Care Mgmt Coord RN-Good Sam Hospital Full Time Day

TriHealth•Cincinnati, OH

2d•Onsite

About The Position

The Care Management Coordinator oversees the processes and documentation involved in applying evidence-based practice at the bedside. The role directs and/or completes government and commercial utilization management functions, assesses and coordinates implementation of discharge plans, and performs utilization review for patients served. The coordinator collaborates with the multidisciplinary team to provide effective, efficient, and appropriate care, optimize patients’ health status, and support smooth transitions between levels of care. The position requires weekend, holiday, and off-site commitments, except for Hospice of Cincinnati. This is a full-time, day-shift position at Good Sam Hospital in Cincinnati, Ohio. The role is part of TriHealth’s Care Management department and supports patient-centered care, interdisciplinary collaboration, and professional development.

Requirements

Associate’s degree required.
Diploma in Nursing required.
Must obtain a BSN within five years of hire.
Three to four years of clinical nursing experience required.
Registered Nurse.
Excellent communication skills.
Ability to negotiate and problem solve.
Ability to establish effective working relationships with healthcare team members and external customers.
Knowledge and experience in 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, including CMS requirements for patient status.
Coordinate development of a comprehensive plan of care with patient and family involvement through an interdisciplinary team process.
Ensure patients’ healthcare goals are met in relation to evidence-based quality care.
Complete initial utilization reviews using InterQual criteria and take follow-up action when criteria are not met, documenting according to the Utilization Review Plan.
Oversee processes and documentation associated with evidence-based practice at the bedside.
Direct and/or complete government and commercial utilization management functions.
Assess and coordinate implementation of discharge plans.
Collaborate with the multidisciplinary team to optimize care and transitions between levels of care.