Community Transition Program Pps Jobs in Usa
19,104 positions found — Page 2
Position Summary:
The Manager of Client Services and Community Outreach at Entrusted Hearts Home Care leads efforts to ensure exceptional client care while driving growth through community engagement. This role oversees daily office operations, develops and maintains key referral relationships, executes marketing initiatives, and fosters client acquisition, satisfaction, and retention. The ideal candidate is self-motivated, relationship-focused, and passionate about making a meaningful impact in home care.
Entrusted Hearts Home Care, a division of Baptist Village Communities, is a growing private duty home care agency serving Owasso and the surrounding areas, committed to providing compassionate, high-quality care. We’re seeking someone who is passionate about connecting with the community, building strong relationships, and helping families access the care they need. If you thrive in a dynamic environment, love engaging with people, and want to make a meaningful impact every day, this is the role for you.
Key Responsibilities:
- Manage efficiently while ensuring high-quality care and exceptional customer service.
- Oversee daily operations of the office in alignment with the organization’s mission, vision, and core values.
- Execute the Home and Community-Based Services (HCBS) strategic marketing plan to achieve growth goals and objectives.
- Position Entrusted Hearts Home Care (EH) as a leader in HCBS within its service area; expanding service opportunities as a result of increasing brand awareness, extending outreach, and generating referrals.
- Focus on client acquisition, satisfaction, and retention.
- Engage with the local community by participating in events and collaborating with organizations and professionals that serve our target audience through community marketing efforts.
- Develop trusted relationships with church and not-for-profit senior living community leaders.
- Cultivate partnerships/relationships with key referral sources with a minimum of 20 in-person visits per month.
- Maintain a detailed marketing and activity log.
- Establish and follow an inquiry process that ensures timely responses, confidence in the organization, and a high inquiry conversion rate.
- Review inquiries to determine next steps and action items.
- Conduct case conferences to ensure client needs are being met.
- Participate in quarterly reviews with the EH Director to evaluate progress toward performance metrics.
- Perform other tasks as assigned by the EH Director.
Qualifications
- Must be self-motivated and able to work independently
- Must possess strong interpersonal skills, the capability of relating to various people and personalities, and must maintain a professional appearance.
- Must demonstrate the ability to hire, direct, and manage personnel.
- Must possess strong organizational and time-management skills.
- Must have a valid Driver's License.
- Must pass a background screening.
Working Requirements
- Must possess sight/hearing senses or use prosthetics that will enable these senses to function adequately to meet the position requirements.
- Must be able to bend, stretch, reach, lift, or move up to 25 pounds at a time, turn, and walk. Occasionally lift/move up to 50 pounds.
Benefits
- 403B Retirement savings plan
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid sick time
- Paid personal time off
- Referral bonus program
- Tuition reimbursement
- Vision insurance
Interested applicants can apply on our website at
Location: Seattle, WA; Dallas, TX; Long Beach, CA; Miami, FL; North Charleston, SC; Berkeley, MO; or Hazelwood, MO (Hybrid-2-3 days and or remote)
Duration: 6 Months Contract
Description:
The client is looking for a highly experienced and detail-oriented Senior SAP Functional Analyst/Lead focusing on SAP Production Planning (PP) to join the team.
The Functional Analyst will have in-depth knowledge and hands-on experience with SAP Production Planning (PP) modules. This position will focus on implementation and support of SAP projects and Products. A successful candidate will understand the importance of collaboration as this position will focus on working directly with multiple stakeholders including business, solution architects and developers to implement SAP projects.
Responsibilities
- Conducts Workshops and contributes towards process solutioning
- Collaborates with cross functional teams comprising of business Subject Matter Experts (SMEs), Architects, Developers and System Integrators (SIs) (vendor consultants) on current processes and proposing solutions to enhance current systems for projects and products
- Identifies, recommends, and implements complex configuration solutions and implements full cycle configuration to meet business needs
- Creates and updates associated documentation including BPDs, Process Flows, Key decision documents (KDDs), configuration design documents(CDD), Functional Design Specs (FDS), and WRICEF objects.
- Translates functional specifications into application design documents, coordinates with the development team, tests new functionality or Enhancements, prepares test plans and test scripts, and performs unit tests and integration tests
- Propose and recommend SAP standardized best practices and solutions as per clean core guidelines.
- Participates in the project delivery during testing cycles and leads the root cause analysis and correction of issues
- Works with the usage of the SAP Solution Manager, Signavio
- Handles and leads the development of objects independently in collaboration with the team
- Works with the SAP project systems
- Understands the SAP Activate methodology and Agile (SAFe) development methods
- Contributes to the overall project management plan using SAP activate methodology
- Works with SAP S/4 Hana and FIORI
Basic Qualifications (Required Skills/Experience):
- 12+ years of experience with SAP PP consulting
- 4+ years of experience in S/4HANA Production Planning
- Experience with SAP S/4 HANA PP, QM
- Experience with 2 E2E full life cycle implementation in SAP S/4 HANA
- Experience with SAP Production Planning in a large and complex business environment
- Experience working with Interfaces
- Experience with SAP module specifics including user exits, batch jobs. and standard SAP reports
Preferred Qualifications (Desired Skills/Experience):
- Experience with SAP Production planning including material master, MRP Types and lot sizing procedures, back flush, range of coverage, scrap and FIORI applications, MRP areas, MRP views, forecasting, planning strategies, demand management, BOMS, item categories, center-control keys, capacity levelling and evaluations, routing and advanced routing, strategy groups, usage of stock requirements, S&OP, Flexible planning, and SAP PP configurations
- Experience in the Aerospace and Defense industry
- Experience with special planning procedures
- Experience with discrete and repetitive manufacturing
- Experience with central function activities ECM/OCM/Batch
- Experience in cross functional integration with sales(SAP SD), procurement(SAP MM),warehouse (SAP EWM), costing(SAP FICO), quality(SAP QM)
- Experience with WBS
- Experience with S4 Hana PPDS, DDMRP,
- Experience with SAP Quality Management
- Experience with IBP or other planning tool is a plus.
