Conemaugh Nason Medical Center is seeking a PRN Case Manager. The PRN Case Manager monitors and manages patient care to promote continuity of care, optimal patient outcomes, patient satisfaction, cost efficiency, and compliance.

Conemaugh Nason Medical Center is a 45-bed hospital that serves rural and suburban populations in Roaring Spring, Altoona, and parts of Blair, Bedford, and Huntingdon counties. Caring for the community since 1900, Conemaugh Nason Medical Center prides itself on providing safe, high quality, compassionate care. With a state-of-the art cardiac catheterization lab, Conemaugh Nason offers a range of inpatient, and outpatient cardiac services close to home when every minute matters. The hospital provides 24/7 emergency care as an accredited chest pain center, and offers comprehensive outpatient, imaging, diagnostic, and specialty services. As a LifePoint Health National Quality Leader, Conemaugh Nason is leading the way among peers by delivering the highest quality of care for patients.

Conemaugh Nason is also a member of the Conemaugh Health System, a Duke LifePoint Healthcare system. Conemaugh Health System serves more than a half-million patients each year through the Nason Physician Group, Conemaugh Physician Group and Medical Staff, a network of four hospitals, specialty clinics and patient-focused programs.

Essential Functions:

Skilled in Case Management functions and care coordination.

Ensure the efficient and effective deployment of the organization's resources and reviews patient care to safeguard against unnecessary and inappropriate medical care.

Utilize InterQual to determine severity of illness and intensity of service for all patients assigned an acute care bed.

Uses clinical assessment skills to monitor how a patients clinical status responds to treatment and therapies and acts when variance in condition is identified.

Ensures that appropriate patient status is documented and correctly registered.

Proactively interacts with patients and families during the admission process to set expectations for the course of stay and discharge planning.

Communicates expected length of stay to the care team.

Communicates findings of inpatient medical necessity screenings and ongoing concurrent review to third party payors

Proactively analyzes information from the care team to support inpatient admission.

Proactively removes barriers to patient management and discharge planning.

Follows the Care Management policy and procedure for utilizing Physician Advisors

Interacts with attending physicians, physician advisor and department chairs about any identified quality issues and utilization issues

Follows CMS and regulatory requirements for Case Management processes.

Coordinates concurrent denial/appeal process for assigned cases.

Organizational Expectations:

Demonstrates support of the mission, vision, values, goals and general policies of Conemaugh Nason Medical Center.

Complies with corporate compliance guidelines and requirements of federal, state and local regulatory and accrediting agencies.

Adheres to the standards of professional ethics and handles confidential information in strict conformance with departmental and Medical Center policies.

Provides quality care and services consistent with Medical Center standards and participates in the Medical Center’s Continuous Quality Improvement Program.

Demonstrates flexibility and adaptability in response to unexpected changes in the workload, emergencies, staffing and scheduling.

Uses tact, sensitivity, sound judgment and a professional attitude when relating with co-workers, patients, families, and visitors.

Performs duties in a self-directed and cooperative manner with minimal need for supervision. Uses time constructively for maximum productivity.

Treats all co-workers, patients, families, and visitors with consideration to their rights, cultural diversity, privacy, comfort and emotional needs. Serves as a patient advocate and fosters a work culture of Diversity, Equity, and Inclusion.

Attends all mandatory trainings and completes all required Life Talent education assignments within a timely manner. Keeps updated regarding Medical Center changes through meeting attendance and review of posted information; attends briefs, debriefs, and huddles.

Abides by and references the Employee Handbook and other pertinent facility policies, including clinical, non-clinical, safety, and infection control.

Job Requirements:

Education

Graduate of a RN program required

Bachelor of Science in Nursing preferred

Three or more years of Case Management experience is preferred

Required Licenses

Currently Registered Nurse License in the Commonwealth of Pennsylvania

Basic Life Support (BLS)

Required Skills

Requires critical thinking skills

Decisive judgment and the ability to work with minimal supervision

Must be able to work in a stressful environment and take appropriate action

Excellent communication skills

Ability to be self-directed and independent

Serves as expert resource for severity of illness criteria and resource utilization/appropriateness

Competitive wage and benefits package, 401K, PTO and onsite occupational health!