How Much Does A Case Manager Make Jobs in Usa

25,063 positions found — Page 10

Case Manager - RN
✦ New
Salary not disclosed
Dubuque, IA 1 day ago
Description:

About Us

Hines is a nationwide, independent leader in personalized managed health care, focused on what’s important to you—comprehensive services with the program excellence and cost containment that you demand. Hines & Associates, Inc.’s reputation as an industry leader is founded on over three decades of innovative and professional health care excellence. Serving all aspects of the industry, Hines is committed to conserving health care dollars while ensuring quality care through effective programs and personalized service.

We are growing and are looking for nurses who are ready to leave hands on nursing and expand their careers! Come work in a supportive, safe and friendly environment that provides opportunities for growth!

Overview:

Our Case Manager role allows you to utilize your clinical nursing experience to develop a plan for meeting health care needs of the patient, while continuing to professionally grow in health care knowledge and perspective. Be the patient advocate you desire to be!

Specialty Case Manager positions also available!

- Oncology: Minimum of 2 years acute oncology preferred but not required.
- Chronic Condition: Minimum of 2 years of disease management preferred but not required.
- Behavioral Health: Minimum of 2 years in a full-time acute inpatient setting or specialty area (i.e., emergency department, inpatient BH (including float), or treatment program)

This position is full-time, Monday - Friday, no weekends or nights! This is an in-office position until successful completion of the orientation period and then there is an option for a hybrid option of two days working from home and three days in the office.

- A regular full-time schedule.
- Hybrid home/office opportunity after successful completion of orientation period.
- No weekends, nights or holidays!
- Competitive Benefit Package, Includes Long Term Care
- 401K with company match
- Generous time off policy

Hines is a 37 year company recognized in the industry for high standards and quality work

PM21

Requirements:

Qualifications:

- Hines and Associates only hires licensed/certified medical professionals with an unrestricted license/certification in the state or in a state that has licensure reciprocation with the state of the office location the employee is working in. Must be an RN.
- Successful completion of case management orientation program
- Minimum of 2 years full time acute impatient setting or specialty area (i.e. ICU, ER, Oncology, NICU, Acute Rehab)
- Excellent communication skills
- Basic typing/computer knowledge with minimum keyboarding speed of 35WPM; 6) Previous case management experience helpful but not required.
- Previous case management or insurance industry experience helpful but not required.

Physical Requirements:

- No significant physical exertion required.
- rare travel to do onsite evaluations for patients as required at homes, hospitals, etc.

*Hines welcomes diversity and as an equal opportunity employer all qualified applicants will be considered regardless of race, religion, color, national origin, sex, age, sexual orientation, gender identity, disability or protected veteran status.*

PI8ef3c0e2705a-362
Not Specified
RN In Hospital Transiton of Care Case Manager - Relocation Offered!
✦ New
USD $89,065.00/Yr. - USD $162,801.00/Yr
Washington, DC 1 day ago
About this Job:

General Summary of Position

An exciting new role has been added to the team, offering a unique opportunity to make a direct impact on patient outcomes at a critical point in care. The In-Hospital Transition of Care RN Case Manager partners closely with hospital discharge planners to coordinate patient care at discharge, ensuring seamless continuity across care settings and reducing avoidable readmissions through proactive coordination, patient education, and timely follow-up.

 

This position is based at either Washington Hospital Center or The Psychiatric Institute of Washington (PIW) and offers the opportunity to work across diverse patient populations, with flexibility to provide coverage at both locations.

 

In this highly collaborative and autonomous role, the RN Case Manager manages a complex caseload and takes ownership of case management program(s), driving high-quality, cost-effective outcomes while enhancing the patient experience. The role includes coordinating and managing care for members/enrollees, completing pre-authorization reviews to ensure medical necessity and timely access to services, and conducting pharmacy reviews aligned with the population served. Working alongside an interdisciplinary team, you will play a key role in discharge planning, connecting patients to the right resources, and ensuring smooth transitions across the continuum of care.

 

This is an excellent opportunity for a nurse who thrives in a fast-paced environment, values critical thinking and autonomy, and is passionate about improving care transitions and patient outcomes. We are committed to fostering a supportive, inclusive environment where associates from diverse backgrounds can grow, advance, and make a meaningful difference.

Primary Duties and Responsibilities

 

 

  • Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Actively develops and manages complex case management cases and develops individualized plans of care according to NCQA standards/ guidelines and the District of Columbia Contract.
  • Acts as a liaison to MedStar Family Choice contracted vendors to facilitate care. Identifies gaps in contracted services and develops a plan to access care.
  • Acts as an advocate while assisting members/enrollees to coordinate and gain access to medical psychiatric psychosocial and other essential services to meet their healthcare needs. Authorizes and monitors covered services according to policy.
  • Assists hospital case management staff with discharge planning if applicable. Makes recommendation to alternate tier of Case Management programs or level of care as acuity necessitate.
  • Attends and participates in MFC staff meetings Clinical Operations department meetings Special Needs Forums work groups District/ community agencies meetings etc. as assigned. Provides input completes assignments and shares new findings with other staff. Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Provides face to face case management in the community as the member/enrollee's health necessitate.
  • Demonstrates behavior consistent with MedStar Health mission vision goals objectives and patient care philosophy.
  • Demonstrates skill and flexibility in providing coverage for other staff.
  • For assigned Case Management program(s) develops strategies assessment(s) and evaluation/goal tools according to NCQA standards/ guidelines and District of Columbia Contract for the population served. Utilizes standards/ guidelines to manage and document interactions for the program (s). Responsible for verifying that assigned program utilizes up-to-date standards in the medical and behavioral health community for the population served. Keeps informed about disease processes treatment modalities and resources.
  • Identifies and reports potential coordination of benefits subrogation third party liability worker's compensation cases etc. Identifies quality risk or utilization issues to appropriate MedStar personnel.
  • Identifies inpatients requiring additional services and initiates care with appropriate practitioners.
  • Maintains current knowledge of MFC benefits and enrollment issues in order to accurately coordinate services.
  • Maintains timely and accurate documentation in the clinical software system per Clinical Operation department's policy.
  • Monitors utilization of all services for fraud waste and abuse.
  • Performs telephonic ACD line coverage for Clinical Operations' needs.
  • Enters authorization as appropriate to the program and sends the reviews to Medical Director as appropriate. Coordinates review decisions and notifications per policy NCQA standards/ guidelines and District of Columbia Contract for timely decision making.
  • Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
  • Participates in multi-disciplinary quality and service improvement teams.

Minimal Qualifications
Education

  • Graduate of an accredited School of Nursing required and
  • Bachelor's degree preferred

Experience

  • 1-2 years Case management experience required and
  • 1-2 years UM or related experience required and
  • 3-4 years Diverse clinical experience required
  •  

Licenses and Certifications

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the District of Columbia and/or the State of Maryland based on work location(s) Upon Hire required and
  • CCM - Certified Case Manager Upon Hire preferred

Knowledge Skills and Abilities

  • Verbal and written communication skills. Ability to use computer to enter and retrieve data. Ability to create edit and analyze Microsoft office (Word Excel and PowerPoint) preferred.
This position has a hiring range of : USD $89,065.00 - USD $162,801.00 /Yr.
permanent
SCO RN Case Manager I
$84,000-108,000 Yearly Salary
Lynn, Massachusetts 5 days ago

Great Life work Balance position with excellent benefits! 

The RN Case Manager  provides comprehensive case management for assigned SCO members with complex needs to ensure cost effective quality of care.  This professional provides quality patient care via the development, implementation & evaluation of individual patient care plans.  This individual will adhere to established professional standards of care, and the Element Care policies and procedures. This is a full-time position, Monday- Friday 8-4 position; no nights, weekends or holidays!

