Cincinnati Children's Hospital Medical Center
RN Care Manager-Healthvine
Cincinnati Children's Hospital Medical Center, San Jose, California, United States, 95199
JOB RESPONSIBILITIES
Evaluation and Outcomes -
Evaluate the timeliness and availability of treatments and services and adjusting level of service according to changing needs. Evaluate actual patient outcomes in relation to expected outcomes for the care managed population. Identifies quality improvement opportunities such as consistent issues with smooth care progression and communicates them to the department's management/leadership team, providing supporting data and reference to evidence based practice when possible. Participates in the management of metrics (outcomes, value, and experience) across the continuum of care.
Monitoring -
Monitor the patient's progress in achieving the goals, objectives, and expected outcomes of the plan at specified time frames. Utilizes Critical Pathways and /or Clinical Guidelines to monitor patient progress toward health. Follows through on the status of key diagnostic and treatment tests and procedures to insure continued progression. Interacts with involved departments and other members of the healthcare team to negotiate and expedite scheduling and completion of tests and procedures. Identifies, documents and communicates barriers to the plan of care to the healthcare team. Serves as the contact person for and works collaboratively with the multidisciplinary team to manage resource usage/utilization.
Coordination -
Facilitates communication and coordination between members of the health care team across all phases of care. Involves the patient, family and caregivers in the decision-making process in order to minimize fragmentation in services. Leads the coordination of care, setting priorities and encouraging the appropriate use and timeliness of health care services Facilitates a smooth transition of care by ensuring that key components of the plan of care and/or patient needs are communicated to subsequent care providers across the continuum. Demonstrates an understanding of legal and regulatory issues (HIPPA, EMTALA, regulatory agencies, CMS, legal P&P) impacting the care delivery and reimbursement process. Negotiates and advocates for the patient for services and resources needed. Provides patient/family education regarding post-acute services, community resources, or other needs as identified. Creates an environment to support patient safety by integrating patient safety goals into daily practice based on the patient's age and the population served.
Implementation -
Implementing the agreed upon plan of care. Provides self-management support to high risk/complex patients and families, including helping families identify and overcome barriers to care. Utilizes collaborative communication skills to establish a working partnership with the patient/family/caregiver, treatment team, and community resources/providers. Educates the patient, family and caregiver along with members of the health care delivery team about treatment options. Empowers the patient, family, and caregiver to problem-solve by exploring options of care when available and alternative plans, when necessary, to achieve desired outcomes. Encourages the appropriate use of health care services and strives to improve quality of care and maintain cost effectiveness on a case-by-case basis. Support and facilitate all care transitions from inpatient to outpatient, practice to practice and from pediatric to adult systems of care.
Planning -
Planning with the patient, family or caregiver and providers, to maximize health outcomes and ensure quality, cost effective care. Works with the patient, family and caregiver, to establish treatment goals that meet the patient's healthcare and safety needs. Integrates patient, family and caregiver decisions and choice into the planning process. Coordinates the plan of care and maintains documentation of case updates and discussion/events involving individuals responsible for patient welfare (e.g. family, providers, and care team members). Identifies the need for patient/family team meeting, participates in the meeting and documents the outcomes. Proactively identifies medical and psychosocial services needed by the patient. Reassess plan of care and adjusts plan according to patient needs.
JOB QUALIFICATIONS
Bachelor's degree in a related field.
ACEN/CCNE accredited BSN OR MSN OR Associate/Diploma RN AND 2+ years of experience and BSN/MSN.
5+ years of work experience in a related job discipline.
Active Ohio RN License. May be required to obtain other state licensure.
Primary Location
South Campus
Schedule
Full time
Shift
Day (United States of America)
Department
PS Network Staff
Employee Status
Regular
FTE
1
Weekly Hours
40
*Expected Starting Pay Range
Annualized pay may vary based on FTE status $81,723.20 - $104,208.00
Market Leading Benefits Including*:
Medical coverage starting day one of employment. View employee benefits here.
Competitive retirement plans
Tuition reimbursement for continuing education
Expansive employee discount programs through our many community partners
Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions
Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group
Physical and mental health wellness programs
Relocation assistance available for qualified positions
*Benefits may vary based on FTE Status and Position Type
About Us At Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children’s.
Cincinnati Children's is:
Recognized by U.S. News & World Report as a
top 10
best Children's Hospitals in the nation
for more than 15 years
Consistently among the top 3 Children's Hospitals for
National Institutes of Health (NIH)
Funding
Recognized as one of
America’s Best Large Employers
(2025),
America’s Best Employers for New Grads
(2025)
One of the nation's
America’s Most Innovative Companies
as noted by Fortune
Consistently certified as
great place to work
A
Leading Disability Employer
as noted by the
National Organization on Disability
Magnet® designated for the fourth consecutive time by the
American Nurses Credentialing Center (ANCC)
We Embrace Innovation—Together. We believe in empowering our teams with the tools that help us work smarter and care better. That’s why we support the responsible use of artificial intelligence. By encouraging innovation, we’re creating space for new ideas, better outcomes, and a stronger future—for all of us.
