Care Progression Manager

Jefferson Health Plans • Philadelphia, PA

12d • Onsite

About The Position

The Care Progression Manager collaborates across interdisciplinary teams to advance health system strategies, including initiatives focused on value-based care and payer population management. The role partners with clinical, operational, and financial stakeholders to align care progression workflows with organizational goals for quality, efficiency, and cost-effectiveness. The manager progresses patients’ care based on medical criteria for inpatient status.

This position oversees timely care progression, safe discharge planning, and appropriate post-acute services; applies clinical criteria to monitor medical necessity and reduce avoidable days; and helps resolve barriers to care. The role also monitors length of stay, readmissions, and throughput metrics and contributes to efforts that improve efficiency and patient outcomes. The position is based at 1101 Market in Philadelphia, Pennsylvania, and the listed work shift is rotating.

Requirements

• Bachelor’s degree in Nursing.
• Five years of experience in an inpatient acute-care hospital.
• Excellent oral and written communication skills to facilitate reviews and discussions with providers.
• Pennsylvania Registered Nurse license upon hire, or New Jersey Registered Nurse license upon hire.

Nice To Haves

• Master’s degree in Nursing.
• Knowledge of care and utilization management.
• Strong interpersonal and organizational skills to manage a caseload and communicate with multidisciplinary team members.
• Ability to work independently and set priorities to ensure appropriate use of hospital resources.
• Ability to lead individuals and groups.

Responsibilities

• Oversee the patient population to ensure timely progression of care, safe discharge planning, and appropriate post-acute services using evidence-based criteria.
• Identify clinical conditions, testing, and value-based clinical interventions that can be completed in the ambulatory setting with appropriate follow-up.
• Apply clinical criteria to monitor medical necessity, reduce avoidable days, and resolve barriers to care in collaboration with physicians, nursing, and utilization management.
• Collaborate in the development and implementation of performance improvement activities with care management, physicians, and utilization management.
• Interact with coworkers, visitors, and other staff consistently with Jefferson’s values.
• Monitor length of stay, readmissions, and throughput metrics; identify trends; and contribute to initiatives that improve efficiency and patient outcomes.

Benefits

• Medical insurance, including prescription coverage.
• Supplemental insurance.
• Dental insurance.
• Vision insurance.
• Life and AD&D insurance.
• Short- and long-term disability coverage.
• Flexible spending accounts.
• Retirement plans.
• Tuition assistance.
• Voluntary benefits, including access to group insurance rates and discounts.
• Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service.
• Medical insurance, including prescription coverage, is available to all colleagues, including those working less than part-time.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager