RN Care Manager: Transitions & Care Coordination

highmarkhealth; Pittsburgh (Allegheny County); On-site; USD 85,000 - 110,000; Full time

Job summary

Allegheny Health Network seeks a Registered Nurse specializing in care management to coordinate care and promote optimal resource utilization. The role supports discharge planning, patient satisfaction, and appropriate length of stay across care settings.

Requires a nursing degree (BSN preferred) and 3+ years in clinical nursing; PA RN licensure or eNLC is preferred. Strong communication and collaboration with providers and care teams are essential.

Qualifications

• Bachelor's degree in Nursing required or Nursing Diploma with equivalent experience.
• Minimum of 3 years in a clinical nursing role.
• Current PA RN licensure or multi-state licensure via eNLC preferred.

Responsibilities

• Assess patient physical, psychosocial, and economic needs for care transition planning.
• Coordinate and communicate the continuum of care transition plan with providers and care team.
• Document and validate data to monitor interventions and outcomes; interview and chart review related to readmission.
• Ensure compliance with accreditation, regulatory requirements, and payer guidelines; support performance improvement and customer service.
• Obtain pre-certifications and post-acute/continuation-of-stay authorizations per guidelines; address denials with care teams.

Skills

Critical thinking

Problem solving

Flexibility

Communication skills

Collaboration

Education

Bachelor's Degree in Nursing

3 years clinical nursing experience

PA RN licensure or eNLC

Job description

Allegheny Health Network seeks a Registered Nurse specializing in care management to coordinate care and promote optimal resource utilization. The role supports discharge planning, patient satisfaction, and appropriate length of stay across care settings.

Requires a nursing degree (BSN preferred) and 3+ years in clinical nursing; PA RN licensure or eNLC is preferred. Strong communication and collaboration with providers and care teams are essential.