Comprehensive job description provided upon request.
Cincinnati Children’s is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability
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Evaluation and Outcomes -
Evaluate the timeliness and availability of treatments and services and adjusting level of service according to changing needs. Evaluate actual patient outcomes in relation to expected outcomes for the care managed population. Identifies quality improvement opportunities such as consistent issues with smooth care progression and communicates them to the department's management/leadership team, providing supporting data and reference to evidence based practice when possible. Participates in the management of metrics (outcomes, value, and experience) across the continuum of care.
Monitoring -
Monitor the patient's progress in achieving the goals, objectives, and expected outcomes of the plan at specified time frames. Utilizes Critical Pathways and /or Clinical Guidelines to monitor patient progress toward health. Follows through on the status of key diagnostic and treatment tests and procedures to insure continued progression. Interacts with involved departments and other members of the healthcare team to negotiate and expedite scheduling and completion of tests and procedures. Identifies, documents and communicates barriers to the plan of care to the healthcare team. Serves as the contact person for and works collaboratively with the multidisciplinary team to manage resource usage/utilization.
Coordination -
Facilitates communication and coordination between members of the health care team across all phases of care. Involves the patient, family and caregivers in the decision-making process in order to minimize fragmentation in services. Leads the coordination of care, setting priorities and encouraging the appropriate use and timeliness of health care services Facilitates a smooth transition of care by ensuring that key components of the plan of care and/or patient needs are communicated to subsequent care providers across the continuum. Demonstrates an understanding of legal and regulatory issues (HIPPA, EMTALA, regulatory agencies, CMS, legal P&P) impacting the care delivery and reimbursement process. Negotiates and advocates for the patient for services and resources needed. Provides patient/family education regarding post-acute services, community resources, or other needs as identified. Creates an environment to support patient safety by integrating patient safety goals into daily practice based on the patient's age and the population served.
Implementation -
Implementing the agreed upon plan of care. Provides self-management support to high risk/complex patients and families, including helping families identify and overcome barriers to care. Utilizes collaborative communication skills to establish a working partnership with the patient/family/caregiver, treatment team, and community resources/providers. Educates the patient, family and caregiver along with members of the health care delivery team about treatment options. Empowers the patient, family, and caregiver to problem-solve by exploring options of care when available and alternative plans, when necessary, to achieve desired outcomes. Encourages the appropriate use of health care services and strives to improve quality of care and maintain cost effectiveness on a case-by-case basis. Support and facilitate all care transitions from inpatient to outpatient, practice to practice and from pediatric to adult systems of care.
Planning -
Planning with the patient, family or caregiver and providers, to maximize health outcomes and ensure quality, cost effective care. Works with the patient, family and caregiver, to establish treatment goals that meet the patient's healthcare and safety needs. Integrates patient, family and caregiver decisions and choice into the planning process. Coordinates the plan of care and maintains documentation of case updates and discussion/events involving individuals responsible for patient welfare (e.g. family, providers, and care team members). Identifies the need for patient/family team meeting, participates in the meeting and documents the outcomes. Proactively identifies medical and psychosocial services needed by the patient. Reassess plan of care and adjusts plan according to patient needs.
JOB QUALIFICATIONS
Bachelor's degree in a related field.
ACEN/CCNE accredited BSN OR MSN OR Associate/Diploma RN AND 2+ years of experience and BSN/MSN.
5+ years of work experience in a related job discipline.
Active Ohio RN License. May be required to obtain other state licensure.
Primary Location
South Campus
Schedule
Full time
Shift
Day (United States of America)
Department
PS Network Staff
Employee Status
Regular
FTE
1
Weekly Hours
40
*Expected Starting Pay Range
Annualized pay may vary based on FTE status $81,723.20 - $104,208.00
Market Leading Benefits Including*:
Medical coverage starting day one of employment. View employee benefits here.
Competitive retirement plans
Tuition reimbursement for continuing education
Expansive employee discount programs through our many community partners
Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions
Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group
Physical and mental health wellness programs
Relocation assistance available for qualified positions
*Benefits may vary based on FTE Status and Position Type
About Us At Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children’s.
Cincinnati Children's is:
Recognized by U.S. News & World Report as a
top 10
best Children's Hospitals in the nation
for more than 15 years
Consistently among the top 3 Children's Hospitals for
National Institutes of Health (NIH)
Funding
Recognized as one of
America’s Best Large Employers
(2025),
America’s Best Employers for New Grads
(2025)
One of the nation's
America’s Most Innovative Companies
as noted by Fortune
Consistently certified as
great place to work
A
Leading Disability Employer
as noted by the
National Organization on Disability
Magnet® designated for the fourth consecutive time by the
American Nurses Credentialing Center (ANCC)
We Embrace Innovation—Together. We believe in empowering our teams with the tools that help us work smarter and care better. That’s why we support the responsible use of artificial intelligence. By encouraging innovation, we’re creating space for new ideas, better outcomes, and a stronger future—for all of us.
Comprehensive job description provided upon request.
Cincinnati Children’s is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability
#J-18808-Ljbffr