RN Case Manager
Conemaugh Meyersdale Medical Center
Meyersdale, PA

Registered Nurse (RN) - Case Manager

Registered Nurse (RN) - Case Manager (Meyersdale Medical Center) 
Job Type: Full-time | Monday-Friday daylight, typically 0700-1500 or 0800-1600, No call 

Your experience matters 

Conemaugh Meyersdale Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse (RN) joining our team, you're embracing a vital mission dedicated to making communities healthier ^®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

More about our team 

Conemaugh Meyersdale is a National Quality Program-designated hospital committed to providing exemplary, community‑focused care. Our highly supportive and collaborative team-including close partnership with case management-embraces a "no one works alone" culture, ensuring seamless care coordination for patients and families. Leadership leads with compassion and purpose, supported by a structured orientation designed to set every team member up for success.

How you'll contribute 

A Registered Nurse (RN) who excels in this role:

• Promotes patient safety and quality

• Knowledgeable in all patient coverage from Swing Bed days to Admitted and Observation requirements along with Medicare discharge reviews

• Works closely with Providers, insurance companies and Medicare for medical review of cases 

• Manages the denial process; Communicates with insurance companies and assists with Peer to Peer process and written appeals

• Facilitates daily IDT meetings

• Reviews admissions and verifies status for appropriateness

• Obtains authorizations

• Manages observation patients 

• Applies 2-Midnight Rule

• Ensures compliance with CMS IM 1 & IM

• Keeps forms and documents up to date and ensure compliance with usage 

• Tracks length of stay and readmissions and provides reviews

• Monitors readmissions

• Utilizes the NAVINET program for admission and discharge of Blue Cross patients

• Utilizes UPMC portal for authorizations and updates of UPMC patients

• Leads discharge planning and assessment for all patients

• Arranges for appropriate DME & DME face to face process; Assists with ER patients as needed for DME, Home Health referrals or placement needs.

• Arranges for home health & other appropriate community resources

• Completes recertification requirements over 96 hours

• Keeps current with the updated InterQual guidelines 

• Follows ER transfers for potential post-acute Swing Bed program patient admission

• Reviews referred swing bed patients for appropriateness to ensure criteria is met

• Maintains positive communication with Providers and Case Management 

• Obtains certification and develops goals and discharge assessment with plan for Swing Bed patients

• Completes recertifications for Swing Bed patients at 14 &30 days

• Completes follow up phone calls for all patients discharged home 

• Maintains required stats and reports stats out to committees

• Completes monthly departmental dashboards

• Completes DCM to O slides each month and participates in the completion of the monthly quality report

• Understand the insurance contract process

• Works in conjunction with COO to develop and implement Swing Bed Program; Utilization Management Policy; Discharge Planning Process; Readmission (7 & 30 day) Policy; update policies as required               

Why join us We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: 

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.

• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.

• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.

• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).

• Professional Development: Ongoing learning and career advancement opportunities.

What we're looking for 
Applicants should have a current state RN license and Graduate of an accredited nursing school. Additional requirements include:

• Diploma, Associates or Bachelor's degree in Nursing

• A minimum of three (3) years experience as a professional Nursing or one (1) year Registered Nurse experience with Case Management

• Case Management experience preferred

• Certification in BLS, ACLS and PALS within one year of employment 

• Certification in Case Management preferred

More about Conemaugh Meyersdale Medical Center 

Conemaugh Meyersdale Medical Center is a 20-bed critical access hospital that has served the rural Meyersdale community for 70 years. The hospital provides 24/7 emergency care as an accredited chest pain center, and offers high-quality, comprehensive outpatient, imaging, diagnostic, and specialty services close to home. Conemaugh Meyersdale Medical Center also provides primary care services, preventative care, and community education to the Meyersdale community through its Family Health Care Rural Health Clinic.

EEOC Statement

"Conemaugh Meyersdale Medical Center is an Equal Opportunity Employer.  Conemaugh Meyersdale Medical Center is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."