs of patients.

The Pediatric Certified Diabetic Educator should have a broad knowledge base in diabetes care. This position is responsible for facilitating the education management of patients with newly diagnosed or poorly controlled diabetes from point of entry into Billings Clinic through the continuum of care. The strength of the role is in education and active collaboration with the multidisciplinary team and physicians to promote quality patient care. The Pediatric Certified Diabetic Educator promotes effective utilization; monitors health care resources and assumes a leadership role with the multidisciplinary team to achieve optimal clinical, financial and resource outcomes. This position develops and provides education to Billings Clinic staff, patients, as well as to care providers and family member of diabetics.Essential Job Functions•Supports and practices the mission and philosophy of Billings Clinic, Care Management and the Diabetes program.•Education. Provides education to patients and families based on their specific needs including new patient education, injection and pump skills, training and troubleshooting and sick day management. Provides and coordinates education to nurses for disease related technology. Facilitates local and regional diabetes education for coordination of care between care providers of children with diabetes (school nurses, foster families, regional CDEs, etc.)•Quality Improvement. Identifies issues, purposes solutions and reviews findings of monitoring and evaluation activities Accountable for oversight, planning, implementation and evaluation of the American Diabetes Association Educationally Recognized Diabetes Self-Management Education Program for Billings Clinic for pediatric patients. Acts as a change agent by participating in work re-design projects. Participates in maintaining•Professional Development. Develop, implement and monitor policies/procedures of care related to diabetes patients and blood glucose monitoring protocols. Proactively support staff by advancing competence of diabetes care through education development•Assessment. Gathers timely information from patient, family, medical team, medical record and other key resources. Anticipates needs based on reason for admission and discharge needs. Interacts and educates patients, families and public. Considers legal issues: Guardianship, care providers. Reassesses patient as needs change or dictate. Initial chart review (prior to assessment) and concurrent chart reviews. Identifies physical, psychological and spiritual needs and incorporates them into the plan of care. Encourage use of blood glucose protocols. Attend Diabetes Rounds as designated by the program director•Planning: Formulation of Discharge Plan. Attend scheduled Diabetes Team meetings. Demonstrates timely intervention. Demonstrates creativity when needed. Considers resources available. Collaborates with physician(s) and other appropriate resources on treatment goals, projected length of stay, and discharge plan. Advocates for patient and family (care conferences, health care team meetings). Facilitates patient care conferences as needed. Reviews physician orders. Ensures compliance/accuracy with discharge plan. Make follow-up appointments for Diabetes Clinic as needed.•Implementation: Patient Care Coordinator. Interacts with community resources/networks. Demonstrates knowledge of community resources. Ensures confidentiality. Ensures services appropriate for age/level of care. Monitors clinical pathways and collects appropriate data as dictated. Educates and trains staff for management of diabetes patients.•Evaluation: Matches plan to patient/family physical, emotional, resource, and safety needs. Identifies risk management issues and communicates to supervisor/Risk Management Department. Communicates variances in discharge plan to patient, family and medical team.•Interdisciplinary Team Participation: Incorporates team recommendations into plan. Ensures discharge needs are addressed and consensus reached. Incorporates clinical pathways info as appropriate/available. As delegated by the health care team, provides patient care and treatments according to scope of RN license, adhering to policy and procedures; documentation is concise and thorough.•Documentation. Contents thorough and timely. Reflects plan, limitations, patient choice, legal considerations, family input, and education. Meets Cerner and other department/organizational/ professional documentation standards.•Facility Compliance//HIPAA/QI/PRO. Participates in interdepartmental collaboration. Develops/implements processes/protocols and promotes changes as organizational needs dictate. Participates in process to ensure compliance and monitors knowledge of requirements. Reports needs/noncompliance issues. Completes assigned projects/duties. Assists in maintaining .•Utilization Review. Demonstrates resource management. Demonstrates cost effectiveness. Provides timely interventions. Collaborates with care management team members. Monitors patient care to avoid redundancy, duplication or fragmentation.•Professional Accountabilities. Demonstrates care Management standards. Participates in committees/unit involvement. Participates in and/or seeks out continuing education opportunities to maintain Diabetes Certification once attained.•Safety. Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.•Performs other duties as assigned or needed to meet the needs of the department/organization

May be eligible for tuition loan repayment, relocation assistance, and sign on incentiveThe Therapist/Social Worker is an integral part of a multidisciplinary team working with patients in an acute inpatient mental health setting. While promoting the health and wellness of patients, Therapist/Social Work staff provide comprehensive services, which include therapy (individual, group and family), discharge planning, case management, care coordination, crisis intervention as well as addressing psychosocial and other needs of patients and their families. Under the direction of department leadership, therapist/social work staff provides services consisting of therapy, comprehensive case management, care coordination, continuing care services, and clinical social work services including crisis intervention. In addition, the Therapist/Social Worker is responsible for providing education addressing physical, psychosocial, financial, environmental and other needs of patients and families and/or significant others. The Therapist/Social Worker is part of an interdisciplinary team who