Care Mgmt Coord RN-Good Sam Hospital Full Time Day

TriHealth•Cincinnati, OH

1d•Onsite

About The Position

TriHealth is seeking a Care Management Coordinator RN for the Care Management department at Good Sam Hospital in Cincinnati, Ohio. The role oversees the processes and documentation involved in applying evidence-based practice at the bedside and directs or completes government and commercial utilization management functions. The coordinator assesses and supports implementation of discharge plans, performs utilization review, and works with the multidisciplinary team to provide effective, efficient, and appropriate care. The position aims to optimize patients’ health status and ensure smooth transitions between levels of care. The role requires a full-time schedule of 80 hours bi-weekly on day shift. Weekend, holiday, and off-site commitments are required, except for Hospice of Cincinnati. The position requires an associate degree and nursing diploma, with a BSN to be obtained within five years of hire. TriHealth describes its nursing culture as emphasizing professional development, collaboration, continuing education, advanced degrees, specialty certification, community health, nursing research, evidence-based practice, and collaborative relationships among nurses, physicians, and other caregivers. The work involves frequent communication and interaction with patients, families, healthcare team members, and external customers. Physical and sensory activities listed include frequent sitting, standing, walking, lifting under 50 pounds, pushing, and pulling; occasional lifting over 50 pounds, kneeling, stooping, and reaching; and consistent concentration, learning, communication, reasoning, hand use, reading, and visual acuity. TriHealth team members are expected to demonstrate its SERVE standards and ALWAYS behaviors, including welcoming and assisting patients and guests, addressing service issues, improving quality and safety, respecting differences and contributions, using time and resources responsibly, and showing courtesy and compassion.

Requirements

Associate degree required.
Diploma in Nursing required.
Obtain a BSN within five years of hire.
Three to four years of clinical nursing experience required.
Excellent communication skills.
Ability to negotiate.
Ability to problem-solve.
Ability to establish effective working relationships with healthcare team members and external customers.
Knowledge of and experience with computer keyboarding.

Nice To Haves

Membership in a professional organization preferred.

Responsibilities

Assess patients using current practice guidelines, evaluate progress toward clinical goals and the next level of care, and reassess as clinical conditions change.
Ensure commercial and government payment requirements are met for continued-stay reviews and other conditions of participation.
Ensure CMS requirements for patient status are met.
Coordinate development of a comprehensive plan of care through patient and family involvement in an interdisciplinary team process.
Ensure patients’ healthcare goals related to evidence-based quality care are met.
Complete initial utilization reviews using InterQual criteria.
Take and document follow-up action according to the Utilization Review Plan when criteria are not met.
Oversee processes and documentation associated with applying evidence-based practice at the bedside.
Direct or complete government and commercial utilization management functions.
Assess and coordinate implementation of discharge plans.
Collaborate with the multidisciplinary team to support appropriate care and smooth transitions between levels of care.