Responsibilities:

  • Develops a plan of care that corresponds with the physicians’ orders through assessment of patient's needs, condition, environment, and consultation with other health team members, at time of initial visit and updates plan of care regularly as necessary and documents this care following Element Care procedures.
  • Ensures the delivery of competent, quality patient care in the home. 
  • Maintains an ongoing responsibility for assigned caseload. 
  • Oversees the implementation and evaluation of individual patient plans of care. 
  • Maintains communication with Commonwealth Care Alliance (CCA) and Element Care staff as well as the provider community as appropriate
  • Provides patient education opportunities.
  • Works with both members and their family members 
  • Actively participates in team knowledge sharing activities. 
  • Performs other duties, as assigned.

Qualifications:

  • Registered Nurse currently licensed in the Commonwealth of MA
  • Bachelor of Science degree in Nursing preferred. 
  • Minimum of three (3) years experience as a licensed, registered nurse, preferable five (5) years, including home care clinical experience.  
  • Proficient in the use of Microsoft Office tools. 
  • Experience working with case management data systems.
  • Ability to travel locally on a frequent basis.
  • Covid vaccinated preferred.
  • Spanish Speaking preferred

 

Benefits:

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Paid time off
  • Retirement plan
  • Supplemental benefits
 Salary range:$84,000$108,000

EEO Statement

Element Care is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability.

Element Care is committed to valuing diversity and contributing to an inclusive working environment.


To learn more about Element Care, please click this link:  Element Care 30th Anniversary Video



Compensation details: 84 Yearly Salary



PIacf3a69d2544-3631

Not Specified
Hospital Case Manager
✦ New
$85,000-100,000 Yearly Salary

DCI Donor Services

Sierra Donor Services (SDS) is looking for a dynamic and enthusiastic team member to join us to save lives!! Our mission at SDS is to save lives through organ and tissue donation, and we want professionals on our team that will embrace this important work!! We want people to join our team in the role of Hospital Case Manager with previous experience with families, counseling, bereavement and/or crisis intervention. This position will be the onsite Hospital Case Manager at Santa Rosa Memorial Hospital to facilitate all aspects of making organ donation happen.

SUMMARY FUNCTION:

The Hospital Case Manager is responsible for providing support for organ donation activities within the assigned facility/facilities to maximize opportunities for organ donation. Provides consistency and promotes trust in the donation process by ensuring excellent donor evaluation, management, and organ yield.

Works with donor hospital personnel, physicians, and Organ Recovery Coordinators (ORC’s) or Donation Coordinators (DCs) to obtain organ and tissue authorization. Must utilize consistent communication and empathy for both the donor family and potential transplant recipients. Extensive on-call services and call duties are required. May assist with the bereavement program and provide care to both donor and non-donor families as applicable.


COMPANY OVERVIEW AND MISSION

Sierra Donor Services is a designated organ procurement organization (OPO) within the state of California – and is a member of the DCI Donor Services family.

For over four decades, DCI Donor Services has been a leader in working to end the transplant waiting list. Our unique approach to service allows for nationwide donation, transplantation, and distribution of organs and tissues while maintaining close ties to our local communities.

DCI Donor Services operates three organ procurement/tissue recovery organizations: New Mexico Donor Services, Sierra Donor Services, and Tennessee Donor Services. We also maximize the gift of life through the DCI Donor Services Tissue Bank and Sierra Donor Services Eye Bank.

Our performance is measured by the way we serve donor families and recipients. To be successful in this endeavor is our ultimate mission. By mobili


With the help of our employee-led strategy team, we will ensure that all communities feel welcome and safe with us because we are a model for fairness, belonging, and forward thinking.



