Imagine a career at one of the nation's most advanced health networks.

Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.

LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day.

Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.

Coordinates patient care; assesses, evaluates, and updates the care plan; and functions as a clinician, case manager, and educator to achieve optimal clinical and quality outcomes. Manages care and resources to reduce unnecessary utilization and collaborates in the development and implementation of performance improvement activities.

Job Duties

• Assesses the patient at the point of entry to the health care system in order to identify the expected length of stay, anticipated post-hospital care needs, and documents all care in the EHR appropriately.
• Assists in the development, implementation, and evaluation of a multidisciplinary, individualized patient plan of care that includes an appropriate transition plan.
• Analyzes patient outcomes and hospital performance indicators and makes suggestions for areas of improvement.
• Establishes patient care management plans, interventions, treatment goals, and self-management goals and assesses the health care, educational, and psychosocial needs of the patient/family.
• Collaborates with multidisciplinary healthcare teams and provides the patient and/or family in the development and implementation of plans.
• Develops and maintains knowledge of Medicare, Medicaid, and key payer benefits and reimbursement methodologies.
• Assists patients/families with self-management through education, visits, and telephonic engagement and encourages and supports patient adherence to their care plans.
• Communicates with physicians, patients, families, and other members of the healthcare team to coordinate transition planning.
• Researches, evaluates, and recommends resources to meet medical and non-medical needs of patients and families.

• Bachelor’s Degree Nursing
• 3 years experience in one of the following settings: care coordination, disease management, home health care, hospital, or physician office setting and
• 1 year prior electronic medical record (EMR) experience.
• Ability to incorporate strategies for interacting with persons from diverse backgrounds.
• Ability to set priorities to coordinate care plans efficiently.
• Knowledge of computer applications and analytical tools.
• Knowledge of nursing theory and application of learning theory.
• Proven leadership skills.
• RN - Licensed Registered Nurse_PA - State of Pennsylvania Upon Hire

• Master’s Degree Nursing

Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities.

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Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes.