RN Case Manager (Full Time, 40 Hours), West Penn Hospital

Job Title

This job has responsibility for creating, implementing, and evaluating care plans for patients and their families/caregivers across the health continuum.

This position is located on-site at West Penn Hospital, which has Magnet recognition, private patient rooms, free employee parking, and a generous benefit package.

At Allegheny Health Network, employees trust working together and place patients at the center of all they do. This 9 Hospital system, a part of Highmark Health, is transforming the future of healthcare by providing highly effective services to customers, patients, and communities.

This role is full-time, 40 hours per week. Hours are approximately 0800-1600 per day.

Essential 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.

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).
• Professional Certification within 5 years of start date. Incumbents in role as of 12/1/2022 have until 12/31/2026 to obtain
• 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)
• CPR American Heart Association
• Act 34 Criminal Background Clearance Certificate
• Act 33 Child Abuse Clearance Certificate
• Act 73 FBI Fingerprinting Criminal Background Clearance Certificate

Preferred

• Nationally recognized Case Management Certification
• Transition planning and understanding of community and facility resources
• Knowledge of motivational interviewing techniques
• BSN

Licenses or Certifications

Required

• None

Preferred

• ACM Certification (Accredited Case Manager) - American Case Management Association - American Case Management Association
• Case Management - American Board of Occupational Health Nurses (ABOHN) and Certified Case Manager (CCM)
• Commission for Case Manager Certification (CCMC)