Highmark Inc. Monroeville , PA 15146
Posted 2 weeks ago
Company :
Allegheny Health Network
Job Description :
GENERAL OVERVIEW:
This job has responsibility for creating, implementing, and evaluating care plans for patients and their families/caregivers across the health continuum. Incumbents will utilize nationally recognized standards of practice for case management by collaborating with providers, clinical teams, health plans, and external partners while advocating for patients and caregivers in order to align goals and plans. Incumbents will serve as professional role models, utilizing their expertise in care management to promote a collaborative professional environment that optimizes outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization. Serves as key team members in the management of readmissions, length of stay, ED utilization, and patient/family satisfaction.
ESSENTIAL RESPONSIBILITIES:
QUALIFICATIONS:
Minimum
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
Professional Certification within 5 years of start date. Incumbents in role as of 12/1/2022 have until 12/31/2025 to obtain
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)
Preferred
Nationally recognized Case Management Certification
Transition planning and understanding of community and facility resources
Knowledge of motivational interviewing techniques
BSN
LICENSES or CERTIFICATIONS
Required
Preferred
American Case Management Association
American Case Management Association
Certified Case Manager (CCM)
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
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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
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Highmark Inc.