Nurse Case Manager - Philadelphia, PA

TRIUNE Health Group•Philadelphia, PA

13h

About The Position

TRIUNE Health Group is a nationally recognized, mission-driven managed healthcare company with over 35 years of experience. The Nurse Case Manager coordinates resources and develops flexible, cost-effective options for catastrophically or chronically ill or injured individuals, supporting quality, individualized, holistic treatment goals and timely return to work when appropriate. The position provides medical case management through coordination with patients, physicians, other healthcare providers, employers, and referral sources. It involves assessing and evaluating treatment plans and coordinating care and related services. The role primarily involves sedentary work, with occasional field visits or meetings and travel requirements. The position may allow reasonable accommodations or modified duties, including telephonic case management, where appropriate. Compensation is competitive and commensurate with experience; the position is eligible for incentive compensation awards.

Requirements

Graduate of an accredited school of nursing.
Current RN licensure in the state of operation.
Fluency in English, including speaking, reading, and writing.
Three or more years of recent clinical experience.
Valid driver’s license and ability to travel 90% of the time.
Proven leadership skills.
Excellent verbal and written communication skills, including effective interaction with patients, customers, and coworkers by phone, email, in person, and formal presentations.
Methodical approach to accomplishing job-related goals.
Strong analytical and organizational skills, including multitasking with attention to detail.
In-depth knowledge of multiple software packages, particularly Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and the Internet.
Maintain a friendly, professional attitude; demonstrate initiative, a solution-oriented approach, dependability, and adaptability; keep management informed about current situations or opportunities.
Ability to perform the stated physical and communication demands, including prolonged sitting and computer use, sustained concentration, and repetitive hand and wrist movements; reasonable accommodations may be available.

Nice To Haves

Clinical experience in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, or neurology is preferred.
CCM is preferred.

Responsibilities

Provide medical case management by coordinating with patients, physicians, other healthcare providers, employers, and referral sources.
Use case-management processes to assess, plan, implement, and evaluate care and individual progress and outcomes.
Evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness.
Facilitate care, including negotiating and coordinating durable medical equipment and home health services, and ensuring clear communication.
Assess rehabilitation facilities for appropriate care, facilitate transportation, and coordinate home architectural assessments when required.
Communicate medical information clearly and compassionately to patients and families.
Keep current with medical terminology and federal and state laws related to healthcare, Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.
Use computers, cell phones, fax machines, and scanning equipment to prepare organized and timely reports while complying with HIPAA and safety rules.
Research medical and community resources for people with catastrophic or chronic diagnoses and ensure accessibility.
Travel for field visits and other work needs; the posting states the role requires the ability to travel 90% of the time.
Perform other duties as assigned.