RN Care Manager

1 week ago

West Conshohocken, United States Tandigm Health Full time

RN Care Manager - Post Acute (Field Based) Tandigm Health, a transformational leader in population health management, is looking for an RN Care Manager - Post Acute in the greater Philadelphia area. We offer a competitive compensation and benefits package and are proud to share a culture of diversity and inclusion. *Primary Duties and Responsibilities: * We are seeking a compassionate and dedicated RN SNF Care Manager to play a vital role in ensuring seamless continuity of care for patients in a skilled nursing facility (SNF) setting. This position focuses on addressing the comprehensive physical, psychological, and social needs of patients through a collaborative and patient-centered approach. In this role, you will develop and coordinate individualized care plans in partnership with multidisciplinary SNF staff, utilizing your nursing expertise and experience. You will work closely with patients and their families to provide education, support, and guidance, ensuring quality outcomes and safe care transitions. As a pivotal member of the care team, you will facilitate access to necessary services and resources, monitor patient progress, and adjust care plans to align with evolving needs and goals. The RN SNF Care Manager may perform care management functions either on-site or telephonically, demonstrating flexibility and adaptability to address patient needs effectively. Reporting findings and updates to the SNF Care Management leadership, you will contribute to a culture of excellence in care delivery. If you are a skilled RN with a commitment to delivering high-quality, patient-centered care and thrive in a collaborative environment, we invite you to apply for this rewarding opportunity. Essential Functions Reviews patients' clinical records within 24 hours of admission to the skilled nursing facility (SNF) Monday through Friday, and within 72 hours after weekend SNF admission. Conducts regular review of clinical and functional status and patient's goals on-site or telephonic, where assigned. Discuss and coordinate with SNF clinical staff, patient's treatment plans, discharge expectations, and when applicable, Advanced Care Planning (ACP) to ensure patient's wishes are respected. Meets with patient, patient's family, and caregivers as warranted to discuss care and treatment plan. Prioritizes patient care needs and advocates for a safe discharge to patient's next disposition. Coordinates provisions for discharge from facilities, including follow up appointments, home health, durable medical equipment, social services, transportation, etc., to maintain continuity of care. Communicate (provide a warm hand off) and collaborate with patient's PCP and care management personnel to assist with seamless transitions of care. Educates patients and/or families about preventive care, management of health conditions, and use of prescribed medical treatments and/or medications. Provide education and support to patients and their families regarding available resources and services. Collaborates with other clinical and administrative staff in a positive, constructive manner. Initiates and/or oversees data entry into EMR systems on all patients within 24 hours of patient contact. Maintains timely, accurate and complete documentation of patient care and progress. Demonstrates flexibility when performing assignments to meet organization and client goals. Demonstrates, by action and attitude, the standard of high patient satisfaction, treating each patient with respect. Demonstrates, by action and attitude, the standard of high staff and physician satisfaction, treating staff and physicians with respect. Participates actively in regularly scheduled team meetings, including daily care team meetings within assigned facilities and attends continuing medical education (CME) programs as needed. Meet all facility requirements and bylaws for Nursing Staff. Meet all Tandigm provider credentialing and QI standards. Consistently exhibits behavior and communication skills that demonstrate Tandigm's commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Uses, protects, and discloses Tandigm patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. Assumes other Care Management duties as delegated. Adheres to and responsible to abide by all information security policies, processes, and/or activities. Reports security events or potential events or other security risks to the organization to management. Performs additional duties as assigned. Required Qualifications: Education Current RN license in Pennsylvania Graduation from an accredited school of nursing (BSN preferred) Experience At least one year of recent clinical experience (3-5 years preferred) Must have valid driver's license and insurance. Previous care management, utilization review, or discharge planning experience preferred. HMO experience preferred. Knowledge, Skills, Abilities Excellent fund of knowledge with respect to the practice of medicine Commitment to service excellence and patient satisfaction Knowledge of current standards of patient care and thorough understanding of RN scope of practice. Able to make sound, independent judgements, and act professionally under pressure. Skills in establishing and maintaining effective working relationships with other teammates, patients, and the general public. Ability to speak with patients and assess health needs in a compassionate manner. Able to quickly analyze, comprehend and create written/verbal clinical and business communication and documentation. Ability to multi-task in a fast-paced clinical setting Excellent verbal, written and interpersonal communication skills. Ability to relate to culturally diverse patients and community. Ability to develop positive interaction with patients, families, physicians, administrators, and teammates in order to effectively care for the patient. Computer proficiency Applicants must be authorized to work in the US; work visa sponsorship will not be provided. * Equal Employment Opportunities (EEO): * Tandigm provides Equal Employment Opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. Search Firm Representatives Please Read Carefully: Tandigm Health, LLC does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

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