Care Management Coordinator

Job Responsibilities

• Using current practice guidelines, assesses all patients, evaluating progress toward clinical goals and next level of care.
• Reassesses as clinical condition changes.
• Complete initial utilization review using Interqual criteria.
• Take follow up action to resolve the situation when criteria are not met by implementing and documenting according to the Utilization Review plan.
• Collaborate with the multidisciplinary team to assure effective, efficient, appropriate care in order to optimize the health status and assure a smooth transition between levels of care for patients served.
• Perform utilization review for patients served.

Job Requirements

• 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 keyboarding
• Professional organization membership preferred
• 3-4 years experience Clinical in Nursing

Job Qualifications

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

Skills

• Knowledge of current practice guidelines
• Ability to negotiate and problem solve
• Effective communication skills
• Experience in computer keyboarding
• Collaboration with multidisciplinary teams
• Utilization review and discharge planning expertise

Benefits

• Professional development opportunities through continuing education classes, formal education leading to advanced degrees, and specialty certifications
• Nurse membership in local, regional, and national nursing organizations related to the appropriate nurse specialty
• Involvement in activities that improve the health of the community
• Nursing research activities and use of evidence-based practice

Pay

Details about pay are not specified in the job description.

Schedule

Details about the schedule are not specified in the job description.

TriHealth SERVE Standards and ALWAYS Behaviors

• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
• Respect cultural and spiritual differences and honor individual preferences
• Respect everyone’s opinion and contribution, regardless of title/role
• Speak positively about my team members and other departments in front of patients and guests
• Value the time of others by striving to be on time, prepared and actively participating
• Pick up trash, ensuring the physical environment is clean and safe
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste
• Acknowledge wins and frequently thank team members and others for contributions
• Show courtesy and compassion with customers, team members and the community