promotes health and addresses medical and non medical barriers. Essential Job Functions• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service. • Assesses patient medical records for treatment plan, identifies actual and potential discharge needs at the time of admission for assigned patients. • Identifies, screens and assess patients, families and/or significant others who require therapy/social work services in a timely manner. • Integrates social work plan into overall patient care plan through participation in interdisciplinary team collaboration may include RN care management, physicians, nurses and other members of the health care team as service area dictates. Promotes collaboration and communication among team members. • Provides patient, family, significant other education, and emotional support utilizing individual, family and group modalities (care conferences). • Meets with patient, family, significant other as appropriate to develop plan of care taking into consideration choice, support network(s), resource needs (financial, housing, transportation, etc.), and appropriate level of care. • Provides crisis intervention, therapeutic support and coping skills on adjustment to illness/disability. • Identifies physical, psychosocial, and spiritual needs and incorporates them into the plan of care. • Demonstrates sensitivity and awareness about population specific needs or special issues related to culture, race, gender, age religion, sexual orientation, etc. • Demonstrates the ability to identify symptoms/indicators of abuse, neglect, and exploitation in specific patient populations and provide appropriate interventions, including mandated reporting. • Assess and responds to legal issues such as Living Wills, Durable Power of Attorney, guardianship, etc. • Supports patients to ensure they can function to the best of their ability and maintain optimal health related to their medical condition. Provide education and information to patient's identified support systems. • Supports patients to stabilization using individual and group therapy techniques. • Utilizes interviews and patient medical record reviews to identify actual or potential barriers and care needs. • Interacts with patients, support systems, healthcare professionals, 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 from a medical/psychosocial/financial perspective, assesses the needs of patients and support systems. • Discusses evaluations, goals and treatments with patients and support systems to enhance patient and support system engagement. • Collaborates with the multidisciplinary team to identify needs of patients and their support systems. • Understands and utilizes hospital and community based financial resources and entitlements such as SSD, SSI, Medicaid, charity care, mental health, HCFS, Patient Financial Representatives, Public Health and other outside resources as needed. • Coordinates and implements discharge/transitional planning activities within expected length of stay in collaboration with the multidisciplinary team. • Accountable for appropriate and patient focused discharge planning; including placement in alternative living environments. • Advocates on behalf of patients and takes a lead role assisting patients with complex psychosocial needs. • Keeps supervisor informed of barriers to discharge, patient/family dissatisfaction, and/or agency conflicts. • Coordinates with referral agencies as indicated to ensure services are in place before discharge. This includes providing necessary paperwork in a timely manner to process the referral and enhancing positive working relationships with community agencies. • Demonstrates and utilizes knowledge of internal and external agency services/resources related to the needs of specific patient populations and the ability to be creative in coordinating services. • Refers patients, families, and significant others to appropriate services to ensure continuity and quality of care (information and referral). • Monitors the need for revisions in the care plan and makes recommendations to physician(s) and interdisciplinary team when indicated. Demonstrates resourcefulness when collaborating with the interdisciplinary team. • Modifies treatment plans to reflect changes in patients or their support system status and needs. • Demonstrates the ability to evaluate compliance with medical/psychiatric treatment protocols and intervene to address barriers. • Helps navigate patient through the healthcare system. • Provides timely referral and coordinates with agencies/facilities to ensure services are in place to meet the patient's and organizational needs to achieve continuity and quality of care. • Demonstrates and utilizes knowledge of services/resources related to the needs of specific patient populations. • Maintains current knowledge regarding insurance benefit reimbursement, community resource and ancillary clinical services to meet the needs of internal and external customers. • Serves as a resource to staff on psychosocial needs of patients and families, resources, and discharge/transitional planning. • Documents care management interventions in medical record including patient, family and/or significant other communication, discharge/transition plan, support system and disposition status. • Documentation is timely, reflects professional practice and is consistent with departmental/organizational policy. • Monitors, evaluates and documents patient progress related to the plan of care. • Maintains data and reporting information as required by department and other programs. • Provides utilization review functions as required by the department. • Identifies service gaps and participates in hospital and departmental programs to address and improve quality of care. • Adheres to department and organizational policies addressing confidentiality, infection control, patient rights, medical ethics, advance directives, disaster protocols and safety. • Maintain competency in organizational and departmental policies/processes relevant to job performance. • Adheres to regulatory, legal, compliance, and professional licensure/certification requirements in day-to-day practice. • Participates in continuing education, department planning, work teams, and process improvement activities. • Demonstrates the ability to be flexible, open minded and adaptable to change • Maintain competency in organizational and departmental policies/processes relevant to job performance. • Performs other duties as assigned or needed to meet the needs of the department/organization.

