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_Are you ready to make a difference in the lives of patients and their families? Join our dynamic team at UPMC Washington as a Case Manager, where every day is an opportunity to bring compassion, coordination, and care to those who need it most. If you're passionate about healthcare and thrive in a fast-paced environment, we want to hear from you!_

Responsibilities:

* Provide case management according to program descriptions including member/patient education, follow up on a timely basis and eliminating barriers to care.

* Successfully engage member/patient to develop an individualized plan of care to promote healthy lifestyles, close gaps in care, reduce unnecessary ER utilization and hospital readmissions.

* Develop and coordinate the individualized plan of care with the member/patient, members/patient's family, providers and community agencies as applicable. Involve other staff to support the individualized plan of care based on identified needs of the member/patient

* Based on assessment of members/patients needs and environment, identify applicable barriers, problems, goals, and interventions that will address those needs and improve or maintain the health status of the member/patient.

* Follow-up with the member/patient according to established clinical program protocols and timeframes to monitor their status, evaluate the effectiveness of the individualized plan of care, and identify new needs.

* Modify the individualized plan of care or case status based on the status of the member/patient.

* Contact members/patients to determine if there is a need for case management intervention based on protocols and timeframes established for the applicable clinical program.

* Conduct comprehensive assessments that include the medical, behavioral, pharmacy, and social needs of the member/patient.

* Review UPMC Health Plan and EMR data for services the member/patient has received and identify gaps in care based on clinical standards of care.

* Perform duties and responsibilities in accordance with the philosophy and standards of UPMC, including conveying courtesy, respect, enthusiasm, and a positive attitude through contacts with staff, members/patients, peers, and external contacts.

Schedule: Primarily Monday-Friday, 7AM-3:30PM (mostly 8-hour shifts but there is a possibility of 10 hour shifts as well), with a weekend rotation about every 6 weeks. Rotating holiday coverage is required. This position will work on all the inpatient units.

+ Five years of experience in clinical, utilization management, home care, discharge planning, and/or case management required.

+ Three years of experience in a managed care environment preferred.

+ Ability to interact with physicians and other health care professionals in a professional manner required.

+ Computer proficiency required.

+ Excellent verbal and written communication and interpersonal skills requiredLicensure, Certifications, and Clearances:

+ Valid Pennsylvania RN licensure required.

+ Bachelor's degree in nursing preferred.

+ Case Manager certification preferred.

+ RN license in other states as assigned.

+ Registered Nurse (RN)

+ Act 33 with renewal

+ Act 34 with renewal

+ Act 73 FBI Clearance with renewal

_*Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state._

UPMC is an Equal Opportunity Employer/Disability/Veteran