RN Case Manager, West Penn Hospital

2 weeks ago


Pittsburgh, Pennsylvania, United States Highmark Health Full time
Job Summary

We are seeking a skilled RN Case Manager to join our team at West Penn Hospital, part of the Allegheny Health Network. As a RN Case Manager, you will play a critical role in creating, implementing, and evaluating care plans for patients and their families/caregivers across the health continuum.

Key Responsibilities
  • Conduct comprehensive assessments of patients and their families/caregivers to identify clinical/physical needs, social determinants of health, and economic barriers impacting their ability to manage their health.
  • Effectively identify barriers and analyze situations for assigned patient population to determine safe plans for transition and care coordination.
  • Coordinate clinical care with patients, families, providers, and interdisciplinary teams to ensure effective outcomes and care.
  • Advocate for patients and families through effective communication with providers, interdisciplinary team members, payers, and post-acute partners.
  • Leverage industry standards to provide education to patients, families, providers, and interdisciplinary team partners on care appropriateness, documentation requirements, utilization review principles and criteria, insurance benefits and limitations, transition planning requirements, length of stay, and resource utilization.
Requirements
  • Bachelor's Degree in Nursing or equivalent experience.
  • 3 years of experience in a clinical nursing role.
  • Current PA RN license.
  • Professional Certification within 5 years of start date.
  • CPR certification.
  • Critical thinking and problem-solving skills.
  • Flexibility and adaptability to change.
  • Strong communication and collaboration skills.
Preferred Qualifications
  • Nationally recognized Case Management Certification.
  • Transition planning and understanding of community and facility resources.
  • Knowledge of motivational interviewing techniques.

We are an equal opportunity employer and welcome applications from diverse candidates. If you are passionate about delivering high-quality patient care and have a strong commitment to teamwork, we encourage you to apply for this exciting opportunity.



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