Care Manager
20170104
Position Number: 55195
Location: Allegheny General Hospital
Allegheny Health Network is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities. With more than 14,000 employees including 7,400 health care professionals, nearly 200 primary care and specialty care practices, Allegheny Health Network includes seven hospitals in Pennsylvania with nearly 2,400 licensed beds.
Allegheny Health Network’s clinical expertise ranges from primary care to the most complex surgical procedures. Services include cancer diagnosis and treatment, cardiovascular care, neurological and neurosurgical services, organ transplantation, orthopedic and rehabilitation services, and women’s health.
Department: Case Management
Status: Full-time
Shift: Inpatient Area's: Daylight, 40 hours per week shift- rotating weekends (typically every 4th to 5th weekend)
THIS IS A UNION POSITION
Job Summary: Responsible and accountable for facilitating the provision of quality and cost-effective care delivery for a designated patient population during an acute episode of care. Ensures optimal care management, patient outcomes and reimbursement based upon enactment of the nursing process.
Job Responsibilities:
- Coordinates the clinical care with the patient, family, physician(s), and other members of the interdisciplinary team.
- Completes and documents admission, concurrent, and discharge reviews of all inpatients and selected outpatients.
- Develops and implements an effective discharge plan while incorporating input from the patient, family, physician(s), and other members of the interdisciplinary team.
- Identifies, analyzes, collects, and communicates data relative to quality and cost issues related to the assigned patient population.
- Expands industry knowledge base for professional growth and development while providing ongoing applicable education to the patient, family, physician(s), and other members of the interdisciplinary team (IDT) including, but not limited to, appropriateness of care, documentation requirements, severity of illness and intensity of services criteria, insurance benefits/requirements/limits, discharge planning requirements, length of stay and resource utilization issues.
- Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies.
Requirements:
- Current license to practice professional nursing in the state of Pennsylvania required.
- BA/BS Required
- Current CPR certification required.
- Case Management certification preferred.
- Inpatient clinical nursing experience in an acute hospital setting with two (2) years experience in the population to which the individual is to be assigned required or 2 years relevant CM/UM experience in another healthcare setting.