Company :

Job Description :

GENERAL OVERVIEW

Coordinates patient progress toward achieving quality and cost outcomes; mobilizes resources and manages the system in response to concurrent variances according to the pre-established standards.

This position will be responsible for Behavioral Health Case Management

Shift is M-F 8 hours, daylight – 1 every 6 weekends, 2 holidays/year

ESSENTIAL RESPONSIBILITIES

• Responsible for utilization management. (50%)
• Communicates and collaborates with physicians and multidisciplinary teams to ensure appropriate management of resources to attain patients individualized goals in an appropriate and timely manner and appropriate setting. (30%)
• Implements an effective discharge plan. (20%)

QUALIFICATIONS

Minimum

• BA/BS degree and Nursing school diploma required

• RN license - State of PA

• 5 years acute Medical/Surgical and/or specialty care nursing required.

Preferred

• Experience in utilization management and/or employment by a third party payor/review agency preferred.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

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 number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice