RN Case Manager (Full Time)- AHN Wexford

Job Title

Allegheny Health Network

General Overview

This job has responsibility for creating, implementing, and evaluating care plans for patients and their families/caregivers across the health continuum. Incumbents will utilize nationally recognized standards of practice for case management by collaborating with providers, clinical teams, health plans, and external partners while advocating for patients and caregivers in order to align goals and plans. Incumbents will serve as professional role models, utilizing their expertise in care management to promote a collaborative professional environment that optimizes outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization. Serves as key team members in the management of readmissions, length of stay, ED utilization, and patient/family satisfaction.

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. (20%)

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. (20%)

Coordinates the clinical care with the patient, family, provider(s), and members of the interdisciplinary team. (25%)

Advocates for patients and families through effectively communicating with providers, interdisciplinary team members, payers, and post-acute partners to assure effective outcomes and care. (15%)

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. (10%)

Actively seeks professional development opportunities through professional certification, mentoring/precepting, and/or participation on department/hospital/system committees. (5%)

Adheres to the policies, procedures, rules, regulations, and requirements of hospitals and other clinical settings. (5%)

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)

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)

Additional Employment Requirements:

CPR American Heart Association

Act 34 Criminal Background Clearance Certificate

Act 33 Child Abuse Clearance Certificate

Act 73 FBI Fingerprinting Criminal Background Clearance Certificate

Professional Certification within 5 years of start date. Incumbents in role as of 12/1/2022 have until 12/31/2026 to obtain