Home Health Care Registered Nurse For Weekends

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience.
Under the supervision of the Transition of Care Clinical Program Manager, The Transition of Care (TOC) Nurse is responsible for managing a member's successful transition from an acute or post-acute level of care to home and is accountable for developing, implementing, and evaluating comprehensive transitional care interventions for high risk medical and/or surgical members for Prominence Health. He/she is responsible for facilitating the post-acute care of members that are at risk for poor health outcomes, frequent emergency room visits, and hospital readmissions.
The TOC nurse identifies hospitalized high-risk, complex members for program enrollment and communicates with all entities involved in the care of the member to promote and maximize care coordination. Inpatient/SNF workflow includes visiting members at the bedside, member and family education regarding disease states and self-care, identification of member-level concerns regarding discharge, and anticipation of potential gaps in care. The inpatient/SNF encounters are designed to educate members/caregivers surrounding their post discharge health care needs and to empower them to play an active and informed role in managing their care post-discharge.
Upon member hospital/SNF discharge, the post-discharge workflow includes a scheduled periodic telephonic follow-up for 30 days and an in person visit, when appropriate. This includes a focus on medication reconciliation and adherence, management of member's quality of life and functionality, management of both acute and chronic disease states, identification and rectifying gaps in care, support of member's ability to perform self-cares, coordination of post-discharge appointments and services (durable medical equipment, home health), and coordination of care across the care continuum.
The TOC Nurse will adhere to the CMSA Standards of Practice for Case Management. The TOC Nurse refers and contributes to the development of the plan of care of members in Care Management. Additionally, the position participates in efforts associated with the successful operation of the SNP CM program and that the model of care (MOC) meets or exceeds regulatory and accreditation requirements for the Centers for Medicare and Medicaid Services (CMS), state Medicaid offices (as relevant), and NCQA.
*Hybrid Friday-Tuesday (Sat/Sun required, in-person visits on weekends). Excellent Medical, Dental, Vision and Prescription Drug Plans
401(K) with company match and discounted stock plan
More information is available on our Benefits Guest Website: benefits.uhsguest.About Universal Health Services:
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.Associate or Bachelor's Degree in Nursing , required .

Active, unrestricted, current, and valid Registered Nurse licenses in the States of Practice (Nevada, Texas and/or Florida), required.
Certified Case Manager (CCM), C ase Management Nurse - Board Certified (CMGT-BC), Accredited Case Manager - RN (ACM-RN), or Certified Managed Care Nurse (CMCN), preferred.
Minimum of three (3) years in clinical nursing practice, required .
Minimum of three (3) years of Case Management/Transition of Care experience in a managed care outpatient or community environment, preferred.
Recent working knowledge of Milliman Care Guidelines, preferred.
Ability to effectively communicate in English (Nevada, Texas, and Florida markets). Preferred Spanish (Texas and Florida markets), and/or Spanish, French Creole, and/or Tagalog (Florida market), both verbally and in writing depending on the State of RN licensure and employment location, preferred .
*Hybrid Friday-Tuesday (Sat/Sun required, in-person visits on weekends). UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS
During the recruitment process, no recruiter or employee will request financial or personal information (e.g., We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.