MAJOR DUTIES AND RESPONSIBILITIES

  1. Provides extensive on call services to obtain authorization for organ and tissue donation. On-call responsibilities may be affected by increased donor activity, staffing shortages, etc. Facilitates the authorization process for potential organ and tissue donor families prior to, during and after death declaration.
  2. Evaluates potential donors. Assesses potential donor families, obtains appropriate authorization for donation, conducts Medical/Social History interview, and assists donor families through identification of potential end of life decisions, attending family meetings and providing donation information as needed. Responsible for medical management of donors prior to recovery activities. Directs the placement of anatomical gifts as necessary. Provides transplant surgeons with information necessary to determine appropriate recipients. Coordinates and assists in the surgical recovery of organs and perioperative management of the donor when necessary.
  3. Provides support to Hospital Development Coordinator, in the assigned facility, to identify formal and informal leaders, assesses their respective roles, degree of influence and needs. Works collaboratively with these leaders and utilizes their expertise to improve and promote donation. Assists in policy and procedure development. Functions as an expert clinical resource for the hospital regarding organ and tissue donation.
  4. Will visually assess donors, interpret charts, document information and communicate findings. Collaborates with hospital and medical staff to provide potential donor families with accurate and timely information regarding the patient’s current clinical course. Maintains communication with hospital staff and attending physician regarding the potential donor family’s understanding of the prognosis and acts as a family advocate to the health care team as necessary. In the event of neurological deterioration and/or cardiac cessation, provides education to the potential donor family to include signs and symptoms of brain death, the process of diagnosing brain death, or cardiac cessation and withdrawal of support. As appropriate, discusses organ Family Care Coordinator and tissue donation opportunities with the potential donor family with the goal being to obtain authorization for donation.
  5. In the event the potential donor stabilizes and is no longer considered a potential organ donor, establishes an appropriate support system in collaboration with the health care staff, brings closure to the relationship with the family and returns if needed or requested.
  6. Provides appropriate information for the bereavement program to all potential organ and tissue donor families who wish to participate. As appropriate, provides a follow-up letter to donor families. Facilitates donor family and recipient communication in accordance with company policy and procedure.
  7. Performs other duties as assigned.

PHYSICAL TRAITS: Walks, stands and sits. Must drive to on call assignments. Communicates verbally and in writing with donor families, hospital personnel and physicians.

QUALIFICATIONS:

Education Required: RN/PA/Paramedic or related health care degree or licensure or BA/BS preferred and equivalent work experience. OPO experience.

Experience: Two to four years’ Healthcare experience with families, counseling, bereavement and/or crisis intervention preferred. Acute care social worker experience strongly desired.

Licenses/ Certifications: Valid driver license with ability to pass MVR underwriting requirements.

Computer Skills: Working knowledge of computers and basic data entry skills required.



DCIDS is an EOE/AA employer – M/F/Vet/Disability

Compensation details: 85 Yearly Salary



PIe1592e019a9

permanent
RN Case Manager - Inpatient Case Management Everet
Salary not disclosed
Everett, MA 3 days ago

Location: CHA Everett Hospital 
Work Days: Mon - Friday and Rotating Weekends/Holiday
Category: Registered Nurse
Department: Inpatient Case Management Everett  
Job Type: Part Time
Work Shift: Day 
Hours/Week: 24.00 
Union Name: MNA Everett

Department Description

Inpatient Case Management provides psychosocial assessments, evaluations, and referrals for adults, and/or families with psychiatric illness, substance abuse, and medical illness. Casework or therapy takes place in the hospital setting. Cross Training to all areas of Care Management.

Under the general supervision of the Director of Care Management, the RN Case Manager provides clinically-based case management to support the delivery of effective and efficient patient care consistent with the Centers for Medicaid and Medicare Conditions of Participation. The RN Case Manager will collaborate with other members of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize criteria to confirm medical necessity for admission and continued stay. With the patient, family and health care team, create a post-acute care plan appropriate to the patient's needs and resources and facilitate this transition in concert with that patient's inpatient and post-acute care teams. 

Qualifications/Requirements:

  • BSN preferred
  • Current or Conditional MA RN Licensure 
  • Current American Heart Association (AHA) for Healthcare Providers BLS (Basic Life Support) certification is required 
  • Licensure and Certifications: 
  • Certification in Case Management preferred

Please note that the final offer may vary within the listed Pay Range, based on a candidate's experience, skills, qualifications, and internal equity considerations.

