It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: SSM is looking for an experienced nurse with Hospice/Home Health/Liaison or Case Management experience that has a dynamic personality with a ton of energy and passion for Hospice and Home Health care. Someone with resilience, but has a smile on their face all the time. Someone who knows all the challenges Home Health and Hospice may have but sees a path forward to solving for them. Required to obtain licenses for MO, IL, OK and WI within 6 months of starting Schedule: 3 days during the normal work week supporting Home Health, and then every weekend supporting Hospice. Weekend work primarily involves managing urgent hospice referrals, supporting timely admissions, and getting HH referrals started for Monday. This is potentially subject to change as we continue to work on staffing coverage across the teams. The selected individual will be responsible for; • Communication with patients/families to discuss continuum of care services. • Meeting/Communicating with referral sources (case management, social work, clinics, providers, SNF/ALF facilities etc). • Care coordination between continuum of care departments, such as branch departments, business development etc. • Eligibility/Chart Review to determine appropriateness for continuum of care services Job Summary: Reviews and analyzes patient referrals to determine the appropriateness of home health, hospice and infusion services. Coordinates all aspects of service to optimize the patient’s smooth transition from hospital to home care. Communicates key components of patient’s needs and physicians' orders to clinicians to help establish the patient’s plan of care. Provides educational information to case managers, physicians, key hospital staff, and nursing home staff regarding qualifying criteria, access to services, etc. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES • Assesses patient care needs by gleaning hospital records and/or referral provided information for information necessary to determine the appropriateness of referral and to initiate patient records. • Identifies educational needs for patients/significant others. • Adheres to skilled service/homebound regulations of payers. • Plans for patient care by ensuring that information regarding pending referrals is passed on to nursing supervisors, clinical supervisor or rehab services, and others as necessary in a timely manner. • Coordinates with nursing supervisors, clinical supervisor or rehab services, and others in initiating care. • Seeks appropriate orders in planning multidisciplinary care. • Completes evaluation of care by reassessing patients systematically to identify progress and trends that require intervention; this may include seeing the rehospitalized patient and/or reviewing his/her record. • Communicates with supervisor regarding the cases he/she is managing while awaiting the initiation of care. • Assesses and discerns environmental factors which are hazardous and/or unsafe and responds according to policy and agency expectation. • Works in a constant state of alertness and safe manner. • Performs other duties as assigned.
SSM Health is a healthcare system that hires nurses for utilization management and care coordination roles. As a Manager Registered Nurse in Utilization Management, you would lead a team overseeing care coordination, utilization review, and regulatory compliance across the continuum of care, with responsibilities including managing denials and appeals, analyzing utilization data, and ensuring patients receive appropriate care while maintaining cost-effectiveness. The position is fully remote for candidates residing in Missouri, Oklahoma, Illinois, or Wisconsin, with standard Monday-Friday hours and occasional weekend support.