- SAP certifications in SAP S/4 PP, QM, MM is a plus
- Applicable and appropriate educational/certification credentials from an accredited institution and/or equivalent experience is required.
Job Title: SAP PP/MRP Consultant
Location: Nashville, TN (Hybrid Onsite)
**Direct Hire Position**
Note: "This role is open only to individuals who DO NOT require visa sponsorship."
Key Responsibilities:
- Create new/modify existing system configuration, related to Production Planning and document design clearly.Create new/modify existing system configuration, related to PP and document design clearly.Collaborate with production teams to manage MRP processes, ensuring efficient planning of materials, inventory control, and demand management. Work closely with procurement, logistics, and production departments to streamline MRP processes.
- Design, configure, and integrate Warehouse Management (WM) functionalities with SAP PP. Ensure seamless material movement, warehouse operations, and inventory accuracy across production and storage environments.
- Manage and implement various label printing programs in a production setting, ensuring compliance with labeling standards, product identification, and traceability requirements. Collaborate with IT and production teams to automate labeling processes.
- Analyze production processes and provide recommendations for improvement using SAP PP and MRP functionalities. Ensure production planning aligns with operational capacity, material availability, and lead times.
Qualifications:
- Bachelor’s Degree (Business or Logistics preferred).
- 5+ years of functional/configuration experience in SAP-PP
- At least 1 full life cycle implementation of SAP ECC (PP)
- Experience supporting manufacturing plant personnel with day-to-day ERP system processes
- Flexibility, adaptability, and process improvement approach.
- Technical proficiency in Microsoft Office.
- Strong written and verbal communication skills.
Were unique. You should be, too.
Were changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
Were different than most primary care providers. Were rapidly expanding and we need great people to join our team.
The Nurse Case Manager 1 (RN) is responsible for achieving positive patient outcomes and managing quality of care across the continuum of care. The incumbent in this role will first and foremost serve as an advocate for our patients. He/She works closely with other members of the care team to develop effective plans of care and high levels of care coordination. This care planning and coordination may follow the patient from our centers into acute and post-acute facilities, as well as, their home environments. The Nurse Case Manager 1 (RN) role also involves establishing relationships with patients families and care givers, primary care physicians, specialists, other care providers, social workers, other case managers and nurses, acute and post-acute facilities, home health care companies, and health plans. He/She adheres to strict departmental goals/objectives, standards of performance, regulatory compliance, quality patient care compliance and policies and procedures.
CORE JOB DUTIES/RESPONSIBILITIES:
- Manages and plans for transitions of care, discharge and post discharge follow-up for patients admitted to key, high-volume/high-priority hospitals.
- Establishes a trusting relationship with patients and their caregivers.
- Collaborates with clinical staff in the development and execution of the plan of care and achievement of goals. Reports variations to PCP/Transitional Care Physicians (TCP) and implements actions as appropriate.
- Builds relationships with preferred acute care providers (hospitalists, specialists, etc.).
- Directs referrals to preferred providers.
- Coordinates the integration of social services/case management functions in the pre-acute, ER, acute and post-acute setting. Coordinates the patient care, discharge and home planning processes with hospital case management departments, and other healthcare facilities.
- In conjunction with the PCP, Hospitalist, Medical Director, insurance case manager and the hospital case manager, coordinates the patient transition to the appropriate/least constrictive level of care using a preferred provider.
- Keeps the PCP aware of patient(s) condition via e-mail, DASH, HITS or other appropriate means of communication.
- Introduces self to patient/family and explains Nurse Case Managers role and processes to contact the Nurse Case Manager for questions, guidance and education.
- Provides high intensity engagement with patient and family.
- Facilitates patient/family conferences to review treatment goals and optimize resource utilization; provides family education and identifies post-hospital needs.
- Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient/familys ability to make informed decisions.
- Addresses advanced care planning including treatment goals and advance directives.
- Refers cases to social worker (Hospital and ChenMed/JenCare/Dedicated) for complex psychosocial and economic needs.
- Refers cases where patient and/or family would benefit from counseling required to complete complex discharge plan to social worker.
- Reports observed or suspected child or adult abuse pursuant to mandated requirements.
- Obtains onsite and EMR access at priority facilities.
- Maintains clinical and progress notes for each patient receiving care and provides progress report to PCP and others as appropriate.
- Submits required documentation in a timely manner and in appropriate computer system.
- Participates in surveys, studies and special projects as assigned.
- Conducts concurrent medical record review using specific indicators and criteria as approved by medical staff. Acts as patient advocate: investigates and reports adverse occurrences, and performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.
- Promotes effective and efficient utilization of clinical resources and mobilizes resources to assist in achieving desired clinical outcomes within specific timeframe.
- Conducts review for appropriate utilization of services from admission through discharge. Evaluates patient satisfaction and quality of care provided.
- Communicates with physicians at regular intervals throughout hospitalization and develops an effective working relationship. Assists physicians to maintain appropriate cost, case and desired patient outcomes.
- Coordinates the provision of social services to patients, families and significant others to enable them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services.
- Completes expanded assessment of patients and family needs at time of admission. Completes psychosocial assessment.
- Directs and participates in the development and implementation of patient care policies and protocols to provide advice and guidance in handling unusual cases or patient needs.
- Attends meetings as assigned
- Performs other duties as assigned and modified at managers discretion.
There are 4 Nurse Case Manager 1 Roles with additional Essential Job Functions:
Acute Case Manager (primarily hospital based)
Responsibilities include all the above Core duties/responsibilities plus the following:
- Identify appropriateness of inpatient vs. observation status.
- Identify and manage safety risk (complete a social assessment), identify functional status (ADLs and PT needs), discuss medications and self-management, identify and correct knowledge deficits.
- Implement the ACM Coaching program with the appropriate patient population.
- In markets as appropriate, when patient in SNF, in conjunction with the post-acute physician, coordinate the transition to a lower level of care as soon as appropriate using a preferred provider if further services are needed.
- Facilitate discharge to appropriate level of care and preferred providers
- Communicate discharge to all stakeholders including PCP, Center Manager and Community Case Manager.
- Document the appropriate date that the patient is medically discharged and update as appropriate.
