Care Management Coord RN-Optional

TriHealth; Cincinnati (OH); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Retirement plan

Tuition reimbursement

Job summary

TriHealth's Bethesda North Hospital seeks a dedicated Registered Nurse to join the Care Management team as a Care Management Coordinator in an optional role. This position emphasizes evidence-based bedside practices, utilization reviews, and discharge planning within a multidisciplinary setting.

Strong communication, problem solving, and collaboration across care settings are essential. Weekend/holiday coverage is required, with Hospice Cincinnati exception noted.

Qualifications

• Associate's Degree or Diploma in Nursing.
• Hires into position to obtain BSN within 5 years of hire.
• BLS/CPR certification.
• Registered Nurse licensure.
• Excellent communication skills.
• Ability to negotiate with multidisciplinary teams.
• Problem solving and critical thinking.
• Fosters collaboration with healthcare team and external customers.
• Knowledge of computer keyboarding/computers.
• Professional organization membership preferred.
• 3-4 years clinical nursing experience.

Responsibilities

• Assess patients using current practice guidelines and coordinate care transitions.
• Perform initial utilization review using Interqual criteria and document actions.
• Coordinate development of a comprehensive care plan with patient/family and interdisciplinary team.
• Ensure CMS and commercial payment requirements are met for continued stay reviews.

Skills

Registered Nurse

BLS/CPR

Communication

Problem solving

Negotiation

Interdisciplinary teamwork

Computer skills

BSN in progress

Teamwork

Education

Nursing Diploma

BSN in progress

Job description

Care Management Coord RN Opportunity at Bethesda North Hospital – Join TriHealth!

Are you a passionate and patient-focused Registered Nurse looking to make a meaningful impact? TriHealth is seeking a Care Mgmt Coord RN to join our team in an Optional role within our Care Management department.

This is a unique opportunity to expand your expertise working in a supportive and collaborative environment.

Why Join TriHealth at Bethesda North?

• Be part of a leading, multidisciplinary health system known for excellence in care
• Collaborate with a dedicated team
• Practice in a multi-disciplinary health system
• Thrive in a patient-centered culture that supports innovation and professional growth

Location: Bethesda North Hospital 10500 Montgomery Rd. Montgomery, OH 45242

Schedule: Optional

Incentives & Benefits:

We offer competitive shift differentials, opportunities for professional growth, and a comprehensive benefits package that may include medical, dental, vision, paid time off, retirement savings plans, and tuition reimbursement.

*PRN positions not eligible for TriHealth benefits

Job Overview:
The Care Management Coordinator is responsible for overseeing the processes and documentation that occur as evidence based practice is applied at the bedside. Directs and or completes all functions of the government and commercial utilization management process. Assesses and coordinates implementation of the discharge plan. Collaborates with the multidisciplinary team to assure effective, efficient, appropriate care in order to optimize the health status and assure a smooth transition between levels of care for patients served. Performs utilization review for patients served. Requires weekend, holiday, and off site commitment, with the exception of Hospice of Cincinnati.

Job Requirements:

• Associate's Degree or Diploma in Nursing
• Hires into position (internal and external) required to obtain BSN within 5 years of hire
• BLS/CPR (Basic Life Support for Healthcare Providers)
• Registered Nurse
• Excellent communication skills
• Ability to negotiate
• Problem solve
• Establish effective working relationship with members of the healthcare team and external customers
• Knowledge & experience in computer key boarding
• Professional organization membership preferred
• 3-4 years experience Clinical in Nursing

Job Responsibilities:

• Using current practice guidelines, assesses all patients, evaluating progress toward clinical goals and next level of care. Reassesses as clinical condition changes.
• Complete initial utilization review using Interqual criteria. Take follow up action to resolve the situation when criteria are not met by implementing and documenting according to the Utilization Review plan.
• Coordinate the development of a comprehensive plan of care through patient/family involvement in an interdisciplinary team process. Ensure the patient's health care goals are met related to evidenced based quality care.
• Ensure that all commercial and government payment requirements are met for continued stay reviews, and other conditions of participation. Ensure that CMS requirements are met for patient status.

Working Conditions:

Climbing – Rarely

Concentrating – Consistently

Continous Learning – Consistently

Hearing: Conversation – Consistently

Hearing: Other Sounds – Consistently

Interpersonal Communication – Consistently

Kneeling – Occasionally

Lifting <10 Lbs – Frequently

Lifting 50+ Lbs – Occasionally

Lifting <50 Lbs – Frequently

Pulling – Frequently

Pushing – Frequently

Reaching – Occasionally

Reading – Consistently

Sitting – Frequently

Standing – Frequently

Stooping – Occasionally

Talking – Consistently

Thinking/Reasoning – Consistently

Use of Hands – Consistently

Color Vision – Consistently

Visual Acuity: Far – Consistently

Visual Acuity: Near – Consistently

Walking – Frequently