Case Manager RN - ED (Full Time, Nights), St. Vincent

Highmark Inc

Erie, PA

JOB DETAILS
SKILLS
Analysis Skills, CPR Certification, Case Management, Certified Case Manager (CCM), Clinical Medicine, Clinical Nursing, Communication Skills, Computer Security, Corporate Policies, Customer Support/Service, Documentation, English Language, Facebook, Federal Bureau of Investigation (FBI), Federal Laws and Regulations, HIPAA (Health Insurance Portability and Accountability Act), Health Economics, Health Insurance, Health Plan, Healthcare, Hospital, Hospital Systems, Industry Standards, Information/Data Security (InfoSec), Internet Security, Interviewing Skills, Legal Standards, LinkedIn, Mentoring, Nursing, Nursing Credentials, Occupational Health, Operating Room Nursing, Patient Assessment, Patient Care, Patient Education, Problem Solving Skills, QoS (Quality of Service), Quality of Care, Registered Nurse (RN), Regulatory Compliance, Regulatory Requirements, Resource Utilization, Risk, Sales, Security Policy, State Laws and Regulations, Team Player, Utilization Management, YouTube
LOCATION
Erie, PA
POSTED
30+ days ago

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Nursing

Case Manager RN - ED (Full Time, Nights), St. Vincent

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Case Manager RN - ED (Full Time, Nights), St. Vincent

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Erie PA, 16502, 232 West 25th St

Company :

Allegheny Health Network

Job Description :

St. Vincent Hospital

St. Vincent Hospital is a Magnet-designated hospital for excellence in nursing, serving the people in the Lake Erie region since 1875 with a quality of care and service second to none!

Allegheny Health Network

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.

GENERAL OVERVIEW:

This job has responsibility for creating, implementing, and evaluating care plans for patients and their families/caregivers across the health continuum. Incumbents will utilize nationally recognized standards of practice for case management by collaborating with providers, clinical teams, health plans, and external partners while advocating for patients and caregivers in order to align goals and plans. Incumbents will serve as professional role models, utilizing their expertise in care management to promote a collaborative professional environment that optimizes outcomes, engages patients/caregivers in their healthcare, and supports effective resource utilization. Serves as key team members in the management of readmissions, length of stay, ED utilization, and patient/family satisfaction.

ESSENTIAL RESPONSIBILITIES:

  • Contributes to or completes comprehensive assessment of patients and their families/caregivers, inclusive of clinical/physical needs, social determinants of health, and economic barriers impacting their ability to manage their health. (20%)
  • Effectively identifies barriers and analyzes situations for assigned patient population, including risk for admission/readmission, external resources, and patient/family capacity in order to determine safe plans for transition and care coordination. (20%)
  • Coordinates the clinical care with the patient, family, provider(s), and members of the interdisciplinary team. (25%)
  • Advocates for patients and families through effectively communicating with providers, interdisciplinary team members, payers, and post-acute partners to assure effective outcomes and care. (15%)
  • Leverage understanding of industry standards to provide applicable education to patients, families, providers, and interdisciplinary team partners including but not limited to: appropriateness of care, documentation requirements, utilization review principles and criteria, insurance benefits and limitations, transition planning requirements, length of stay, and resource utilization. (10%)
  • Actively seeks professional development opportunities through professional certification, mentoring/precepting, and/or participation on department/hospital/system committees. (5%)
  • Adheres to the policies, procedures, rules, regulations, and requirements of hospitals and other clinical settings. (5%)

QUALIFICATIONS:

Minimum

  • Bachelor's Degree in Nursing -OR- Bachelor's Degree and Nursing Diploma -OR- 6 years of relevant experience in lieu of a degree
  • 3 years in a clinical nursing role
  • Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).
  • Professional Certification within 5 years of start date. Incumbents in role as of 12/1/2022 have until 12/31/2026 to obtain
  • Critical thinking and problem solving
  • Flexibility and adaptability to change
  • Strong communication and collaboration skills with ability to tailor style according to target audience (providers, peers, clinical team members, patients, families)
  • 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

  • Nationally recognized Case Management Certification
  • Transition planning and understanding of community and facility resources
  • Knowledge of motivational interviewing techniques
  • BSN

LICENSES or CERTIFICATIONS

Required

  • None

Preferred

  • ACM Certification (Accredited Case Manager) - American Case Management Association - American Case Management Association
  • Case Management - American Board of Occupational Health Nurses (ABOHN) and

Certified Case Manager (CCM)

  • Commission for Case Manager Certification (CCMC)

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

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.

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 the email below.

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

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

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Job Details

  • Job category Nursing
  • Position Type Full Time
  • Posted 05/01/2026
  • Location(s) Erie PA, 16502, 232 West 25th St
  • Line of Business
  • Entity
  • Recruiter
  • Hiring Manager
  • Experience Level
  • Job Family RN Staff-AHN
  • Req ID J280430

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

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.

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 the email below.

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

2026 Highmark Health. All Rights Reserved.

About the Company

H

Highmark Inc

Highmark provides millions of people with the security of quality health insurance

Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.

Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.

Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.

COMPANY SIZE
1,000 to 1,499 employees
INDUSTRY
Healthcare Services
FOUNDED
1996
WEBSITE
https://www.highmark.com/hmk2/index.shtml