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Manager, Case Management - AVH- Full Time

Highmark HealthHighmark Health·Health Insurance

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Posted

11 days

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About the role

Company :

Allegheny Health Network

Job Description : 

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.

Allegheny Valley Hospital is a 188 bed community, union hospital serving the surrounding neighborhoods of Natrona Heights.

GENERAL OVERVIEW:

Incumbent provides oversite to daily operations. Attracts/hires talent and coordinates orientation/onboarding.  Ensures team efficiency through scheduling, competency assessment (formal plan). Collaborates with team members on complex patients. Assures compliance with regulatory/policy/workflows through documentation review, observation and interaction. Embraces the core values and leads with integrity, determination and professionalism. 

ESSENTIAL RESPONSIBILITIES:

  • Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority. (25%)
  • Serves as a change agent and role model.  Responsible for implementation of mission, vision, philosophy, core values, evidence based practice (EBP), and standards of the organization, and nursing service within their defined areas of responsibility.20%
  • Leads collaborative discussions resulting in the efficient transition of medically or socially complex patients (20%)
  • Engages with resources, develops action plans and provides communication to leaders and clinical partners regarding metrics: throughput, LOS and delays. (10%)
  • Mentors and engages with team to assure the following is occurring: (25%)
    • Conduct assessment to determine patient/family and health care team treatment goals, and need for post-acute services based on payer coverage, community resources, and patient preferences, and barriers to discharge
    • Address psychosocial, clinical, and financial barriers to discharge as identified in assessment in conjunction with the patient/family and health care team
    • Arrange appropriate level of post-acute services according to patient's   needs and preference and payer coverage in collaboration with the physician and health care team
    • Communicate with and update the patient/family, physician, and health care team regarding progress on the discharge plan
    • Arrange appropriate transportation to post-acute venues
  • Other duties as assigned.   

QUALIFICATIONS:

Minimum

  • Master's degree in Nursing or other related field (Education and experience will be considered in lieu of degree)
  • 3 years in Management
  • 3 years in Acute Health care setting
  • Current PA RN licensure
  • 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

  • Professional National certification

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

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Aplyr's read

Highmark Health is a major player in the health insurance sector, offering diverse roles from clinical to technical, attracting healthcare professionals and tech experts alike.

Synthesized from recent postings & public sources

What's promising

  • Highmark Health offers a comprehensive range of health insurance products, enhancing job stability.
  • The company provides diverse career paths, from clinical roles to tech positions.
  • Highmark Health's focus on wellness programs supports a culture of employee well-being.

What to watch

  • The healthcare industry faces regulatory uncertainties that could impact Highmark Health.
  • Limited public information about internal career advancement opportunities.
  • Potential for high-stress environments in clinical roles due to patient care demands.

Why Highmark Health

  • Highmark Health integrates insurance with wellness programs, offering a holistic approach to healthcare.
  • The company has a strong regional presence, particularly in Pennsylvania.
  • Highmark Health's diverse hiring across clinical and technical roles supports a multidisciplinary workforce.

Aplyr’s read is generated by AI from public sources. Was it useful?

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About Highmark Health

Highmark Inc. is a health insurance company that provides a range of health care products and services, including medical, dental, and vision insurance, as well as wellness programs.

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