In keeping with federal, state and local laws, Cambridge Health Alliance (CHA) policy forbids employees and associates to discriminate against anyone based on race, religion, color, gender, age, marital status, national origin, sexual orientation, gender identity, veteran status, disability or any other characteristic protected by law. We are committed to establishing and maintaining a workplace free of discrimination. We are fully committed to equal employment opportunity. We will not tolerate unlawful discrimination in the recruitment, hiring, termination, promotion, salary treatment or any other condition of employment or career development. Furthermore, we will not tolerate the use of discriminatory slurs, or other remarks, jokes or conduct, that in the judgment of CHA, encourage or permit an offensive or hostile work environment. 

Cambridge Health Alliance brings Care to the People - including your neighbors, friends and family. Our local hospitals and care centers serve our vibrant, diverse communities, and play an integral role in improving health. As passionate advocates for the underserved, we actively partner with our communities to take on challenging public health issues, and conduct important research to help reduce barriers to care. We believe that everyone deserves access to high quality, convenient health care. This is why our employees believe in where they work and why many build long, rewarding careers at CHA.


Healthcare is changing rapidly. CHA has a strategic plan that charts a proactive course for our future. It is built on a vision of equity and excellence for everyone, every time. It also recognizes that our workforce is our most valuable asset and prioritizes competitive salaries, benefits and professional development opportunities for employees. The strategic plan is changing the way we provide care and improving the health and experience of our patients; we are looking for smart, committed, compassionate people who want to be part of making our vision of better health and equity a reality.


At CHA, you can believe in where you work and go home every day knowing you made a difference. Join our team and help us bring Care to the People.

Not Specified
RN Home Health Case Manager - Full-time
✦ New
Salary not disclosed
San Angelo, TX 9 hours ago
Job Summary

Assess, plans, implements and provides direct nursing care. The case manager is responsible for facilitating the patient's plan of care from admission through discharge. The RN case manager coordinates the patient care with providers, nurses, therapists, social worker, aids, outsides (insurance's, DME's, pharmacies, APS, AAA, Meals for the Elderly, Specialized Transportation, etc.) and the patient's family and/or caregivers as needed in an efficient and cost effective.

Physical Requirements
  • The ability to perform the duties and responsibility of the position, with or without reasonable accommodations for disabilities.
  • The ability to consistently lift, push or pull loads of up to fifty (50) pounds. (Unless nursing 50)
  • Sufficient strength, mobility and stamina to make frequent location and position changes, assist with patient care, and perform other physical activities of average difficulty.
  • Candidates whose disabilities make them unable to meet the requirements will still be considered fully qualified if they can perform the essential functions of the job with reasonable accommodations.
  • May be exposed to infectious or contagious disease.
  • May have to handle emergency situations.
  • May be subject to irregular hours.
  • May be required to wear protective equipment such as eye protection, face protection, masks, sterile/nonsterile gloves, isolation gowns.
  • May be exposed to toxic/caustic/chemicals/detergents.
  • Physical activities include continuous sitting, and occasional walking, standing, bending, squatting, climbing, kneeling and twisting.
  • Activity Conditions (Occasionally, Frequently, Continuously):
    • Sitting- Occasionally
    • Walking- Frequently
    • Standing- Frequently
    • Bending-Occasionally
    • Squatting - Frequently
    • Climbing-Occasionally
    • Kneeling-Occasionally
    • Twisting-Occasionally

Visual and Hearing Requirements
  • Must be able to see with corrective eye wear.
  • Must be able to hear clearly with assistance.

Working Conditions

Primarily Works in a well-lighted and air-conditioned environment with period of heavy workload and stress. This role may include working in less-than-ideal home conditions, which can include exposure to extreme temperatures and environments that may not meet typical cleanliness standards such as clutter, unkept surfaces, and homes with pets. Works in various conditions.

Performance: Essential Functions

Decision Making: Ability to make decisions and takes appropriate action based on the information they have. Recognizes own limitations and consults with the supervisor, manager, or team member when appropriate.

Time Management: Works efficiently and manages duties to ensure that tasks are completed with accuracy and within the scheduled shift or reasonable amount of time.

Quality & Quantity: Demonstrates accurate, knowledge and skill to carry out job duties. Follows departmental work policies and procedures. Speed and consistency of output and time utilization of job duties.

