Highmark Health

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.

This position is located on-site at Allegheny Valley Hospital

This position is non-patient facing.

This person will work primarily daylight shift from 7:00am-3:00pm Monday thru Friday with weekend rotation (typically every third but varies based on need).

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 preestablished standards.

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
• 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

• Experience in utilization management and/or employment by a third party payer/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 any category protected by applicable federal, state, or local law.

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