May be eligible for $3,000 sign on incentiveMay be eligible for relocation assistanceMay be eligible for tuition loan reimbursementUnder 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.• Interventions and Care Coordination• 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.• 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 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.• Documentation• 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.• Safety/Quality Assurance/Risk Management• 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.• Professional Accountabilities• 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.• Inpatient Care Management Specific• 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 staffEnsures 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.

The Therapist/Social Worker is an integral part of a multidisciplinary team working with patients in an acute inpatient mental health setting. While promoting the health and wellness of patients, Therapist/Social Work staff provide comprehensive services, which include therapy (individual, group and family), discharge planning, case management, care coordination, crisis intervention as well as addressing psychosocial and other needs of patients and their families.Under the direction of department leadership, therapist/social work staff provides services consisting of therapy, comprehensive case management, care coordination, continuing care services, and clinical social work services including crisis intervention. In addition, the Therapist/Social Worker is responsible for providing education addressing physical, psychosocial, financial, environmental and other needs of patients and families and/or significant others. The Therapist/Social Worker is part of an interdisciplinary team who promotes health and addresses medical and non medical barriers.Essential Job Functions• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service.• Assesses patient medical records for treatment plan, identifies actual and potential discharge needs at the time of admission for assigned patients.• Identifies, screens and assess patients, families and/or significant others who require therapy/social work services in a timely manner.• Integrates social work plan into overall patient care plan through participation in interdisciplinary team collaboration may include RN care management, physicians, nurses and other members of the health care team as service area dictates. Promotes collaboration and communication among team members.• Provides patient, family, significant other education, and emotional support utilizing individual, family and group modalities (care conferences).• Meets with patient, family, significant other as appropriate to develop plan of care taking into consideration choice, support network(s), resource needs (financial, housing, transportation, etc.), and appropriate level of care.• Provides crisis intervention, therapeutic support and coping skills on adjustment to illness/disability.• Identifies physical, psychosocial, and spiritual needs and incorporates them into the plan of care.• Demonstrates sensitivity and awareness about population specific needs or special issues related to culture, race, gender, age religion, sexual orientation, etc.• Demonstrates the ability to identify symptoms/indicators of abuse, neglect, and exploitation in specific patient populations and provide appropriate interventions, including mandated reporting.• Assess and responds to legal issues such as Living Wills, Durable Power of Attorney, guardianship, etc.• Supports patients to ensure they can function to the best of their ability and maintain optimal health related to their medical condition. Provide education and information to patient's identified support systems.• Supports patients to stabilization using individual and group therapy techniques.• Utilizes interviews and patient medical record reviews to identify actual or potential barriers and care needs.• Interacts with patients, support systems, healthcare professionals, 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 from a medical/psychosocial/financial perspective, assesses the needs of patients and support systems.• Discusses evaluations, goals and treatments with patients and support systems to enhance patient and support system engagement.• Collaborates with the multidisciplinary team to identify needs of patients and their support systems.• Understands and utilizes hospital and community based financial resources and entitlements such as SSD, SSI, Medicaid, charity care, mental health, HCFS, Patient Financial Representatives, Public Health and other outside resources as needed.• Coordinates and implements discharge/transitional planning activities within expected length of stay in collaboration with the multidisciplinary team.• Accountable for appropriate and patient focused discharge planning; including placement in alternative living environments.• Advocates on behalf of patients and takes a lead role assisting patients with complex psychosocial needs.• Keeps supervisor informed of barriers to discharge, patient/family dissatisfaction, and/or agency conflicts.• Coordinates with referral agencies as indicated to ensure services are in place before discharge. This includes providing necessary paperwork in a timely manner to process the referral and enhancing positive working relationships with community agencies.• Demonstrates and utilizes knowledge of internal and external agency services/resources related to the needs of specific patient populations and the ability to be creative in coordinating services.