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Nursing Jobs in Monongahela, PA

RN Case Manager (Part Time) - West Penn Hospital

apartment Allegheny Health Network location_onPittsburgh, PA

Company Allegheny Health Network Job Description GENERAL OVERVIEW Registered nurse who is proficient in the coordination of care and manages coordination of care in accordance with recognized standards of practice for Care Management. Professional role model utilizing expertise in care management to promote a collaborative professional environment that supports excellence of care and achievement of optimal resource utilization. Also facilitates appropriate LOS, patient satisfaction and reimbursement for all patients. ESSENTIAL RESPONSIBILITIES Assumes role in assessment of patient physical, psychosocial, and economic needs for effective transition of care planning to a variety of levels of care. In collaboration with the care team, facilitates the development and communication of the continuum of care transition plan to appropriate health service providers. Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes. Interviews and collects patient specified data and chart review related to readmission. Knowledgeable of and complies with accreditation and regulatory requirements. Integrates performance improvement principles and customer service principles into all aspects of job responsibilities. Obtains or ensures acquisition of appropriate pre-certification authorizations from third party payers and placement to appropriate level of care prior to hospitalization utilizing medical necessity criteria and third party guidelines. Obtains or facilitates acquisitions of urgent / emergent authorizations, continued stay authorizations and authorizations for post-acute services as needed and with compliance with all regulatory and contractual requirements. Documents, monitors, intervenes/resolves and reports clinical denials/appeals and retrospective payer audit denials. Collaboratively formulates plans of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and third party payers. Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc. Serves as an educational resource to all AHN staff regarding utilization review practice and governmental commercial payer guidelines. Adheres to the policies, procedures, rules, regulations and laws of the hospital and all federal and state regulatory bodies. Communicates telephonically and electronically with the outpatient providers in an effort to enhance the continuum of care. Assumes responsibility for AHN required continued education and own professional growth. Performs other duties as assigned or required. QUALIFICATIONS Minimum Bachelor’s Degree in Nursing -OR- Bachelor’s Degree and Nursing Diploma -OR- 6 years of relevant experience in lieu of a degree 3 years in a clinical nursing role Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). Professional Certification within 5 years of start date. Incumbents in role as of 12/1/2022 have until 12/31/2025 to obtain Critical thinking and problem solving Flexibility and adaptability to change Strong communication and collaboration skills with ability to tailor style according to target audience (providers, peers, clinical team members, patients, families) CPR – American Heart Association Act 34 Criminal Background Clearance Certificate Act 33 Child Abuse Clearance Certificate Act 73 FBI Fingerprinting Criminal Background Clearance Certificate Preferred Nationally recognized Case Management Certification Transition planning and understanding of community and facility resources Knowledge of motivational interviewing techniques BSN LICENSES or CERTIFICATIONS Required None Preferred ACM Certification (Accredited Case Manager) - American Case Management Association - American Case Management Association Case Management - American Board of Occupational Health Nurses (ABOHN) and Certified Case Manager (CCM) Commission for Case Manager Certification (CCMC) Disclaimer The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice

PCU

Telemetry

Part-time

RN Registered Nurse, PCU/Tele (Part Time) - West Penn Hospital

apartment Allegheny Health Network location_onPittsburgh, PA

Company Allegheny Health Network Job Description PCU/TELEMETRY UNIT West Penn’s (T9) Progressive Care Unit is a 20 bed, cardiac monitored unit. The care provided to patients on this unit could include heart failure, post cath, digestive disorders, severe sepsis, strokes, and pulmonary edema. WEST PENN HOSPITAL West Penn Hospital has Magnet® recognition, private patient rooms, free employee parking and a generous benefit package (for full-time and part-time status employees). ALLEGHENY HEALTH NETWORK At AHN, employees trust working together and place patients at the center of all they do. This 9 Hospital system, a part of Highmark Health, is transforming the future of healthcare by providing highly effective services to customers, patients and communities. AHN has commitment and dedication to being inclusive, valuing fresh perspectives, and offering the best growth and educational opportunities to employees. General Overview The Registered Nurse assesses human responses and plans, implements and evaluates nursing care for individuals or families for whom the nurse is responsible. The Registered Nurse is fully responsible for all actions as a licensed nurse and is accountable to patients for the quality of care delivered. Essential Responsibilities The registered nurse provides leadership in a professional practice setting. Team player who contributes to building the team by helping others succeed through role modeling and mentoring. Assigns or delegates tasks based on the needs of the patient and skill level of the RN, LPN or support staff. Assigns duties and lunches for staff when performing charge role. Considers maintenance of a safe environment, patient condition, complexity of the intervention and predictability of the outcome. Provides peers with both verbal and written feedback regarding clinical practice and role performance. Shares knowledge and skills with peers and colleagues. Willingly accepts mistakes of self and others, creating a culture in which risk taking is not only safe but expected. Participates on interdisciplinary team to evaluate clinical care or health services. Promotes patient safety initiatives (ex National Patient Safety Goals). Participates in department specific quality initiatives ( ex EBP population specific). Assures appropriate order sets are used. Supervises delegates and evaluates assigned LPN scope of practice as appropriate. Utilizes the nursing process to assess, plan, evaluate and implement a patient plan of care according to the individual needs of the patient as prescribed by physician, nurse and hospital policy including patient and family. Derives culturally and age appropriate expected outcomes involving the patient, family and other health care providers. Analyzes the health status of the individuals and families comparing the data with the norm, when possible, to determine patient care needs. Assesses patient reports/records change of condition and notifies physician and/or supervisor and intervenes appropriately and documents accordingly. Accepts assignments in areas other than primary unit, and performs duties within individualized competency. Demonstrates a commitment to continuous lifelong learning for self and others. Promotes advancement of the profession through participation in professional organizations. Seeks both formal and independent learning activities using current research findings and other evidence to maintain and develop clinical and professional skills and knowledge. Participates in systematic peer review and obtains informal feedback regarding one’s own practice from patients, peers, professional colleagues and others. Identifies areas of strength, as well as, areas in which professional development would be beneficial. Meets time and attendance guidelines per hospital policy. Continuously evaluates and assesses patient and family satisfaction. Participates I department specific patient satisfaction initiatives. Promotes compassionate communication that is patient and family centered. Assesses for and attempts to resolve patient/family concerns. Utilizes effective time management skills to complete assigned duties and responsibilities within established work shift. Qualifications Minimum Act 34 Criminal Background Clearance Certificate Act 33 Child Abuse Clearance Certificate Act 73 FBI Fingerprinting Criminal Background Clearance Certificate Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). CPR certification Preferred Certification in area of specialty Disclaimer The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice