RN Case Manager Inpatient (Part Time), Allegheny General Hospital

Company :

Allegheny Health Network

Job Description :

Date Posted: 20240228

Location: Allegheny General Hospital

Department: Case Management, Inpatient

Status: Part Time

Shift: 48 hours every two weeks

Daylight M-F, 24 hours per week, rotating weekends and holidays

Union: Yes

CASE MANAGEMENT:

The Case Management Department at Allegheny General Hospital assists patients and their support systems in managing medical conditions effectively. Our team of talented Case Managers aims to individualize health care to meet each patient's specific needs with a patient-centric and outcome-driven focus.

ALLEGHENY GENERAL HOSPITAL:

• AGH is a Level I Shock Trauma Center

• 5 state of the art ICU’s

• State of the art Cancer Center

• 550+ Beds

ALLEGHENY HEALTH NETWORK:

At AHN, employees trust working together and place patients at the center of all they do. This 9 Hospital system, a part of Highmark Health, is transforming the future of healthcare by providing highly effective services to customers, patients and communities. AHN has commitment and dedication to being inclusive, valuing fresh perspectives, and offering the best growth and educational opportunities to employees.

GENERAL OVERVIEW

This job oversees, develops, and manages the end-to-end claims functions and operational inputs including but not limited to the receipt of claims, operational correspondences, and corporate correspondences for multiple customer segments; fully utilizes the support mechanisms available to complete the required delivery of high-performance, efficient, and low-cost production. Responsible for mail services, imaging, and Optical Character Recognition (OCR) including vendor relations and communicating with operational areas regarding issues related to supported technology. Manage utilization review, translation of foreign claims, coordination of benefits (COB), and processing of claims with unique processing arrangements including Federal Employee Program (FEP) and Medicare Advantage.

ESSENTIAL 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.

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 PA RN license

• Nationally recognized Case Management Certification within 5 years of start date.

• CPR certification

• 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)

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J237357

Highmark Health Culture:

Located in the dynamic community of West Mifflin, PA, Highmark Health is a beacon in the healthcare industry, offering diverse job opportunities for those dedicated to making a difference in healthcare services. As a premier healthcare provider, we are dedicated to excellence and innovation across various healthcare sectors, positioning us as a top choice for professionals seeking healthcare jobs near West Mifflin, PA. Our mission is to deliver unparalleled healthcare services to our community, a commitment that is at the core of our culture and motivates our ongoing search for passionate individuals to join our team.

Highmark Health has become a key player in the West Mifflin, PA healthcare landscape, not only by providing exceptional care but also by generating extensive employment opportunities for healthcare professionals. Whether you are a seasoned RN Case Manager Inpatient (Part Time), Allegheny General Hospital or a recent graduate ready to embark on your healthcare career, Highmark Health offers a supportive and dynamic environment where your talents are valued and your professional development is encouraged. With our broad operations in West Mifflin, PA, we are continually seeking skilled individuals to fill roles in various categories, ensuring a steady demand for healthcare professionals in our community.

Highmark Health is at the forefront of addressing the growing need for quality healthcare in West Mifflin, PA, offering numerous job openings for those searching for healthcare positions in their vicinity. Our dedication to adopting the latest healthcare technologies and methodologies means our team is ever-expanding, with a keen interest in hiring professionals such as (RN) Case Managers for Assisted Living, Associate Dentists, Clinical Pharmacists, Field Training Audiologists, Occupational Therapists, Social Workers, and Staff Physical Therapists, who are eager to positively impact our patients' lives. Joining Highmark Health places you among a group of dedicated professionals committed to delivering the best healthcare in West Mifflin, PA, and beyond.

For individuals in West Mifflin, PA seeking healthcare jobs near them, Highmark Health offers a unique chance to work in a cutting-edge facility that prioritizes both the professional growth of its staff and the health of its patients. We recognize the significance of local employment opportunities in building a strong community and proudly provide a variety of positions that accommodate the diverse expertise within the healthcare field. From clinical roles like (RN) Case Managers, Associate Dentists, and Clinical Pharmacists to specialized positions such as Field Training Audiologists, Occupational Therapists, Social Workers, and Staff Physical Therapists, Highmark Health is eager to attract and retain top talent in and around West Mifflin, PA.

In conclusion, Highmark Health is more than a leader in healthcare; we are a significant employer in the healthcare sector within West Mifflin, PA. Our dedication to excellence in healthcare services is paralleled by our commitment to creating job opportunities for those seeking healthcare positions close to home. By choosing to grow your career with Highmark Health, you're not just joining a team of exceptional healthcare professionals; you're also contributing to the well-being of the West Mifflin, PA community. We invite you to explore the exciting career opportunities at Highmark Health and take the first step toward a rewarding healthcare career, right here in West Mifflin, PA.

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