Computer Knowledge & Electronic Equipment Use: Demonstrates ability to consistently utilize electronic equipment and online computer programs to perform job duties, including electronic documentation, and order entry.

Resource Utilization: Consistently utilizes and maintains supplies and equipment to minimize lost charges and unnecessary equipment repair-replacement.

Confidentiality: Adheres to established policies on privacy and security requirements for compliance with the Health Insurance Portability and Accountability Act (HIPAA), as applicable by Shannon Policy.

Responsibilities
Supervises the Following Positions

Positions: N/A

Performance: Position Specific Essential Functions
  • Assumes responsibility for preventing incidents that could lead to injury, promptly reports unsafe conditions that require actions from others, promptly report incidents and completes paperwork, and consistently utilizes equipment properly.
  • Interacts with people openly, directly, tactfully, and cooperatively, accepts criticism and is not defensive. Considers the impact of the decisions on others and involves them. Shares information and resources with others, works effectively with others to achieve a desired result, is patient, and uses humor. Knows how to utilize appropriate channels of communication and chain of command, identifies patients and families physical, psychosocial, financial, discharging needs, and obtains to refer/consult HH Therapists, Social Worker and aides indicated.
  • Demonstrates knowledge and judgment needed to meet the nursing needs of the patient. Demonstrates knowledge of diagnosis coding appropriate to the Plan of Care. Demonstrates knowledge of coverage criteria under Medicare, Medicaid, VA, and commercial insurance.
  • Looks for ways to continually improve processes in order to positively affect outcomes such as customer satisfaction, clinical financials, etc. Demonstrates the quality work with of doing the right thing in the right way' also is flexible and responsive to change.
  • Demonstrates understanding of Patient Rights and delivers care in accordance with policies and procedures regarding patient confidentiality, advance directives, informed consent, personal privacy, patient values/beliefs, and resolution to patient complaints.
  • Demonstrates the knowledge, skills and abilities necessary to perform nursing procedures for patients in the following age groups: newborn, children, adolescents, adults, and geriatric). Utilizes established criteria to determine appropriateness of Home Health admission. Identifies patient needs and health status from assessment data including physician's history, physical assessment, lab data, etc. Develops a plan of care/discharge plan in collaboration with other members of the healthcare team, analyzes clinical and assessment data to report/discuss with HH staff, physicians, third parties to make adjustments as needed for continued authorization of treatment plans. Demonstrates active collaboration and leads staff as indicated to ensure that there is completion and reporting of lab testing, treatment orders, maintaining accurate medication list, scheduling of visits for the HH episode of care and development/maintenance of the problem/intervention lists. Ensures adequate patient/caregiver knowledge of disease processes, medications, skilled and non-skilled procedures, treatment and discharge planning.
  • Performs other duties as assigned.
Qualifications

Education
  • Required
    • High School Diploma, GED, or equivalent
    • Completion of an accredited Nursing program

Experience:
  • Required
    • One year of experience in Nursing
    • One year of experience in Home Health

Certification/Licensure:
  • Required
    • Registered Nurse (RN), with authorization to practice in the State of Texas
    • Basic Life Support (BLS) Certification
      • Must obtain within ninety (90) days of start date
    • Valid Texas Driver's License
    • Auto Insurance
permanent
Home Health Case Manager - Home Health
✦ New
🏢 Shannon Health
Salary not disclosed
San Angelo, TX 9 hours ago
Job Summary

Assess, plans, implements and provides direct nursing care. The case manager is responsible for facilitating the patient's plan of care from admission through discharge. The RN case manager coordinates the patient care with providers, nurses, therapists, social worker, aids, outsides (insurance's, DME's, pharmacies, APS, AAA, Meals for the Elderly, Specialized Transportation, etc.) and the patient's family and/or caregivers as needed in an efficient and cost effective.

Physical Requirements
  • The ability to perform the duties and responsibility of the position, with or without reasonable accommodations for disabilities.
  • The ability to consistently lift, push or pull loads of up to fifty (50) pounds. (Unless nursing 50)
  • Sufficient strength, mobility and stamina to make frequent location and position changes, assist with patient care, and perform other physical activities of average difficulty.
  • Candidates whose disabilities make them unable to meet the requirements will still be considered fully qualified if they can perform the essential functions of the job with reasonable accommodations.
  • May be exposed to infectious or contagious disease.
  • May have to handle emergency situations.
  • May be subject to irregular hours.
  • May be required to wear protective equipment such as eye protection, face protection, masks, sterile/nonsterile gloves, isolation gowns.
  • May be exposed to toxic/caustic/chemicals/detergents.
  • Physical activities include continuous sitting, and occasional walking, standing, bending, squatting, climbing, kneeling and twisting.
  • Activity Conditions (Occasionally, Frequently, Continuously):
    • Sitting- Occasionally
    • Walking- Frequently
    • Standing- Frequently
    • Bending-Occasionally
    • Squatting - Frequently
    • Climbing-Occasionally
    • Kneeling-Occasionally
    • Twisting-Occasionally

Visual and Hearing Requirements
  • Must be able to see with corrective eye wear.
  • Must be able to hear clearly with assistance.

Working Conditions

Primarily Works in a well-lighted and air-conditioned environment with period of heavy workload and stress. This role may include working in less-than-ideal home conditions, which can include exposure to extreme temperatures and environments that may not meet typical cleanliness standards such as clutter, unkept surfaces, and homes with pets. Works in various conditions.

Performance: Essential Functions

Decision Making: Ability to make decisions and takes appropriate action based on the information they have. Recognizes own limitations and consults with the supervisor, manager, or team member when appropriate.

Time Management: Works efficiently and manages duties to ensure that tasks are completed with accuracy and within the scheduled shift or reasonable amount of time.

Quality & Quantity: Demonstrates accurate, knowledge and skill to carry out job duties. Follows departmental work policies and procedures. Speed and consistency of output and time utilization of job duties.

Computer Knowledge & Electronic Equipment Use: Demonstrates ability to consistently utilize electronic equipment and online computer programs to perform job duties, including electronic documentation, and order entry.

Resource Utilization: Consistently utilizes and maintains supplies and equipment to minimize lost charges and unnecessary equipment repair-replacement.

Confidentiality: Adheres to established policies on privacy and security requirements for compliance with the Health Insurance Portability and Accountability Act (HIPAA), as applicable by Shannon Policy.

Responsibilities
Supervises the Following Positions

Positions: N/A

Performance: Position Specific Essential Functions
  • Assumes responsibility for preventing incidents that could lead to injury, promptly reports unsafe conditions that require actions from others, promptly report incidents and completes paperwork, and consistently utilizes equipment properly.
  • Interacts with people openly, directly, tactfully, and cooperatively, accepts criticism and is not defensive. Considers the impact of the decisions on others and involves them. Shares information and resources with others, works effectively with others to achieve a desired result, is patient, and uses humor. Knows how to utilize appropriate channels of communication and chain of command, identifies patients and families physical, psychosocial, financial, discharging needs, and obtains to refer/consult HH Therapists, Social Worker and aides indicated.
  • Demonstrates knowledge and judgment needed to meet the nursing needs of the patient. Demonstrates knowledge of diagnosis coding appropriate to the Plan of Care. Demonstrates knowledge of coverage criteria under Medicare, Medicaid, VA, and commercial insurance.
  • Looks for ways to continually improve processes in order to positively affect outcomes such as customer satisfaction, clinical financials, etc. Demonstrates the quality work with of doing the right thing in the right way' also is flexible and responsive to change.
  • Demonstrates understanding of Patient Rights and delivers care in accordance with policies and procedures regarding patient confidentiality, advance directives, informed consent, personal privacy, patient values/beliefs, and resolution to patient complaints.
  • Demonstrates the knowledge, skills and abilities necessary to perform nursing procedures for patients in the following age groups: newborn, children, adolescents, adults, and geriatric). Utilizes established criteria to determine appropriateness of Home Health admission. Identifies patient needs and health status from assessment data including physician's history, physical assessment, lab data, etc. Develops a plan of care/discharge plan in collaboration with other members of the healthcare team, analyzes clinical and assessment data to report/discuss with HH staff, physicians, third parties to make adjustments as needed for continued authorization of treatment plans. Demonstrates active collaboration and leads staff as indicated to ensure that there is completion and reporting of lab testing, treatment orders, maintaining accurate medication list, scheduling of visits for the HH episode of care and development/maintenance of the problem/intervention lists. Ensures adequate patient/caregiver knowledge of disease processes, medications, skilled and non-skilled procedures, treatment and discharge planning.
  • Performs other duties as assigned.
Qualifications

Education
  • Required
    • High School Diploma, GED, or equivalent
    • Completion of an accredited Nursing program

Experience:
  • Required
    • One year of experience in Nursing
    • One year of experience in Home Health

Certification/Licensure:
  • Required
    • Registered Nurse (RN), with authorization to practice in the State of Texas
    • Basic Life Support (BLS) Certification
      • Must obtain within ninety (90) days of start date
    • Valid Texas Driver's License
    • Auto Insurance
permanent
PACT RN Case Manager
$32.76
Lonsdale, TN 2 days ago

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

Not Specified
Behavioral Health Utilization Management Medical Case Manager
Salary not disclosed
Orange, CA 4 days ago
Behavioral Health Utilization Management Medical Case Manager

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
Not Specified
Registered Nurse Case Manager Home Health Brevard
Salary not disclosed
Asheville, NC 2 days ago
Introduction

Do you want to join an organization that invests in you as a Registered Nurse Case Manager with our Home Health Brevard Team? At CarePartners, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

** This position is eligible for a sign on bonus, apply and find out more!

Benefits

CarePartners, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

- Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
- Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
- Free counseling services and resources for emotional, physical and financial wellbeing

- 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

- Employee Stock Purchase Plan with 10% off HCA Healthcare stock

- Family support through fertility and family building benefits with Progyny and adoption assistance.

- Referral services for child, elder and pet care, home and auto repair, event planning and more

- Consumer discounts through Abenity and Consumer Discounts

- Retirement readiness, rollover assistance services and preferred banking partnerships

- Education assistance (tuition, student loan, certification support, dependent scholarships)

- Colleague recognition program

- Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

- Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Registered Nurse Case Manager Home Health Brevard like you to be a part of our team.

Job Summary and Qualifications

Provides coordinated skilled nursing care to patients of all age groups, in the home. Demonstrates accountability and responsibility in collaborating with the interdisciplinary team to establish and achieve patient goals and maintain high quality patient care. Performs in accordance with physician’s orders and under the supervision of the Clinical Manager.

What you will do in this role:

- Assesses home care patients identifying physical, psychosocial and environmental needs as evidenced by documentation, clinical records, case conferences, team reports, call-in logs and on-site evaluations.
- Completes OASIS, assessment and visit paperwork according to agency policy. Assures clinical notes accurately indicate continuing communication and coordination of services with the physician, other interdisciplinary team members and patient/family/caregiver.
- Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings, communications, and appropriate interventions.
- Supervises and provides clinical direction to home health aides and LPNs/LVNs to ensure quality and continuity of services provided.
- Responsible for participating in on-call rotation and emergency call according to agency policy.

What qualifications you will need:

- Basic Cardiac Life Support must be obtained within 30 days of employment start date
- Drivers License
- Registered Nurse
- Associate Degree

CarePartners Health Services is a healthcare organization serving western North Carolina and offering a full continuum of post-acute care. Located in Asheville, North Carolina, CarePartners provides compassionate post-acute care, including rehabilitation, home health, adult care, hospice and palliative care. CarePartners also offers a full acute care rehabilitation hospital. With more than 1,200 colleagues and 400 volunteers, CarePartners Health Services is dedicated to helping people of western North Carolina live full and productive lives, despite illness, injury, disability or issues related to aging. CarePartners Health Services is a member of Mission Health, an operating division of HCA Healthcare.

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.

{{"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder}}

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Registered Nurse Case Manager Home Health Brevard opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

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.
Not Specified
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