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TriHealthPosted 1 month ago

Care Management Coord RN-Optional

On-siteMontgomery, Ohio, United States

Full TimeLicense Or CertificationEnterpriseHealthcare Tech

Job Summary

Assess all patients using current practice guidelines to evaluate progress toward clinical goals and determine the next level of care. Complete initial utilization reviews using Interqual criteria and coordinate comprehensive plans of care through interdisciplinary team involvement. Ensure all commercial, government, and CMS payment requirements are met for continued stay reviews and patient status. Resolve utilization situations by implementing and documenting actions according to the Utilization Review plan. Collaborate with the multidisciplinary team to optimize patient health status and ensure a smooth transition between care levels. Requires weekend, holiday, and off-site commitment.

Required Qualifications

  • 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
  • Requires weekend, holiday, and off site commitment, with the exception of Hospice of Cincinnati

Desired Qualifications

  • Professional organization membership preferred

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