- Contact the center manager to arrange for a follow-up PCP appointment prior to discharge and whenever possible, communicate this information to the patient/caregiver.
- As appropriate, discuss patients eligibility for CCM or DM programs and identify patient interest in participation.
- Coordinate acute UR physician meetings.
Community Case Manager (primarily clinic and community based)
Responsibilities include all the above Core duties/responsibilities plus the following:
- Provides telephonic or outpatient visits to patients at high-risk for readmissions (as identified by CM Plan) to the ER or hospital, to patients with active care planning requirements, to disease management patients per the Disease Management Plan and to others as referred via transitional care team, acute case managers and Transitional Care team.
- Visits may include evening and weekend hours with the goal of preventing ER visits or hospital admissions.
- Performs clinical functions including disease-oriented assessment and monitoring, medication monitoring, health education and self-care instructions in the outpatient setting.
Coordinate the Plan of Care:
- Conducts/coordinates initial case management assessment of patients to determine outpatient needs.
- Ensures individual plan of care reflects patient needs and services available.
- Makes recommendations to the team.
- Completes individual plan of care with patients and team members.
- Communicates instructions and methodologies as appropriate to ensure that the plan is implemented correctly.
- Assesses the environment of care, e.g., safety and security.
- Assesses the caregiver capacity and willingness to provide care.
- Assesses patient and caregiver educational needs.
- Coordinates, reports, documents and follows-up on Super Huddles and HPP/IDT meetings.
- Helps patients navigate health care systems, connecting them with community resources; orchestrates multiple facets of health care delivery and assists with administrative and logistical tasks.
- Coordinates the delivery of services to effectively address patient needs.
- Facilitates and coaches patients in using natural supports and mainstream community resources to address supportive needs.
- Maintains ongoing communication with families, community providers and others as needed to promote the health and well-being of patients.
- Establishes a supportive and motivational relationship with patients that support patient self-management
- Monitors the quality, frequency and appropriateness of HHA visits and other outpatient services.
- Assists patient and family with access to community/financial resources and refer cases to social worker as appropriate.
Community/Skilled Nursing Facility Case Manager (Community Case Manager Role with additional SNF duties as assigned)
Responsibilities include all the above Core duties/responsibilities plus the following:
- Community Case Manager role as above.
- CM telephonic or onsite visits to SNFs, communication with physical therapists (PT), social workers, patient and families as appropriate.
- Validates appropriate level of care/LOS.
- Validates Discharge plan for safe transition home, utilization of preferred providers or timely transition to long term care.
- Reminds patient of need for 4-day PCP post hospital/SNF discharge visit and future visits.
- Collaborates with payor onsite SNF CMs.
Transitional Case Manager (Blended Acute and Community Case Manager Roles)
Responsibilities include all the above Core duties/responsibilities plus the following:
- Acute and Community Case Manager roles as above.
KNOWLEDGE, SKILLS AND ABILITIES:
- Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
- Critical thinking skills required.
- Ability to work autonomously is required.
- Ability to monitor, assess and record patients progress and adjust and plan accordingly.
- Ability to plan, implement and evaluate individual patient care plans.
- Knowledge of nursing and case management theory and practice.
- Knowledge of patient care charts and patient histories.
- Knowledge of clinical and social services documentation procedures and standards.
- Knowledge of community health services and social services support agencies and networks.
- Organizing and coordinating skills.
- Ability to communicate technical information to non-technical personnel.
- Proficient in Microsoft Office Suite products including Excel, Word, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software.
- Ability and willingness to travel locally, regionally and nationwide up to 10% of the time.
- Spoken and written fluency in English.
- Bilingual preferred.
PAY RANGE:
$36.9 - $52.70 Hourly
The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITS
Were ChenMed and were transforming healthcare for seniors and changing Americas healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. Were growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in peoples lives every single day.
Current Employee apply HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Onsite
Required
Preferred
Job Industries
- Other
Company Overview:
Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs – everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals – because we know that health requires care for the whole person. It’s no wonder 98% of patients report being fully satisfied with Upward Health!
Job Title & Role Description:
The Transitions of Care Nurse (RN) is a field-based role focused on patients experiencing an admission, discharge, or transfer (ADT) event. This nurse responds to real-time ADT alerts, engages patients during hospitalization, and coordinates seamless transitions across care settings. The role ensures safe discharges, prevents avoidable readmissions, and supports patients through the critical first 90-day post-discharge.
Key Responsibilities
- Respond to ADT alerts in real time and deploy to the hospital at admission to enroll patients into Upward Health services.
- Collaborate with hospital staff, providers, and discharge planners to create safe transition plans.
- Conduct a home visit within 2 business days of discharge to reconcile medications, confirm follow-up appointments, and assess home safety.
- Address post-discharge needs, including arranging home health, physical therapy, or durable medical equipment.
- Provide care management for up to 90 days post-discharge, with a focus on preventing readmissions and supporting patient goals.
- Educate patients and caregivers on care plans, treatment adherence, and community resources.
- Document all encounters in the EHR in real time and communicate care updates to the multidisciplinary team.
Skills Required:
- Registered nursing license (unrestricted)
- Experience in hospital-based care coordination, case management, or transitions of care.
- Strong clinical assessment and critical thinking skills.
- Ability to perform in-home visits and collaborate across hospital and community settings.
- Excellent communication and patient education skills.
- Proficiency with electronic health records and digital care coordination tools.
- Reliable transportation, valid driver’s license, and auto insurance.
- Case management certification is a plus but not required
Competencies:
Clinical Expertise:
- Strong knowledge of chronic disease management, care transitions, and evidence-based practices to develop and implement care plans.
Effective Communication:
- Skilled at delivering complex medical information clearly to patients, caregivers, and interdisciplinary teams.
Care Plan Development:
- Proficient in creating personalized care plans that address physical, behavioral, and social health needs.
Technology Proficiency:
- Ability to use electronic health records (EHR) and care management systems to document, track, and coordinate patient care.
Outcome-Oriented:
- Focused on achieving optimal clinical and financial outcomes for patients through effective care coordination and management.
Independent and Team-Oriented:
- Able to work independently in a remote environment while also collaborating effectively with a multidisciplinary team.
Critical Thinking:
- Uses clinical judgment to assess, analyze, and evaluate patient progress, adapting care plans as needed to achieve optimal results.
Multitasking and Prioritization:
- Manages multiple patient cases simultaneously while prioritizing tasks to meet deadlines and ensure comprehensive care.
Patient Engagement:
- Motivates patients to follow care plans and improve self-care skills through regular communication and support.
Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.
California pay range$95,000—$105,000 USDUpward Health Benefits
Upward Health Core Values
Upward Health YouTube Channel
The Transition Specialist, RN, contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The Transition Specialist, RN, conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is required . Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic, complex conditions, with serious and persistent mental illness (SPMI), lived experience of mental illness or both, and helping people transition from institutional settings to the community is preferred. Individuals selected for these positions must complete training specified by HHSC and demonstrate knowledge and skills delivering the Transition Specialist pilot interventions. Bilingual, English/Spanish, is preferred
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates
The Transition Specialist, RN, contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The Transition Specialist, RN, conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is required . Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic, complex conditions, with serious and persistent mental illness (SPMI), lived experience of mental illness or both, and helping people transition from institutional settings to the community is preferred. Individuals selected for these positions must complete training specified by HHSC and demonstrate knowledge and skills delivering the Transition Specialist pilot interventions. Bilingual, English/Spanish, is preferred
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates
The Transition Specialist, RN, contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The Transition Specialist, RN, conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is required . Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic, complex conditions,
with serious and persistent mental illness (SPMI), lived experience of mental illness or both, and helping people transition from institutional settings to the community is preferred. Individuals selected for these positions must complete training specified by HHSC and demonstrate knowledge and skills delivering the Transition Specialist pilot interventions. Bilingual, English/Spanish, is preferred
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates
The Transition Specialist, RN, contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The Transition Specialist, RN, conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is required . Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic, complex conditions, with serious and persistent mental illness (SPMI), lived experience of mental illness or both, and helping people transition from institutional settings to the community is preferred. Individuals selected for these positions must complete training specified by HHSC and demonstrate knowledge and skills delivering the Transition Specialist pilot interventions. Bilingual, English/Spanish, is preferred
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates
The Transition Specialist, RN, contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The Transition Specialist, RN, conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is required . Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic, complex conditions, with serious and persistent mental illness (SPMI), lived experience of mental illness or both, and helping people transition from institutional settings to the community is preferred. Individuals selected for these positions must complete training specified by HHSC and demonstrate knowledge and skills delivering the Transition Specialist pilot interventions. Bilingual, English/Spanish, is preferred
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates
The Transition Specialist, RN, contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The Transition Specialist, RN, conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is required . Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic, complex conditions, with serious and persistent mental illness (SPMI), lived experience of mental illness or both, and helping people transition from institutional settings to the community is preferred. Individuals selected for these positions must complete training specified by HHSC and demonstrate knowledge and skills delivering the Transition Specialist pilot interventions. Bilingual, English/Spanish, is preferred
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates
$5,000 sign on bonus for external candidates with 1 year of nursing experience
$2,500 relocation bonus for over 50 miles OR $5,000 for over 100 miles
Responsible for the oversight, coordination, and management of the functional and financial outcomes during acute illness requiring hospitalization for patients of the Carle Foundation Hospital. Ensures patients receive proactive initial assessment of needs, ongoing evaluations, and initiation of discharge planning while facilitating a safe and timely transition from the acute care/hospital setting to an appropriate level of care outside the hospital. Utilizes the five components of case management: assessment, coordination, monitoring, implementation, and evaluation. Multidisciplinary Rounds are completed daily with the care team at the patient's bedside which assists the team for timely planning and collaboration.
Qualifications
Certifications: Accredited Case Manager (ACM) within 3 years - American Case Management Association (ACMA); Basic Life Support (BLS) within 30 days - American Heart Association (AHA); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR), Education: College Diploma: Nursing, Work Experience:
Responsibilities
Act as a liaison working with patient/family and physician to determine next level of careConducts case review presentations to educate peers on unique or challenging cases and scope of practice issues.Coordinates the transition from inpatient care to post-hospital care, working with pre- and post- hospital providers to ensure responsive and appropriate care is provided post-discharge.Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on all assigned patients.Evaluates effectiveness of plan of care to ensure the progression toward desired patient outcomes.Initiates intervention, both pre-hospital, in-hospital, and post-hospital, for patients and families identified from a proactive initial admission assessment, as well as through referrals from members of the health care team.Initiates timely referrals to other health care team members (quality improvement, risk manager, social workers, physicians, Home Services, etc.)Performs nursing activities of assessment, coordination, planning, monitoring, implementation, and evaluation. Interacts with clients, caregivers and families to assess, plan care, arrange services, monitor, and provide support and education.Proactively investigates coverage for post-hospital needs and presents options to the patient/family and provider.Provides oversight of acute setting plan of care to ensure coordination and completion of services to meet post-hospitalization needs.Lead an interdisciplinary team to achieve organizational goals related to length of stay and readmissions.Track avoidable days on inpatient stays. Readmission assessment of inpatient stays. Assess patients for post discharge needs. Participate in daily white board rounds. Arrange DME, Home Care, Hospice, assisting with returns to ECFs, and Transportation Assist any patient/family care conferences. Participate in department work groups. HRHC: make follow up appointments with primary care provider before patient discharges, makes post discharge phone calls to ensure patient is doing well and has what they need for success. Obtain prior authorizations for swing bed patients, maintain the work ques, and address denials. RMH: make follow up appointments with primary care provider before patient discharges, makes post discharge phone calls to ensure patient is doing well and has what they need for success. Initial utilization review for emergency room patients being admitted.
About Us
Find it here.
Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.
Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We've grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We're developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world's first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet designations, the nation's highest honor for nursing care.
We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. For more information: .
Compensation and Benefits
The compensation range for this position is $34.01per hour - $58.5per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate's experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit /benefits.
$5,000 sign on bonus for external candidates with 1 year of nursing experience
$2,500 relocation bonus for over 50 miles OR $5,000 for over 100 miles
Responsible for the oversight, coordination, and management of the functional and financial outcomes during acute illness requiring hospitalization for patients of the Carle Foundation Hospital. Ensures patients receive proactive initial assessment of needs, ongoing evaluations, and initiation of discharge planning while facilitating a safe and timely transition from the acute care/hospital setting to an appropriate level of care outside the hospital. Utilizes the five components of case management: assessment, coordination, monitoring, implementation, and evaluation. Multidisciplinary Rounds are completed daily with the care team at the patient's bedside which assists the team for timely planning and collaboration.
Qualifications
Certifications: Accredited Case Manager (ACM) within 3 years - American Case Management Association (ACMA); Basic Life Support (BLS) within 30 days - American Heart Association (AHA); Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR), Education: College Diploma: Nursing, Work Experience:
Responsibilities
Act as a liaison working with patient/family and physician to determine next level of careConducts case review presentations to educate peers on unique or challenging cases and scope of practice issues.Coordinates the transition from inpatient care to post-hospital care, working with pre- and post- hospital providers to ensure responsive and appropriate care is provided post-discharge.Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on all assigned patients.Evaluates effectiveness of plan of care to ensure the progression toward desired patient outcomes.Initiates intervention, both pre-hospital, in-hospital, and post-hospital, for patients and families identified from a proactive initial admission assessment, as well as through referrals from members of the health care team.Initiates timely referrals to other health care team members (quality improvement, risk manager, social workers, physicians, Home Services, etc.)Performs nursing activities of assessment, coordination, planning, monitoring, implementation, and evaluation. Interacts with clients, caregivers and families to assess, plan care, arrange services, monitor, and provide support and education.Proactively investigates coverage for post-hospital needs and presents options to the patient/family and provider.Provides oversight of acute setting plan of care to ensure coordination and completion of services to meet post-hospitalization needs.Lead an interdisciplinary team to achieve organizational goals related to length of stay and readmissions.Track avoidable days on inpatient stays. Readmission assessment of inpatient stays. Assess patients for post discharge needs. Participate in daily white board rounds. Arrange DME, Home Care, Hospice, assisting with returns to ECFs, and Transportation Assist any patient/family care conferences. Participate in department work groups. HRHC: make follow up appointments with primary care provider before patient discharges, makes post discharge phone calls to ensure patient is doing well and has what they need for success. Obtain prior authorizations for swing bed patients, maintain the work ques, and address denials. RMH: make follow up appointments with primary care provider before patient discharges, makes post discharge phone calls to ensure patient is doing well and has what they need for success. Initial utilization review for emergency room patients being admitted.
About Us
Find it here.
Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.
Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We’ve grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We’re developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet® designations, the nation’s highest honor for nursing care.
We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information:
Compensation and Benefits
The compensation range for this position is $34.01per hour - $58.5per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit /benefits.
About the Organization
We’re a leading nonprofit food bank serving two counties through two warehouses and a third distribution site. Partnering with 400+ agencies and 900+ distribution points, we deliver nutritious food to families in need.
As we complete construction on a new, state-of-the-art facility, we’re seeking an experienced Project Manager (Independent Contractor) to lead our warehouse consolidation and transition project — moving operations, systems, and people into one optimized hub.
What You’ll Do
- Develop and manage a comprehensive project plan: scope, timeline, milestones, and risk register.
- Coordinate with construction and facilities teams for readiness, utilities, racking, and compliance.
- Lead IT and systems migration (network, ERP/WMS configuration, testing).
- Oversee equipment and inventory transfer, ensuring accuracy and minimal downtime.
- Redesign warehouse workflows for efficiency, safety, and quality.
- Lead change management: staff readiness, communications, and training.
- Report progress to the COO and cross-functional steering team.
What We’re Looking For
- 5+ years of project management experience, ideally in warehouse, logistics, or facility transitions.
- PMP certification or equivalent preferred.
- Experience leading multi-site consolidation projects or operational stand-ups.
- Strong knowledge of warehouse management systems (WMS), IT infrastructure, and food safety standards.
- Exceptional stakeholder management and communication skills.
- Must qualify as an independent contractor under California AB5.
- Passion for community impact and hunger relief.
Contract Details
- Type: 1099 Independent Contractor (not an employee role)
- Estimated Duration: 24 months
- Location: On-site in San Jose, CA
- Schedule: 30–40 hours/week
- Compensation: Competitive, based on experience and project scope
How to Apply
Submit a brief statement of interest, résumé, and hourly or project rate to Julia Kelm, with subject line: “Independent Contractor – Project Manager (Warehouse Transition)”
****Galen Students Only****
Introduction
Do you want to join an organization that invests in you? At HCA Florida Brandon Hospital, you come first! HCA Healthcare is committed to the growth and development of our future nurses!
The HCA Nurse Residency Program is a year-long program designed to give you hands-on experience to help establish valuable clinical and critical thinking skills. As a Mgr Med/Surg you will be surrounded by a supportive community of nurse educators, experienced nurses, and fellow residents that promote learning, clinical application, and socialization, shepherding you through the transition from student nurse to registered nurse.
Benefits
We offer a total rewards package to support your health, life, career and retirement. Some available plans and programs include:
- Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
- Wellbeing support, including free counseling and referral services
- Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
- Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
- Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
- Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
Learn more about Employee Benefits
Note: Eligibility for some benefits may vary by location.
Job Summary and Qualifications
The HCA Nurse Residency Program at HCA Florida Brandon Hospital provides you with the tools necessary to succeed in today’s hospital environment. This paid program will assist you with the transition out of the classroom setting through a formalized series of learning experiences, including:
- Advanced clinical training in a specialty area.
- Monthly educational sessions.
- Preceptorship training with a facility preceptor.
- Measurement and evaluation of skills through hands-on simulations.
- Mentoring from experienced nurse leaders.
- Working collaboratively on an evidence-based practice project.
The RN Resident coordinates and delivers high quality, patient-centered care in accordance with the nature and specific requirements of the department, and consistent with the scope and standards of practice for the relevant state and specialty. In collaboration with medical providers and other members of the care team, the RN Resident provides individualized, comprehensive, and compassionate care using established nursing models such as “Assess, Perform, Teach, and Manage.” The RN Resident serves as an advocate for patients, families and caregivers to support an unparalleled patient experience.
What will you do in this role:
- Assess patient condition during admission and during each shift as scheduled, identifying and reporting any changes in patient status.
- Perform procedures, monitoring, or other functions as ordered by the medical provider(s). Document the administration of care in the patient medical record in a timely and thorough manner.
- Perform the administration of prescribed medications. Monitor patient for therapeutic response. Notify provider and intervene as appropriate in the event of an unintended response to medication.
- Perform exceptional care by responding promptly to patient requests. Strive to anticipate patient needs and resolve them proactively.
- Teach patients, families and caregivers about patient medical condition, patient status, treatment plan, medications and possible side effects, and follow-up measures. Translates complex medical terminology to ensure complete understanding.
What qualifications you will need:
- Basic Cardiac Life Support (BLS) obtained within 30 days of employment
- Advanced Cardiac Life Support (ACLS) obtained within 1 year of employment
- Other Certifications maybe required during employment
- Associate or Bachelor’s degree in Nursing
- Registered Nurse License or Graduate Nurse in the State
- No previous experience needed
- Some travel maybe needed for training
HCA Florida Brandon Hospital is a 400 bed acute care hospital in Brandon, FL. We offer many services including a heart & vascular center, behavioral health center and a women’s center. Our women’s center includes a 36 bed neonatal intensive care unit. We have a reflux center and a bariatric center. We are dedicated to quality and devoted to our community. We have been named a top 100 hospital in America many times. Our intensive care unit has been named a top 100 ICU. Join our friendly hospital with its caring staff located just south of Tampa. We are proud of our colleagues who contribute to the care and services of patients. Whether it is clinical care or our support staff, everyone has an important role in contributing to the health of our community. We hope you’ll consider a career at HCA Florida Brandon Hospital.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Bricks and mortar do not make a hospital. People do."
- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the HCA Florida Brandon Hospital family! We will provide you with the tools and resources you need to succeed in our organization. If you are looking for an opportunity that provides satisfaction and personal growth, we promptly review all applications. Unlock the possibilities and apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
***Please complete only 1 application. Duplicate applications can create delays in processing!***
Introduction
Do you want to join an organization that invests in you? At HCA Houston Healthcare, you come first! HCA Healthcare is committed to the growth and development of our future nurses!
The HCA Nurse Residency Program is a year-long program designed to give you hands-on experience to help establish valuable clinical and critical thinking skills. As a Resident I Graduate Nurse you will be surrounded by a supportive community of nurse educators, experienced nurses, and fellow residents that promote learning, clinical application, and socialization, shepherding you through the transition from student nurse to registered nurse.
Benefits
We offer a total rewards package to support your health, life, career and retirement. Some available plans and programs include:
- Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
- Wellbeing support, including free counseling and referral services
- Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
- Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
- Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
- Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
Learn more about Employee Benefits
Note: Eligibility for some benefits may vary by location.
Job Summary and Qualifications
The HCA Nurse Residency Program at HCA Houston Healthcare provides you with the tools necessary to succeed in today’s hospital environment. This paid program will assist you with the transition out of the classroom setting through a formalized series of learning experiences, including:
- Advanced clinical training in a specialty area.
- Monthly educational sessions.
- Preceptorship training with a facility preceptor.
- Measurement and evaluation of skills through hands-on simulations.
- Mentoring from experienced nurse leaders.
- Working collaboratively on an evidence-based practice project.
The RN Resident coordinates and delivers high quality, patient-centered care in accordance with the nature and specific requirements of the department, and consistent with the scope and standards of practice for the relevant state and specialty. In collaboration with medical providers and other members of the care team, the RN Resident provides individualized, comprehensive, and compassionate care using established nursing models such as “Assess, Perform, Teach, and Manage.” The RN Resident serves as an advocate for patients, families and caregivers to support an unparalleled patient experience.
What will you do in this role:
- Assess patient condition during admission and during each shift as scheduled, identifying and reporting any changes in patient status.
- Perform procedures, monitoring, or other functions as ordered by the medical provider(s). Document the administration of care in the patient medical record in a timely and thorough manner.
- Perform the administration of prescribed medications. Monitor patient for therapeutic response. Notify provider and intervene as appropriate in the event of an unintended response to medication.
- Perform exceptional care by responding promptly to patient requests. Strive to anticipate patient needs and resolve them proactively.
- Teach patients, families and caregivers about patient medical condition, patient status, treatment plan, medications and possible side effects, and follow-up measures. Translates complex medical terminology to ensure complete understanding.
What qualifications you will need:
- Associate or Bachelor’s degree in Nursing
- Registered Nurse License or Graduate Nurse in the State
- No previous experience needed
- Some travel within the Greater Houston Area required for training
HCA Healthcare is where sophisticated, world-class medicine meets the comfort, care and convenience of community hospitals. For more than 40 years, we have proudly been providing high quality, cost-effective, comprehensive healthcare to the Houston Area. Our specialists and nursing staff offer more talent and experience than any other hospitals in the region. We have Level 1 and II Trauma Centers and a heart hospital south of Houston. Our accredited centers provide nationally recognized care in the prevention, diagnosis, treatment and recovery of cardiovascular diseases. HCA Houston Healthcare offers a variety of other services, including Woman Services, Pediatric Care, Breast Diagnostic Center, ACR-accredited Imaging Center, Wound Care Treatment Center featuring Hyperbaric Oxygen Therapy, and much more. We are members of HCA Healthcare, the most comprehensive family of hospitals in the region and part of the leading provider of healthcare in the country. Together we are stronger, smarter and more accessible in providing the patient-centered care you need close to home.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Bricks and mortar do not make a hospital. People do."
- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the HCA Houston Healthcare Clear Lake family! We will provide you with the tools and resources you need to succeed in our organization. If you are looking for an opportunity that provides satisfaction and personal growth, we promptly review all applications. Unlock the possibilities and apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Were unique. You should be, too.
Were changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
Were different than most primary care providers. Were rapidly expanding and we need great people to join our team.
The Community Care team is a multidisciplinary service including Registered Nurse (RN) Community Care nurses, Licensed Practical Nurse (LPN) Community Care nurses, Community Social Workers (CSW) and Community Health Coordinator (CHC) who work with our highest complexity patients and their primary care physicians to meet their medical and social needs with the aims of fully engaging them in our intensive primary care model and maximizing their healthy time at home.
Intensive Community Manager will serve as a clinical lead for a Community Care team. They will coordinate the teams efforts to stabilize our highest risk patients, with special areas of focus including safe transitions of care from facilities back to our primary care teams, stabilization of our highest risk ambulatory patients and outreach to patients who are assigned to us but are not engaged in care.
This person will perform initial assessments and design comprehensive plans of care for many of these patients. This professional will also provide clinical supervision to other team members in delivering the plan of care and in other tasks necessary to meet their needs and engage them in care. As a clinical leader for the team, this person will also be deeply involved in prioritizing team efforts and may also become the direct supervisor for some team members.
This position adheres to strict departmental goals/objectives, standards of performance, regulatory compliance, quality patient care compliance and policies and procedures
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
- Provides in home and telephonic visits to patients at high-risk for hospital admission and readmission (as identified by CM Plan). Main goal to prevent and admission or readmission to the ER/hospital .
- Provides home visits to perform initial assessment of patient and the development of care plan for the Licensed Practical Nurse (LPN) to use as they perform the follow up patient visits, once patient has completed their episode of care management the register nurse (RN) will review patient chart for discharge and conduct final discharge with patient.
- Conducts supervisory visits with License Practical Nurse (LPN) and patient to provide any additional education patient may need and to oversee appropriate patient discharge from case management.
- Performs clinical and Social determination of Heath screening (SdoH) assessments to include disease-oriented assessment and monitoring, medication monitoring, health education and self-care instructions in the outpatient in home setting.
Coordinate the Plan of Care:
- Provides oversight for the License Practical Nurse (LPN) with clear plan of care and education which is mandatory during all LPN visits.
- Conducts/coordinates initial case management assessment of patients to determine outpatient needs.
- Ensures individual plan of care reflects patient needs and services available in the community or review of their benefits.
- Completes individual plan of cares with patients, family/care giver and care team members.
- Communicates instructions and methodologies as appropriate to ensure that the plan is implemented correctly.
- Assesses the environment of care, e.g., safety and security.
- Assesses the caregiver capacity and willingness to provide care.
- Assesses patient and caregiver educational needs.
- Coordinates, reports, documents and follows-up on multidisciplinary team meetings.
- Helps patients navigate health care systems, connecting them with community resources; orchestrates multiple facets of health care delivery and assists with administrative and logistical tasks.
- Coordinates the delivery of services to effectively address patient needs.
- Facilitates and coaches patients in using natural supports and mainstream community resources to address supportive needs.
- Maintains ongoing communication with families, community providers and others as needed to promote the health and well-being of patients.
- Establishes a supportive and motivational relationship with patients that support patient self-management
- Monitors the quality, frequency, and appropriateness of HHA visits and other outpatient services.
- Assists patient and family with access to community/financial resources and refer cases to social worker as appropriate.
- Home visit under the direction of the patients primary care physician to meet urgent patient needed.
- Performs other duties as assigned and modified at managers discretion.
EDUCATION AND EXPERIENCE CRITERIA:
- Associate degree in Nursing required.
- Bachelors Degree in nursing (BSN) or RN with bachelors degree in home in a related clinical field preferred.
- A valid, active Registered Nurse (RN) license in State of employment required.
- A minimum of 2 years clinical work experience required.
- A minimum of 1 year of case management experience in community case management experience highly desired.
- Certified Case Manager certification is preferred. Certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired
- This position requires possession and maintenance of a current, valid drivers license.
- Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment
PAY RANGE:
$35.8 - $51.17 Hourly
EMPLOYEE BENEFITS
Were ChenMed and were transforming healthcare for seniors and changing Americas healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. Were growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in peoples lives every single day.
Current Employee apply HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Onsite
Required
Preferred
Job Industries
- Other
Job Title: Healthcare Marketing and Hospital Liaison
Location: Marion, Ohio
Position Summary
The Marketing and Hospital Liaison represents Marion Rehabilitation within the Marion-area healthcare community. This position plays a key role in promoting the facility’s skilled nursing and rehabilitation services, cultivating strong referral relationships, and supporting community engagement. The liaison will regularly visit area hospitals to meet with patients, families, and discharge planners, ensuring a smooth transition of care and positive representation of Garden Springs Healthcare.
Key Responsibilities
Hospital & Referral Relations
- Represent Marion Rehabilitation at Marion-area hospitals, serving as the primary contact for discharge planners, case managers, and other healthcare professionals.
- Conduct hospital visits to assess potential residents, explain services, and coordinate admissions in collaboration with the internal admissions team.
- Build and maintain strong relationships with hospitals, physicians, and other referral partners to drive census growth and strengthen referral pipelines.
Community Engagement
- Plan, organize, and host community-based events both on and off site to promote Marion Rehabilitation's services and enhance community visibility.
- Represent the facility at local health fairs, senior events, and networking functions.
- Develop partnerships with community organizations, senior centers, and civic groups to foster ongoing engagement.
Marketing & Outreach
- Collaborate with facility leadership to develop and implement outreach and marketing strategies that support census and growth goals.
- Maintain marketing materials and ensure consistent branding and messaging.
- Track referral trends, admissions, and outreach efforts, providing regular updates to leadership.
Customer Service & Communication
- Demonstrate professionalism, empathy, and responsiveness in all interactions with patients, families, and referral partners.
- Ensure timely communication and follow-up throughout the referral and admission process.
- Promote a positive image of Garden Springs Healthcare in all external and internal communications.
Qualifications
- Experience in healthcare marketing, hospital liaison, or admissions role (skilled nursing, rehab, or post-acute care required).
- Strong relationship-building and communication skills.
- Knowledge of Marion & Columbus-area hospitals and healthcare networks required.
- Ability to work independently, prioritize effectively, and meet deadlines.
- Valid driver’s license and reliable transportation required.
Required Skills
- Experience planning and hosting community events.
- Familiarity with Medicare/Medicaid and discharge planning processes.
- Excellent organizational, communication, and presentation skills.
Why Mayo Clinic
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights
- Medical: Multiple plan options.
- Dental: Delta Dental or reimbursement account for flexible coverage.
- Vision: Affordable plan with national network.
- Pre-Tax Savings: HSA and FSAs for eligible expenses.
- Retirement: Competitive retirement package to secure your future.
Responsibilities
The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. The RN supports professional nursing practice across practice settings and across the continuum of care to meet the needs of the patient and family. The RN will function within the Mayo Clinic Nursing Professional Practice Model, which includes accountability for planning, implementing, evaluating and communicating all phases of nursing care for assigned patients. The ANA Nursing: Scope and Standards of Practice provide a basis for the practice of the RN. The RN provides leadership through activities such as preceptor role, informal leadership roles, and quality improvement efforts. The RN delegates patient care according to skill level, experience, patient acuity, fiscal accountability, and adequacy of resources. The RN possesses excellent communication skills; is skillful in mentoring and teaching; and may participate on committees or projects. A subset of employees may be required to drive their personal vehicle as a part of the responsibility of their role.
This role is eligible for TN sponsorship. Successful sponsorship will require state licensure and completion of the VisaScreen or equivalent certification.
Qualifications
Graduate of a nursing program.
All entry-level associate degree registered nurses with a RN start date of April 1, 2020 and after must provide documented evidence of program completion of a baccalaureate degree in nursing program within five years from the last day of the month of the RN start date.
All entry-level associate degree registered nurses with a RN start date prior to April 1, 2020 must provide documented evidence of program completion of a baccalaureate degree in nursing program as stipulated by the degree requirement program in place at time of hire.
One year of RN experience in an applicable care setting or one year of LPN experience at Mayo Clinic is preferred.
Excellent communication skills (verbal and written). Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability to work flexible hours, which may include days, evenings, nights, holidays, and weekends and on-call. Ability to adapt to unpredictable situations within the work setting. Demonstrated leadership, effective communicator, and excellent critical thinking skills.
License or Certification: Current RN license by applicable state requirements. Maintains Basic Life Support (BLS) competency from one of the following programs: American Heart Association or American Red Cross. Positions that are not on campus may not require current Basic Life Support (BLS) competency as determined by the work area.
Additional state licensure(s) and/or specialty certification/training as required by the work area.
Exemption Status
Nonexempt
Compensation Detail
Mayo Clinic has an innovative nursing compensation model that rewards for experience, education, and dedication to the organization. When combined with our competitive tuition reimbursement program, the compensation approach empowers nurses to grow professionally and maximize their earning potential.
Benefits Eligible
Yes
Schedule
Full Time
Hours/Pay Period
60
Schedule Details
1845-0715, 5 shifts per two week pay period, nights vary
Weekend Schedule
Every Other
International Assignment
No
Site Description
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
Recruiter
Jorida Musta
Why Mayo Clinic
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights
- Medical: Multiple plan options.
- Dental: Delta Dental or reimbursement account for flexible coverage.
- Vision: Affordable plan with national network.
- Pre-Tax Savings: HSA and FSAs for eligible expenses.
- Retirement: Competitive retirement package to secure your future.
Responsibilities
The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. The RN supports professional nursing practice across practice settings and across the continuum of care to meet the needs of the patient and family. The RN will function within the Mayo Clinic Nursing Professional Practice Model, which includes accountability for planning, implementing, evaluating and communicating all phases of nursing care for assigned patients. The ANA Nursing: Scope and Standards of Practice provide a basis for the practice of the RN. The RN provides leadership through activities such as preceptor role, informal leadership roles, and quality improvement efforts. The RN delegates patient care according to skill level, experience, patient acuity, fiscal accountability, and adequacy of resources. The RN possesses excellent communication skills; is skillful in mentoring and teaching; and may participate on committees or projects. A subset of employees may be required to drive their personal vehicle as a part of the responsibility of their role.
This role is eligible for TN sponsorship. Successful sponsorship will require state licensure and completion of the VisaScreen or equivalent certification.
Qualifications
Graduate of a nursing program.
All entry-level associate degree registered nurses with a RN start date of April 1, 2020 and after must provide documented evidence of program completion of a baccalaureate degree in nursing program within five years from the last day of the month of the RN start date.
All entry-level associate degree registered nurses with a RN start date prior to April 1, 2020 must provide documented evidence of program completion of a baccalaureate degree in nursing program as stipulated by the degree requirement program in place at time of hire.
One year of RN experience in an applicable care setting or one year of LPN experience at Mayo Clinic is preferred.
Excellent communication skills (verbal and written). Experience working in a team environment. Computer skills required, prior experience with electronic medical record systems preferred. Ability to work flexible hours, which may include days, evenings, nights, holidays, and weekends and on-call. Ability to adapt to unpredictable situations within the work setting. Demonstrated leadership, effective communicator, and excellent critical thinking skills.
License or Certification: Current RN license by applicable state requirements. Maintains Basic Life Support (BLS) competency from one of the following programs: American Heart Association or American Red Cross. Positions that are not on campus may not require current Basic Life Support (BLS) competency as determined by the work area.
Additional state licensure(s) and/or specialty certification/training as required by the work area.
Exemption Status
Nonexempt
Compensation Detail
Mayo Clinic has an innovative nursing compensation model that rewards for experience, education, and dedication to the organization. When combined with our competitive tuition reimbursement program, the compensation approach empowers nurses to grow professionally and maximize their earning potential.
Benefits Eligible
Yes
Schedule
Full Time
Hours/Pay Period
60
Schedule Details
0645-1915, 5 shifts per two-week pay period, days vary
Weekend Schedule
Every Other Weekend
International Assignment
No
Site Description
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.
Recruiter
Jorida Musta