Review and Evaluation Nurse (RN) - Critical Incident Management Unit

Job Description

Job Description

Seeking a highly skilled and detail-oriented Registered Nurse (RN) to join a specialized Critical Incident Management team within a program dedicated to protecting and improving the lives of individuals receiving home and community-based services. This role is ideal for a nurse who wants to move beyond traditional bedside care and take on a position that directly influences quality, safety, and accountability across a broader healthcare system. In this role, you will have the opportunity to make a meaningful impact by ensuring vulnerable populations receive appropriate, effective, and person-centered services that allow them to live as independently and safely as possible.

In this position, you will be responsible for reviewing and evaluating critical incidents and service plans for individuals enrolled in programs such as Community Health Choices, Act 150, and OBRA waivers. Your clinical expertise will be essential in assessing whether services are appropriate, compliant with program requirements, and aligned with each participant’s medical and functional needs. You will play a key role in safeguarding participants by ensuring that any risks to their health, safety, and welfare are properly reported, investigated, and addressed in accordance with established policies and timeframes.

This role offers a unique opportunity to apply your nursing knowledge in a strategic and analytical way. You will evaluate medical documentation, identify trends in incident reporting, and collaborate with interdisciplinary professionals including physicians, social workers, and protective service agencies. Your insights will help shape care decisions, improve service delivery, and contribute to system-wide enhancements in how care is provided to individuals with physical disabilities and complex medical conditions.

A key responsibility of this role includes conducting mortality reviews, where you will assess critical incident reports to determine whether deaths may have resulted from negligent practices or gaps in care. This function is not only essential to maintaining accountability, but also contributes to the development of preventative strategies and best practices aimed at improving outcomes and reducing risk across the system. Through this work, you will directly influence policies and initiatives designed to enhance quality of care and protect vulnerable populations.

In addition to clinical review and analysis, you will serve as a resource and representative for the program, providing guidance to participants, families, providers, and stakeholders. You may also participate in hearings, appeals, and stakeholder discussions, offering your professional expertise to support informed decision-making. This aspect of the role allows you to expand your influence beyond individual cases and contribute to broader program integrity and regulatory compliance.

This position is well-suited for a nurse who values autonomy, critical thinking, and meaningful work that extends beyond direct patient care. You will work both independently and as part of a collaborative team, managing responsibilities in a structured environment while utilizing technology to support remote and hybrid work functions. Your ability to prioritize tasks, communicate effectively, and interpret complex regulations will be essential to your success.

Candidates must hold an active Pennsylvania Registered Nurse license and possess a strong clinical foundation, including knowledge of medical conditions, treatment modalities, and the challenges faced by individuals with physical disabilities. Familiarity with home and community-based services, Medicaid waivers, and care coordination processes is highly valuable. The ideal candidate will also demonstrate strong analytical skills, attention to detail, and a commitment to improving healthcare quality and equity for underserved populations.

This role offers a unique career path for nurses who are looking to leverage their clinical expertise in a way that drives systemic impact. It provides the opportunity to influence care at a population level, contribute to meaningful policy and program improvements, and play a critical role in protecting the health, safety, and dignity of individuals in community-based care settings.