• Refers patients, families, and significant others to appropriate services to ensure continuity and quality of care (information and referral).• Monitors the need for revisions in the care plan and makes recommendations to physician(s) and interdisciplinary team when indicated. Demonstrates resourcefulness when collaborating with the interdisciplinary team.• Modifies treatment plans to reflect changes in patients or their support system status and needs.• Demonstrates the ability to evaluate compliance with medical/psychiatric treatment protocols and intervene to address barriers.• Helps navigate patient through the healthcare system.• Provides timely referral and coordinates with agencies/facilities to ensure services are in place to meet the patient's and organizational needs to achieve continuity and quality of care.• Demonstrates and utilizes knowledge of services/resources related to the needs of specific patient populations.• Maintains current knowledge regarding insurance benefit reimbursement, community resource and ancillary clinical services to meet the needs of internal and external customers.• Serves as a resource to staff on psychosocial needs of patients and families, resources, and discharge/transitional planning.• Documents care management interventions in medical record including patient, family and/or significant other communication, discharge/transition plan, support system and disposition status.• Documentation is timely, reflects professional practice and is consistent with departmental/organizational policy.• Monitors, evaluates and documents patient progress related to the plan of care.• Maintains data and reporting information as required by department and other programs.• Provides utilization review functions as required by the department.• Identifies service gaps and participates in hospital and departmental programs to address and improve quality of care.• Adheres to department and organizational policies addressing confidentiality, infection control, patient rights, medical ethics, advance directives, disaster protocols and safety.• Maintain competency in organizational and departmental policies/processes relevant to job performance.• Adheres to regulatory, legal, compliance, and professional licensure/certification requirements in day-to-day practice.• Participates in continuing education, department planning, work teams, and process improvement activities.• Demonstrates the ability to be flexible, open minded and adaptable to change• Maintain competency in organizational and departmental policies/processes relevant to job performance.• Performs other duties as assigned or needed to meet the needs of the department/organization.Minimum Qualifications Level II• Masters degree in social work preferred; Masters degree in a related field may be considered• Three (3) years of clinical experience preferredTherapist/Social Worker III• Masters degree in Social Work, preferred; other comparable clinical Masters program may be considered• Current Montana Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LCPC), or if entering from a different state, must be licensed in practicing state• Three (3) years experience in a clinical setting with the same or similar duties and expectations of this position, preferred

May be eligible for tuition loan repayment, relocation assistance, and sign on incentiveThe Therapist/Social Worker is an integral part of a multidisciplinary team working with patients in an acute inpatient mental health setting. While promoting the health and wellness of patients, Therapist/Social Work staff provide comprehensive services, which include therapy (individual, group and family), discharge planning, case management, care coordination, crisis intervention as well as addressing psychosocial and other needs of patients and their families. Under the direction of department leadership, therapist/social work staff provides services consisting of therapy, comprehensive case management, care coordination, continuing care services, and clinical social work services including crisis intervention. In addition, the Therapist/Social Worker is responsible for providing education addressing physical, psychosocial, financial, environmental and other needs of patients and families and/or significant others. The Therapist/Social Worker is part of an interdisciplinary team who promotes health and addresses medical and non medical barriers. Essential Job Functions• Supports and models behaviors consistent with the mission and philosophy of Billings Clinic and department/service. • Assesses patient medical records for treatment plan, identifies actual and potential discharge needs at the time of admission for assigned patients. • Identifies, screens and assess patients, families and/or significant others who require therapy/social work services in a timely manner. • Integrates social work plan into overall patient care plan through participation in interdisciplinary team collaboration may include RN care management, physicians, nurses and other members of the health care team as service area dictates. Promotes collaboration and communication among team members. • Provides patient, family, significant other education, and emotional support utilizing individual, family and group modalities (care conferences). • Meets with patient, family, significant other as appropriate to develop plan of care taking into consideration choice, support network(s), resource