RN Case Manager: Care Coordination & Transitions

highmarkhealth; Erie (Erie County); On-site; USD 70,000 - 95,000; Full time

Job summary

Allegheny Health Network, St. Vincent Hospital, is seeking a Case Manager to create, implement, and evaluate care plans for patients and families across the health continuum.

You will use national standards of practice for case management and collaborate with providers, clinical teams, health plans, and external partners to align goals and ensure effective transitions. As a key team member, you will help manage readmissions, length of stay, ED utilization, and patient/family satisfaction,

Qualifications

• Minimum Bachelor's Degree in Nursing -OR- Bachelor's Degree and Nursing Diploma -OR- 6 years of relevant experience in lieu of a degree
• 3 years in a clinical nursing role
• Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).
• Critical thinking and problem solving
• Flexibility and adaptability to change
• Strong communication and collaboration skills with ability to tailor style according to target audience (providers, peers, clinical team members, patients, families)

Responsibilities

• Contributes to or completes comprehensive assessment of patients and their families/caregivers, inclusive of clinical/physical needs, social determinants of health, and economic barriers impacting their ability to manage their health.
• Effectively identifies barriers and analyzes situations for assigned patient population, including risk for admission/readmission, external resources, and patient/family capacity in order to determine safe plans for transition and care coordination.
• Coordinates the clinical care with the patient, family, provider(s), and members of the interdisciplinary team.
• Advocates for patients and families through effectively communicating with providers, interdisciplinary team members, payers, and post-acute partners to assure effective outcomes and care.
• Leverage understanding of industry standards to provide applicable education to patients, families, providers, and interdisciplinary team partners including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and limitations, transition planning requirements, length of stay, and resource utilization.
• Actively seeks professional development opportunities through professional certification, mentoring/precepting, and/or participation on department/hospital/system committees.
• Adheres to the policies, procedures, rules, regulations, and requirements of hospitals and other clinical settings.

Skills

Critical thinking

Problem solving

Flexibility

Adaptability

Communication skills

Collaboration

Education

Bachelor's Degree in Nursing

BSN

6 years of relevant nursing experience in lieu of degree

Job description

Allegheny Health Network, St. Vincent Hospital, is seeking a Case Manager to create, implement, and evaluate care plans for patients and families across the health continuum.

You will use national standards of practice for case management and collaborate with providers, clinical teams, health plans, and external partners to align goals and ensure effective transitions. As a key team member, you will help manage readmissions, length of stay, ED utilization, and patient/family satisfaction,