Care Mgmt Coord RN-Good Sam Hospital Full Time Day

TriHealth, Inc.; Cincinnati (OH); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Tuition Reimbursement

Retirement Plans

Paid Time Off

Job summary

TriHealth's Good Sam Hospital in Cincinnati is seeking a dedicated Care Management Coordinator RN. You will oversee evidence-based practice at the bedside, lead utilization reviews, and coordinate discharge planning with a multidisciplinary team to ensure safe transitions of care.

The role requires RN licensure, applicable nursing experience, and that you obtain a BSN within five years. A comprehensive benefits package supports professional growth and patient-centered care.

Qualifications

• Associate's Degree (Required)
• Diploma in Nursing (Required)
• Hires into position (internal and external) required to obtain BSN within 5 years of hire (Required)
• 3 - 4 years experience Clinical in Nursing (Required)
• 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
• Registered Nurse

Responsibilities

• Using current practice guidelines, assesses all patients, evaluating progress toward clinical goals and next level of care. Reassesses as clinical condition changes.
• 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.
• 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.
• 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.

Job description

Care Management Coord RN Opportunity at Good Sam 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 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 Good Sam?

• 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

Locations:

• Good Sam Hospital 375 Dixmyth Ave, Cincinnati, OH 45220

Work Schedule:

• Full-Time (80 hours bi-weekly)
• Day shift

Incentives & Benefits:

In addition to a comprehensive benefits package—including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement—this role offers competitive pay based on education level and experience.

Please view our benefits page

https://careers.trihealth.com/what-we-offer/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 (Required)
• Diploma in Nursing (Required)
• Hires into position (internal and external) required to obtain BSN within 5 years of hire (Required)
• 3 - 4 years experience Clinical in Nursing (Required)
• 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
• Registered Nurse

Job Responsibilities:

• Using current practice guidelines, assesses all patients, evaluating progress toward clinical goals and next level of care. Reassesses as clinical condition changes.
• 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.
• 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.
• 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.

Other Related Information:

The TriHealth Nursing Vision, Mission, and Philosophy speaks to professional development, collaboration, and our nursing culture. To achieve excellence in nursing care, TriHealth encourages: pursuit of improved knowledge through continuing education classes, formal education leading to advanced degrees, and the attainment of specialty certification; nurse membership in local, regional, and national nursing organizations related to the appropriate nurse specialty; involvement in activities that better the health of our community; nursing research activities and use of evidence-based practice, and all nurses to foster, support, and personally model collaborative relationships amongst nurses, physicians, and other caregivers for the betterment of patient care.

Working Conditions:
Bending -
Climbing - Rarely
Concentrating - Consistently
Continuous 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

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:

Serve: ALWAYS...
Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
Refrain from using cell phones for personal reasons in public spaces or patient care areas

Excel: ALWAYS...
Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
Offer patients and guests priority when waiting (lines, elevators)
Work on improving quality, safety, and service

Respect: ALWAYS...
Respect cultural and spiritual differences and honor individual preferences.
Respect everyone's opinion and contribution, regardless of title/role.
Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS...
Value the time of others by striving to be on time, prepared and actively participating.
Pick up trash, ensuring the physical environment is clean and safe.
Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS...
Acknowledge wins and frequently thank team members and others for contributions.
Show courtesy and compassion with customers, team members and the community