needs (financial, housing, transportation, etc.), and appropriate level of care. • Provides crisis intervention, therapeutic support and coping skills on adjustment to illness/disability. • Identifies physical, psychosocial, and spiritual needs and incorporates them into the plan of care. • Demonstrates sensitivity and awareness about population specific needs or special issues related to culture, race, gender, age religion, sexual orientation, etc. • Demonstrates the ability to identify symptoms/indicators of abuse, neglect, and exploitation in specific patient populations and provide appropriate interventions, including mandated reporting. • Assess and responds to legal issues such as Living Wills, Durable Power of Attorney, guardianship, etc. • Supports patients to ensure they can function to the best of their ability and maintain optimal health related to their medical condition. Provide education and information to patient's identified support systems. • Supports patients to stabilization using individual and group therapy techniques. • Utilizes interviews and patient medical record reviews to identify actual or potential barriers and care needs. • Interacts with patients, support systems, healthcare professionals, 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 from a medical/psychosocial/financial perspective, assesses the needs of patients and support systems. • Discusses evaluations, goals and treatments with patients and support systems to enhance patient and support system engagement. • Collaborates with the multidisciplinary team to identify needs of patients and their support systems. • Understands and utilizes hospital and community based financial resources and entitlements such as SSD, SSI, Medicaid, charity care, mental health, HCFS, Patient Financial Representatives, Public Health and other outside resources as needed. • Coordinates and implements discharge/transitional planning activities within expected length of stay in collaboration with the multidisciplinary team. • Accountable for appropriate and patient focused discharge planning; including placement in alternative living environments. • Advocates on behalf of patients and takes a lead role assisting patients with complex psychosocial needs. • Keeps supervisor informed of barriers to discharge, patient/family dissatisfaction, and/or agency conflicts. • Coordinates with referral agencies as indicated to ensure services are in place before discharge. This includes providing necessary paperwork in a timely manner to process the referral and enhancing positive working relationships with community agencies. • Demonstrates and utilizes knowledge of internal and external agency services/resources related to the needs of specific patient populations and the ability to be creative in coordinating services. • Refers patients, families, and significant others to appropriate services to ensure continuity and quality of care (information and referral). • Monitors the need for revisions in the care plan and makes recommendations to physician(s) and interdisciplinary team when indicated. Demonstrates resourcefulness when collaborating with the interdisciplinary team. • Modifies treatment plans to reflect changes in patients or their support system status and needs. • Demonstrates the ability to evaluate compliance with medical/psychiatric treatment protocols and intervene to address barriers. • Helps navigate patient through the healthcare system. • Provides timely referral and coordinates with agencies/facilities to ensure services are in place to meet the patient's and organizational needs to achieve continuity and quality of care. • Demonstrates and utilizes knowledge of services/resources related to the needs of specific patient populations. • Maintains current knowledge regarding insurance benefit reimbursement, community resource and ancillary clinical services to meet the needs of internal and external customers. • Serves as a resource to staff on psychosocial needs of patients and families, resources, and discharge/transitional planning. • Documents care management interventions in medical record including patient, family and/or significant other communication, discharge/transition plan, support system and disposition status. • Documentation is timely, reflects professional practice and is consistent with departmental/organizational policy. • Monitors, evaluates and documents patient progress related to the plan of care. • Maintains data and reporting information as required by department and other programs. • Provides utilization review functions as required by the department. • Identifies service gaps and participates in hospital and departmental programs to address and improve quality of care. • Adheres to department and organizational policies addressing confidentiality, infection control, patient rights, medical ethics, advance directives, disaster protocols and safety. • Maintain competency in organizational and departmental policies/processes relevant to job performance. • Adheres to regulatory, legal, compliance, and professional licensure/certification requirements in day-to-day practice. • Participates in continuing education, department planning, work teams, and process improvement activities. • Demonstrates the ability to be flexible, open minded and adaptable to change • Maintain competency in organizational and departmental policies/processes relevant to job performance. • Performs other duties as assigned or needed to meet the needs of the department/organization.