Care Management Coord

TriHealth • Cincinnati, OH

3d • Onsite

About The Position

At TriHealth, Care Mgmt Coordinators-RN make a meaningful impact every day.

We’re committed to creating an exceptional place to work and receive care—one
built on strong values, teamwork, and respect. Here, you’ll be supported by a
compassionate community, grow your clinical skills, and contribute to
high‑quality patient care in a trusted health system.

Join us and be part of a team that leads with purpose, supports your
development, and stays true to the values that define who we are at our core.

The Care Management Coordinator is responsible for overseeing the processes and
documentation that occur as evidence based practice is applied at the bedside.
Directs and or completes all functions of the government and commercial
utilization management process. Assesses and coordinates implementation of the
discharge plan. Collaborates with the multidisciplinary team to assure
effective, efficient, appropriate care in order to optimize the health status
and assure a smooth transition between levels of care for patients served.
Performs utilization review for patients served. Requires weekend, holiday, and
off site commitment, with the exception of Hospice of Cincinnati.

Requirements

• Associate's Degree or Diploma in Nursing
• Hires into position (internal and external) required to obtain BSN within 5 years of hire
• BLS/CPR (Basic Life Support for Healthcare Providers)
• Registered Nurse
• Excellent communication skills
• Ability to negotiate
• Problem solve
• Establish effective working relationship with members of the healthcare team and external customers Knowledge & experience in computer key boarding
• 3-4 years experience Clinical in Nursing

Nice To Haves

• Professional organization membership preferred

Responsibilities

• Using current practice guidelines, assesses all patients, evaluating progress toward clinical goals and next level of care. Reassesses as clinical condition changes.
• Complete initial utilization review using Interqual criteria. Take follow up action to resolve the situation when criteria are not met by implementing and documenting according to the Utilization Review plan.
• Coordinate the development of a comprehensive plan of care through patient/family involvement in an interdisciplinary team process. Ensure the patient's health care goals are met related to evidenced based quality care.
• Ensure that all commercial and government payment requirements are met for continued stay reviews, and other conditions of participation. Ensure that CMS requirements are met for patient status.

Benefits

• We offer competitive shift differentials, opportunities for professional growth, and a comprehensive benefits package that may include medical, dental, vision, paid time off, retirement savings plans, and tuition reimbursement.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees