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PACT RN Case Manager Help Others, Make a Difference, Save a Life.
Do you want to make a difference in people's lives every day? Or help people navigate the tough spots in their life? And do it all while working where your hard work is appreciated? You have a lot of choices in where you work…make the decision to work where you are valued! Join the McNabb Center Team as the PACT RN Case Manager today! The PACT RN Case Manager JOB PURPOSE/SUMMARY Summary of role of team : The Program for Assertive Community Treatment (PACT) is an evidence-based treatment modality designed specifically to serve those with severe and persistent mental illness.
Clients served by PACT are typically diagnosed with a thought disorder, have a history of psychiatric hospitalization, and are unable to engage with more traditional forms of outpatient care.
The goals of PACT are to assist individuals in the reduction of mental health symptoms, to function successfully in the community, to live as independently as possible and to reduce hospitalizations and/or incarcerations.
Goals are tailored to each individual's needs and may be adjusted quickly to respond to changes.
PACT interventions include ongoing assessment, case management, medication management, advocacy, group therapy and goal-oriented individual therapy services.
Crisis support is available 24 hours per day, 7 days per week.
Summary of position : The PACT RN Case Manager serves as a clinical member of a multi-disciplinary team by providing treatment and case management support to clients; Duties include: Referral, linkage, and advocacy services to promote access to resources; Side by side support in the community and during appointments to promote engagement and accurate understanding of information; Ongoing assessment of client functioning to relay information to other members of the clinical team; Crisis intervention and emergency services as needed.
Serves as a specialist for medical concerns and medication issues while administering and delivering medications to clients in both the office and community; Embraces the key values of case management: empowerment, normalization, rehabilitation, and continuity of care TYPICAL WORKING CONDITIONS/ENVIRONMENT PACT is an outpatient program, and the majority of duties are performed in the community and client homes.
Services are limited to those that reside in the Knox County catchment area.
This position does include limited time in the office for team meetings and documentation.
PACT is a fast-paced program best suited for individuals that are flexible and able to multitask while prioritizing the evolving needs and concerns of individuals served in order to promote the highest quality outcomes.
JOB DUTIES/RESPONSIBILITIES This job description is not intended to be all-inclusive; and employee will also perform other reasonably related job responsibilities as assigned by immediate supervisor and other management as required.
This organization reserves the right to revise or change job duties as the need arises.
Moreover, management reserves the right to change job descriptions, job duties, or working schedules based on their duty to accommodate individuals with disabilities.
This job description does not constitute a written or implied contract of employment.
1.
Participates as an active member of a multi-disciplinary team.
Begins and ends workday as scheduled and is accessible by phone when working in the field.
Is on time for and participates appropriately in daily treatment team and weekly treatment planning meetings.
Provides detailed written reports when excused from attending treatment meetings.
Responds appropriately to all EMR flags, emails, and voicemails within 2 working days.
Submits to Services Coordinator, or designee, proposed schedule for the following week by the stated deadline.
Schedules shall include standing appointments, other clinically appropriate appointments (medically related, DHS, Social Security, payee, housing, etc.), and unavailable blocks (break, paperwork, travel time, etc.).
Follows protocol for assigned changes in schedule.
2.
Completes documentation in compliance with CARF and SSOC standards.
Documents client contact per program standards.
Documents the administration of injections within 24 hours of service delivery.
Completes all documents including, but not limited to, 6-month treatment plans, 3-month treatment plans, assessments, and crisis plans on or before stated deadlines.
Demonstrates connection between treatment goals and documented services.
3.
Provides primary case management for an assigned group of clients including ongoing assessment, direct clinical treatment, rehabilitation and support services, and medication delivery.
Provides case management for all program participants as needed and directed by supervisory staff.
Delivers medications daily, twice per week, and weekly to identified clients according to established protocol.
Administers injections to clients as directed by the PACT Prescriber and PACT Lead RN.
Educates all clients as needed regarding medications, symptoms, coping strategies, personal growth and development, etc.
Provides side-by-side support as needed to promote client independence.
Acts as a liaison between clients and community agencies, resources, families, and natural supports to facilitate treatment.
4.
Adheres to defined productivity standards regarding client contact.
Clients on assigned caseload shall be met with a minimum of twice per week, unless this is deemed clinically inappropriate by supervisory staff.
Achieves a minimum of 150 contacts per month.
Failed attempts to engage clients for contact shall be documented.
Compensation: Starting salary for this position is approximately $32.76/hr based on relevant experience and education.
Schedule: Schedule is variable and includes a mix of 8am
- 5pm and 11am
- 8pm shifts.
Shifts include a rotation of both weekends and holidays.
Staff provide on call coverage that may include overnight contact with clients.
This position includes some flexibility to allow for coverage during staffing shortages.
Travel : Mostly limited to Knox County with the rare potential for travel to surrounding counties.
This position does require the transportation of clients in a personal vehicle.
Equipment/Technology: This position requires the use of basic technology including a cell phone and computer.
Equipment/Technical Competency : Must possess basic computer skills along with the ability to learn how to successfully navigate the electronic medical record.
QUALIFICATIONS
- PACT RN Case Manager Experience / Knowledge: At least one year of experience working with the SPMI population preferred.
Must have the ability to relate positively with and be emotionally supportive of clients with severe and persistent mental illness.
Education / License : Must have either a Bachelor's or Associate's degree in nursing.
Must have licensure as a registered nurse in the state of Tennessee.
Clinical experience preferred.
Physical/Emotional/Social
- Skills/Abilities: Must have a strong commitment to the right and ability of each person with a severe and persistent mental illness to live in and engage with the community while maintaining access to competent and appropriate support services.
Must have a demonstrated ability to abide by professional/ethical codes of conduct and to establish supportive and respectful relationships with clients.
Must be able to achieve and maintain CPR and HWC certifications.
Must maintain a valid driver's license with an F endorsement, and well as access to a personal vehicle.
Must be able to see and hear normal tones.
Frequent sitting, standing, walking, bending, stooping, and reaching.
Possible exposure to biological hazards.
Location: Knox County, Tennessee Apply today to work where we care about you as an employee and where your hard work makes a difference! Helen Ross McNabb Center is an Equal Opportunity Employer.
The Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment.
Helen Ross McNabb Center conducts background checks, driver's license record, degree verification, and drug screens at hire.
Employment is contingent upon clean drug screen, background check, and driving record.
Additionally, certain programs are subject to TB Screening and/or testing.
Bilingual applicants are encouraged to apply.
Compensation details: 32.76-32.76 Hourly Wage PI3356726500a1-25448-39833449
Position Summary:
Employee works with other members of the patient care team to deliver care to specific patient populations. The employee will maintain competency for population specific groups with consideration of physical, communication, safety, nutrition, and psychosocial needs.
Education, License & Cert:
High School Grad or Equivalent
Experience:
Must be currently enrolled in a practical nurse education and Guthrie's tuition sponsorship program for licensed practical nurses.
Essential Functions:
Participates in the delivery of patient care for population groups under the direction of an RN/LPN including but not limited to the following: • Lifting, turning, and positioning patients utilizing Safe Patient Handling equipment (> 35 pounds), as appropriate. • Observing confused and difficult patients • AM/PM Hygiene care • Toileting, shaving, washing, brushing hair, dental and mouth care • Feeding • Assisting with range of motion exercises • Mobilizing patients ‐ transfers and ambulation, utilizing Safe Patient Handling equipment (> 35 pounds), as appropriate and following the Mobility protocol • Exercise protocols • Discontinuing foley catheter (PA only) • Simple dressing changes • Incentive spirometry supervision • Surgical preps • Postmortem care • Administers cleansing enemas • Removal of peripheral IV catheters • Sits with confused/disoriented patients or those requiring 1:1 observation for safety/suicide purposes, as assigned • Performs and records accurately: • Temperature, pulse, respirations, blood pressure, heights and weights • I & O • Records bowel movements • ADLs and activities • Performs and records the following specimen collection: • Obtains urine, stool, and sputum specimens for patients; instructs patients in proper specimen collection technique. • Completes the following support activities. • Completes EKGs. • Transports patients as needed • Serves, sets up and retrieves trays • Distributes water pitchers as appropriate • Orders and distributes nourishment. • Transports equipment • Transports blood products to and from the patient care area. • Participates in patient safety/patient satisfaction. • Answers call bells • Participates in patient rounding • Reports any signs of abuse to the nursing staff • Recognizes, troubleshoots and initiates corrective action needed on equipment. • Maintains neat and tidy environment (empties laundry, delivers equipment, keeps patient rooms clean and safe). • Inventories and assures disposition of patients' belongings when admitted, transferred, and/or discharged. • Assures proper storage of equipment. • Recognizes emergency situations and initiates plan of action • Notifies RN/LPN of any changes seen in patient's condition • Complies with policies and procedures of the hospital/nursing department. • Supports the philosophy of the hospital and department of nursing. • Maintains CPR certification • Demonstrates cost‐effective patient care by demonstrating proper use and care of equipment, appropriate and prudent use of supplies, accurate charging of supplies; performing other division‐specific tasks, and appropriate utilization of available resources. • Participates in performance improvement activities to improve service and care. Demonstrates strong communication and organizational skills. • Ability to communicate using telephones, computer systems. • Answers telephone promptly and politely, identifying self, title, and department. Receives and sends messages in an accurate and timely fashion. • Communicates with the patients, family, and members of the healthcare team in a concise, tactful and considerate manner. Must represent the hospital in a professional courteous manner, while being sensitive to how others perceive both verbal and non‐verbal communications.
Other Duties:
• Assists in the orientation of new personnel and serves as a role model to other employees. • Demonstrates willingness to accept non‐routine work assignments as appropriate. • Encouraged to participate in community activities • Attends and participates in unit council (70% attendance).
Rev: 2-29-2024
Pay Range $17.00-$23.85/hr DOE
Make a Difference on Your Own Schedule and Terms!
Hiring Case Managers in WashingtonCome join our growing team! A few of our perks:
Create your own schedule!
Great Work/Life balance!
$42/hr. (including 100% of Hourly Wage Paid for Drive Time)
Benefits Available (Paid Time Off, Medical, Dental, Vision, Matching 401k)
We provide in-home care to former Nuclear Weapons Workers who are suffering from chronic and terminal illnesses, as a result of their previous work environment.
Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with chronic/terminal illness due to exposure to toxic substances while working for the Government. The nursing visits are conducted weekly and typically last 1-2 hours per visit. During the visits, the RN-Case Managers do physical assessments including vitals, ensure home safety with medical equipment and supplies, fill weekly medication planners and oversee skilled and non-skilled caregivers providing care in the client's home.
Benefit from one-on-one patient relationships and from the satisfaction of enhancing clients' health, quality of life and peace of mind. You make your own schedule - that leaves you with time to attend school, travel, volunteer or to enjoy activities with your family and friends.
Qualifications
Graduate of a state approved school of professional registered nursing
BSN preferred
Current, unrestricted RN license in the state(s) of practice
Minimum of two (2) years nursing experience including one (1) year in home care or closely related field
One (1) year of supervisory and/or case management experience preferred
Current CPR certification
Essential Functions/Areas of Accountability
Responsible for functions and accountabilities as contained in the case manager job description
Provide direct care and case management of assigned clients
Assist and collaborate with the regional director and other personnel to identify and correct issues and/or improve services.
Plan, implement, and evaluate care provided Participate, coordinate and manage client care conferences as needed.
Serve as a local on-site clinical resource as needed and provides support to ensure client's home care needs are met.
Assist and collaborate with staffing coordinators regarding the appropriateness of staffing and scheduling of personnel within scope of practice, competencies, client needs and complexity of home care.
Adhere to nursing delegation guidelines as described in Agency Scope of Practice policy.
Ensure adherence to Agency policies.
Perform other functions as requested by the regional director which may include the following:
Participate in interviewing, selection, and ongoing evaluation of clinical personnel as requested by the Regional Director
Personnel training, education, and competency validation
Review and evaluate clinical documentation for accuracy and completeness
Participate in all Agency performance improvement initiatives including but not limited to quarterly medical record review
Collect, document, and submit data on infections, occurrences, complaints and grievances, and performance improvement activities
Perform and document supervisory visits as indicated to facilitate problem resolution
Review nurse shift reports for adherence to policy and for opportunities for performance improvement
Home chart completeness
Timeliness of staffing cases post referral
Equipment tracking
Assist with marketing activities such as visiting with clients or physicians to discuss Agency programs as requested
The senior case manager, or similarly qualified alternate, shall be available at all times during operating hours and participate in all activities relevant to the professional services furnished, including the development of qualifications and the assignment of personnel.
Perform additional duties and responsibilities as deemed necessary
Available Benefits Include
Medical
Dental
Vision
401(k)
Company Paid Short Term Disability
Flexible Spending Account (FSA)
Health Savings Account (HSA)
Paid Time Off
Voluntary Benefits
Professional Case Management is an Equal Opportunity Employer.
Make a Difference on Your Own Schedule and Terms!
Hiring Senior Case Managers in WashingtonPCM is looking for a Senior Case Manager who is as passionate about delivering care as we are to come join our amazing team!
A few of our perks:
Great Work/Life balance!
$44-$46 per hour (including 100% of Hourly Wage Paid for Drive Time)
Benefits Available:
Medical, Vision and Dental Insurance
Accrued Paid Time Off
Annual Bonus Eligible
Health Savings Account (HSA)
Flexible Savings Account (FSA)
401(K) with Company Match
Paid Parental Leave
Unlimited Peer Referral Program
Employee Discount Program
We provide in-home care to former Nuclear Weapons Workers who are suffering from chronic and terminal illnesses, as a result of their previous work environment.
Our Senior RN-Case Managers Direct assigned team members of RN Case Managers in the provision of care in accordance with Agency policy and with state-specific nurse practice act, and regulatory requirements.
Qualifications
Graduate of a state approved school of professional registered nursing
BSN preferred
Current, unrestricted RN license in the state(s) of practice
Minimum of two (2) years nursing experience including one (1) year in home care or closely related field
One (1) year of supervisory and/or case management experience preferred
Current CPR certification
Essential Functions/Areas of Accountability
Responsible for functions and accountabilities as contained in the case manager job description
Provide direct care and case management of assigned clients
Assist and collaborate with the regional director and other personnel to identify and correct issues and/or improve services.
Plan, implement, and evaluate care provided Participate, coordinate and manage client care conferences as needed.
Serve as a local on-site clinical resource as needed and provides support to ensure client's home care needs are met.
Assist and collaborate with staffing coordinators regarding the appropriateness of staffing and scheduling of personnel within scope of practice, competencies, client needs and complexity of home care.
Adhere to nursing delegation guidelines as described in Agency Scope of Practice policy.
Ensure adherence to Agency policies.
Perform other functions as requested by the regional director which may include the following:
Participate in interviewing, selection, and ongoing evaluation of clinical personnel as requested by the Regional Director
Personnel training, education, and competency validation
Review and evaluate clinical documentation for accuracy and completeness
Participate in all Agency performance improvement initiatives including but not limited to quarterly medical record review
Collect, document, and submit data on infections, occurrences, complaints and grievances, and performance improvement activities
Perform and document supervisory visits as indicated to facilitate problem resolution
Review nurse shift reports for adherence to policy and for opportunities for performance improvement
Home chart completeness
Timeliness of staffing cases post referral
Equipment tracking
Assist with marketing activities such as visiting with clients or physicians to discuss Agency programs as requested
The senior case manager, or similarly qualified alternate, shall be available at all times during operating hours and participate in all activities relevant to the professional services furnished, including the development of qualifications and the assignment of personnel.
Perform additional duties and responsibilities as deemed necessary
Professional Case Management is an Equal Opportunity Employer.
Make a Difference on Your Own Schedule and Terms!
Hiring Case Managers in WashingtonCome join our growing team! A few of our perks:
Create your own schedule!
Great Work/Life balance!
$42/hr. (including 100% of Hourly Wage Paid for Drive Time)
Benefits Available (Paid Time Off, Medical, Dental, Vision, Matching 401k)
We provide in-home care to former Nuclear Weapons Workers who are suffering from chronic and terminal illnesses, as a result of their previous work environment.
Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with chronic/terminal illness due to exposure to toxic substances while working for the Government. The nursing visits are conducted weekly and typically last 1-2 hours per visit. During the visits, the RN-Case Managers do physical assessments including vitals, ensure home safety with medical equipment and supplies, fill weekly medication planners and oversee skilled and non-skilled caregivers providing care in the client's home.
Benefit from one-on-one patient relationships and from the satisfaction of enhancing clients' health, quality of life and peace of mind. You make your own schedule - that leaves you with time to attend school, travel, volunteer or to enjoy activities with your family and friends.
Qualifications
Graduate of a state approved school of professional registered nursing
BSN preferred
Current, unrestricted RN license in the state(s) of practice
Minimum of two (2) years nursing experience including one (1) year in home care or closely related field
One (1) year of supervisory and/or case management experience preferred
Current CPR certification
Essential Functions/Areas of Accountability
Responsible for functions and accountabilities as contained in the case manager job description
Provide direct care and case management of assigned clients
Assist and collaborate with the regional director and other personnel to identify and correct issues and/or improve services.
Plan, implement, and evaluate care provided Participate, coordinate and manage client care conferences as needed.
Serve as a local on-site clinical resource as needed and provides support to ensure client's home care needs are met.
Assist and collaborate with staffing coordinators regarding the appropriateness of staffing and scheduling of personnel within scope of practice, competencies, client needs and complexity of home care.
Adhere to nursing delegation guidelines as described in Agency Scope of Practice policy.
Ensure adherence to Agency policies.
Perform other functions as requested by the regional director which may include the following:
Participate in interviewing, selection, and ongoing evaluation of clinical personnel as requested by the Regional Director
Personnel training, education, and competency validation
Review and evaluate clinical documentation for accuracy and completeness
Participate in all Agency performance improvement initiatives including but not limited to quarterly medical record review
Collect, document, and submit data on infections, occurrences, complaints and grievances, and performance improvement activities
Perform and document supervisory visits as indicated to facilitate problem resolution
Review nurse shift reports for adherence to policy and for opportunities for performance improvement
Home chart completeness
Timeliness of staffing cases post referral
Equipment tracking
Assist with marketing activities such as visiting with clients or physicians to discuss Agency programs as requested
The senior case manager, or similarly qualified alternate, shall be available at all times during operating hours and participate in all activities relevant to the professional services furnished, including the development of qualifications and the assignment of personnel.
Perform additional duties and responsibilities as deemed necessary
Available Benefits Include
Medical
Dental
Vision
401(k)
Company Paid Short Term Disability
Flexible Spending Account (FSA)
Health Savings Account (HSA)
Paid Time Off
Voluntary Benefits
Professional Case Management is an Equal Opportunity Employer.
Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 04/14/2026 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel MedPro Healthcare Staffing , a Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with one of our top healthcare clients.
Requirements Eighteen months of recent experience in an Acute Care Case Manager setting Active RN License BLS Certifications Degree from accredited nursing program Benefits Weekly pay and direct deposit Full coverage of all credentialing fees Private housing or housing allowance Group Health insurance for you and your family Company-paid life and disability insurance Travel reimbursement 401(k) matching Unlimited Referral Bonuses up to $1,000 Duties Responsibilities The role of the case management nurse (RN) is to coordinate continuity of care for patients often as a liaison between the patient's family and healthcare organization.
Work is administered in a variety of settings, including HMOs, community health organizations, long-term care facilities, behavioral health programs, rehabilitation centers, schools, and case management companies Coordinate continuity of care for patients often as a liaison between the patient's family and healthcare organization Strives to promote self-managed care and the use of healthcare resources in the most cost-effective way possible Ensure that the proper treatment is administered at the appropriate time in order to maximize health and well-being About Agency MedPro Healthcare Staffing is a Joint Commission certified provider of contract staffing services.
Since 1983, we have placed nursing and allied travelers in top healthcare facilities nationwide.
Join us today for your very own MedPro Experience®.
If qualified and interested, please call for immediate consideration.
MedPro Staffing is an Equal Opportunity Employer.
All applicants will be considered for employment without attention to race, color, religion, national origin, age, sex, disability, marital status or veteran status.
Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN
*Weekly payment estimates are intended for informational purposes only and include a gross estimate of hourly wages and reimbursements for meal, incidental, and housing expenses.
Your recruiter will confirm your eligibility and provide additional details.
MedPro Job ID a0Fcx00000HLWW9EAP.
Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined.
Posted job title: Case Manager Registered Nurse Nursing: Case Manager.
About MedPro Healthcare Staffing At MedPro Healthcare Staffing , we believe no one cares more for caregivers than we do.
Our mission is simple: you focus on your patients, and we'll take care of the rest.
As a Joint Commission-certified leader in temporary and contract healthcare staffing since 1983, MedPro has proudly connected nursing and allied travelers with top healthcare facilities across the nation.
With thousands of job opportunities available nationwide, we make it easy to find assignments that align with your goals and lifestyle.
Our on-staff clinical support team—alongside a compassionate group of experienced recruiters—provides hands-on guidance every step of the way.
From Day 1 medical benefits and a 401(k) plan to personalized career support, we're committed to ensuring every professional we serve feels valued, cared for, and empowered to succeed.
Guided by a CEO who is a Registered Nurse, MedPro is built on a foundation of clinical insight and genuine compassion for the caregiving community.
Through The MedPro Experience® , we deliver travel assignments that are rewarding, memorable, and designed to help you DREAM big, EXPLORE often, and ACHIEVE greatness.
Benefits Day 1 medical, dental, and vision benefits for you and your family Weekly pay and direct deposit Unlimited Referral Bonuses starting at $500 On Staff Clinical Support Team Access to nationwide travel assignments MPX Mobile app -24/7 real-time access to jobs, credentials, assignment details, and more Full coverage of all credentialing fees Private housing or housing allowance Tax Free Per Diems, Housing Stipends and Travel Reimbursements Company-paid life and disability insurance Travel reimbursement 401(k) matching Benefits Weekly pay Referral bonus Employee assistance programs5c143e31-5e48-4549-b638-05792d185386
Sweeney Merrigan Law is growing, and we're on the lookout for a tenacious, perceptive Case Manager to join our Pre-Litigation Team. In this role, you won't just be supporting attorneys, you'll be an essential part of our legal process, helping fight negligence and obtain justice for our clients.
Our Case Managers play a central role in keeping files organized, deadlines tracked, and communication flowing smoothly with clients, medical providers, and insurers. If you thrive in a fast-paced legal environment, enjoy digging into facts, and take pride in supporting attorneys with meaningful work, we want to hear from you!
At Sweeney Merrigan, one of Boston's leading personal injury law firms with a deep commitment to justice and client-first service, we pride ourselves on a low-ego, team-oriented workplace where everyone supports each other and works together toward excellence. We're excited to meet passionate professionals who are humble, hungry to grow, and eager to help our pre-litigation team deliver the outstanding support and results our clients deserve.
Job Title
Pre-Litigation Case Manager
Department
Personal Injury – Pre-Litigation
Reports To (Title)
Supervising Attorney
FLSA Status
Exempt Non-Exempt
Position Summary
The Pre-Litigation Case Manager supports the firm's personal injury practice by managing a caseload of matters from file opening through the pre-litigation stage. This role coordinates communication between clients, attorneys, medical providers, and insurance companies while ensuring that all case documentation, billing information, and records are maintained with exceptional organization and accuracy. Effective case management is critical to ensuring cases progress efficiently and are fully prepared for settlement or potential litigation.
Essential Duties and Responsibilities
- Manage a caseload of personal injury matters from initial file setup through the pre-litigation stage while maintaining highly organized and accurate case records
- Communicate regularly with clients, insurance adjusters, medical providers, and other third parties to obtain documentation and coordinate case progress
- Open insurance claims, draft letters of representation and notice letters, and assist with other legal correspondence as directed by the supervising attorney
- Gather and review medical records and billing documentation, confirming balances, payment sources, and treatment details
- Coordinate PIP and MedPay claims, including claim setup, application assistance, billing coordination, and exhaustion notifications
- Contact medical providers, billing departments, and collection agencies to confirm balances, payment histories, and outstanding bills
- Maintain detailed and accurate case notes within the firm's case management system, ensuring every communication, document, and update is properly logged
- Monitor case milestones, deadlines, and treatment updates across multiple active matters
- Assist with preparing demand packages and ensuring that medical records, billing summaries, and supporting documentation are complete
- Provide regular updates to attorneys and internal team members regarding case status
- Maintain strict confidentiality and professionalism when handling client information and financial documentation
Personal injury case management requires careful coordination of documentation, communication, and deadlines to ensure cases progress efficiently and are prepared for settlement negotiations.
Required Qualifications
Education & Experience:
- High school diploma or equivalent required; associate's or bachelor's degree strongly preferred
- 1–3 years of experience in personal injury case management, legal support, medical billing coordination, or a related role in a contingency-based law firm preferred
Skills & Competencies:
- Exceptional organizational skills with the ability to manage numerous active cases simultaneously
- Strong attention to detail and ability to maintain precise records across multiple providers and billing sources
- Excellent written and verbal communication skills with the ability to interact professionally with clients, attorneys, and third-party stakeholders
- Ability to be persistent and proactive when following up with insurance companies and medical billing departments to obtain necessary information
- Comfortable spending a significant portion of the workday communicating with providers and insurers
- Proficiency with case management software and standard office technology
- Ability to prioritize tasks, track deadlines, and maintain highly organized electronic case files
Certifications/Licenses (if applicable):
- None required
Preferred Qualifications (optional)
- Active Notary Public commission or willingness to obtain one
- Fluency in more than one language, enabling effective communication with a broader and more diverse client base
- Prior experience working in a plaintiff-side personal injury law firm
Physical Requirements / Working Conditions
- Prolonged periods of sitting at a desk and working on a computer
- Frequent communication via telephone and electronic communication throughout the workday
Supervisory Responsibilities
Yes No
Compensation and Benefits
Salary range: $45,000 – $60,000 annually, commensurate with experience.
Benefits are provided in accordance with firm policy and may include health insurance and eligibility for 401(k) matching after one year of employment.
Disclaimer
This job description is not intended to be all-inclusive. The employee may be required to perform other related duties as assigned to meet the organization's ongoing needs.
Equal Employment Opportunity Statement
Sweeney Merrigan Law is proud to be an Equal Employment Opportunity employer. We are committed to fostering a diverse and inclusive workplace where all individuals are treated with dignity and respect. We welcome and encourage applications from candidates of all backgrounds, experiences, and perspectives, including but not limited to those based on race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other characteristic protected by applicable law. We believe that a diverse workforce enhances our ability to serve our clients and strengthens our firm culture.
CalOptima
Join Us in this Amazing Opportunity
The Team You'll Join
We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.
More About the Opportunity
We are hoping you will join us as a Behavioral Health Utilization Management Medical Case Manager and help shape the future of healthcare where you'll be an integral part of our BHI ‐ BH Utilization Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Telework.
- If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.
The Medical Case Manager (BHI Utilization Management) will be responsible for reviewing and processing requests for authorization and notification of behavioral health services from health professionals, clinical facilities and ancillary providers. You will be responsible for prior authorizations, concurrent review and related processes. You will utilize CalOptima Health's medical criteria, policies and procedures to authorize referral requests from behavioral health professionals, clinical facilities and ancillary providers. You will directly interact with providers and facilities and serve as a resource for their needs. Together, we are building a stronger, more equitable health system.
Your Contributions To the Team:
- 85% ‐ Utilization Management Services
- Participates in a mission‐driven culture of high‐quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short‐ and long‐term goals/priorities for the department.
- Reviews requests for medical appropriateness by using established clinical protocols to determine the medical necessity of the request.
- Responsible for mailing rendered decision notifications to the provider and member, as applicable.
- Screens inpatient and outpatient requests for the Medical Director's review, gathers pertinent medical information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director's decision and documents follow‐up in the utilization management system.
- Completes the required documentation for data entry into the utilization management system at the time of the telephone call or fax to include any authorization updates.
- Contacts the health networks and/or CalOptima Health Customer Service regarding health network enrollments.
- Identifies and reports any complaints to the immediate supervisor utilizing the call tracking system or through verbal communication if the issue is of an urgent nature.
- Refers cases of possible over/under utilization to the Medical Director for proper reporting.
- Completes care coordination activities as related to Transition Care Management (TCM) activities.
- Reviews International Classification of Diseases (ICD‐10), Current Procedural Terminology (CPT‐4) and Healthcare Common Procedure Coding System (HCPCS) codes for accuracy and the existence of coverage specific to the line of business.
- 10% ‐ Administrative Support
- Assists manager with identifying areas of staff training needs and maintains current data resources.
- Complies with data tracking protocols.
- 5% ‐ Other
- Completes other projects and duties as assigned.
Do You Have What the Role Requires?
- Current California unrestricted license such as LCSW, LPCC, LMFT or RN and related required education PLUS 3 years of clinical experience required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
You'll Stand Out More If You Possess the Following:
- Utilization management reviewer experience.
- Managed care experience.
- Behavioral health clinical experience.
What the Regulatory Agencies Need You to Possess?
- Current California unrestricted license such as LCSW, LPCC, LMFT or RN.
Your Knowledge & Abilities to Bring to this Role:
- Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
- Work independently and exercise sound judgment.
- Communicate clearly and concisely, both orally and in writing.
- Work a flexible schedule; available to participate in evening and weekend events.
- Organize, be analytical, problem‐solve and possess project management skills.
- Work in a fast‐paced environment and in an efficient manner.
- Manage multiple projects and identify opportunities for internal and external collaboration.
- Motivate and lead multi‐program teams and external committees/coalitions.
- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Your Physical Requirements (With or Without Accommodations):
- Ability to visually read information from computer screens, forms and other printed materials and information.
- Ability to speak (enunciate) clearly in conversation and general communication.
- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face‐to‐face interactions.
- Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
- Lifting and moving objects, patients and/or equipment 10 to 25 pounds
Ways We Are Here For You
- You'll enjoy competitive compensation for this role.
- Our current hiring range is: Pay Grade: 313 ‐ $90,820 ‐ $145,312 ($43.66 ‐ $69.8615).
- The final salary offered will be based on education, job‐related knowledge and experience, skills relevant to the role and internal equity among other factors.
- This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**)
- A
Bilingual Case Manager (English/Spanish) – Personal Injury
Miami, FL | Temp-to-Hire | Monday–Friday, 8:00 AM – 5:00 PM
We are seeking a dedicated and detail-oriented Bilingual Case Manager with personal injury experience to join our team in Miami, FL. This is a temp-to-hire opportunity with a consistent weekday schedule and the chance to join a supportive, fast-paced legal environment focused on helping injured clients navigate their medical and legal processes.
About the Role:
As a Case Manager, you will play a key role in coordinating Examinations Under Oath (EUOs) and Independent Medical Exams (IMEs) while managing ongoing communication and documentation for personal injury cases. Your ability to handle sensitive information, communicate effectively in both English and Spanish, and manage detailed casework will directly impact the success of our clients’ outcomes.
Key Responsibilities:
- Schedule and coordinate EUOs and IMEs; send timely and accurate notices to all involved parties
- Maintain ongoing follow-up with clients regarding treatment updates and case progress
- Request, receive, and organize medical records and billing documentation
- Review and analyze medical documentation for accuracy and completeness
- Communicate regular case status updates to clients
- Maintain well-organized, confidential, and compliant case files
Requirements:
- Minimum 1 year of personal injury case management experience
- Bilingual – fluent in English and Spanish (written and verbal)
- Strong organizational skills with high attention to detail
- Excellent communication and customer service skills
- Ability to manage confidential information with discretion
- Must be able to start immediately
- Comfortable working Monday through Friday, 8:00 AM to 5:00 PM
Make a meaningful impact every day as a CenterWell Home Health nurse. You’ll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you’ll develop and manage care plans that support recovery and help patients get back to the life they love.
As a Home Health RN Case Manager, you will:
Provide admission, case management, and follow-up skilled nursing visits for home health patients.
Administer on-going care and case management for each patient, provide necessary follow-up as directed by the Clinical Manager.
Confer with physician in developing the initial plan of treatment based on physician's orders and initial patient assessment. Provide hands-on care, management, and evaluation of the care plan and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision. Revise plan in consultation with physician based on ongoing assessments and as required by policy/regulation.
Coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Home Health Aides, and external providers).
Report patient care/condition/progress to patient's physician and Clinical Manager on a continuous basis.
Implement patient care plan in conjunction with patient and family to assist them in achieving optimal resolution of needs/problems.
Coordinate/oversee/supervise the work of Home Health Aides, Certified Home Health Aides and Personal Care Workers and provides written personal care instructions/care plan that reflects current plan of care. Monitor the appropriate completion of documentation by home health aides/personal care workers as part of the supervisory/leadership responsibility.
Discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation.
Prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes. Prepare visit/shift reports, updates/summarizes patient records and confers with other health care disciplines in providing optimum patient care
Use your skills to make an impact
Required Experience/Skills:
Diploma, Associate, or Bachelor Degree in Nursing
A minimum of one year of nursing experience preferred
Strong med surg, ICU, ER, acute experience
Home Health experience is a plus
Current and unrestricted Registered Nurse licensure
Current CPR certification
Strong organizational and communication skills
A valid driver’s license, auto insurance, and reliable transportation are required.
Pay Range
• $49.00 - $69.00 pay per visit/unit
• $77,200 - $106,200 per year base pay
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
