Primary Location Fairfield Outpatient Department Care Management

• Primary Care Shift Day (United States of America) Schedule Full time Weekly Hours 40 FTE 1 Employee Status Regular
• Expected Starting Pay Range $81,723.20
• $104,208.00
• Starting pay is based on experience, skills, and equity; exceptions may apply for highly qualified candidates.

Additional pay (e.g., shift, on‑call, or weekend differentials) and benefits may apply. Annual pay may vary based on FTE status.

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. 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