Mphc Case Jobs in Usa
4,070 positions found — Page 18
Nurse Case Manager - CFHP - Access to Comprehensive Health Resources (PLEASANTON)
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
permanent
Nurse Case Manager - Improve Maternal Health Outcomes (SAN ANTONIO)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
permanent
Nurse Case Manager - CFHP - Collaborative Interdisciplinary Team Environment (SAN ANTONIO)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
permanent
Nurse Case Manager - CFHP - Collaborative Multi-disciplinary Teamwork (BOERNE)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
permanent
Nurse Case Manager - Maternal Health Specialization (BOERNE)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
permanent
Nurse Case Manager - Interdisciplinary Collaboration (HONDO)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
permanent
Nurse Case Manager - Comprehensive Patient Advocacy (PLEASANTON)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
Coordinates the interdisciplinary treatment plan of care for patients across the healthcare continuum within the maternal patient population. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing, RN or LVN is required. A minimum three years of clinical nursing experience is required. Data entry, referral management, utilization management experience is required. Case Management experience preferred. Experience in a similar setting and working with OB patients preferred. Experience working with EPIC EMR desirable.
LICENSURE/CERTIFICATION
Current licensure in the State of Texas as an RN or LVN is required.
permanent
Nurse Case Manager - CFHP (BOERNE)
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
permanent
K
RN Case Manager- Visiting Hospice Nurse | NJ, Newton
Salary not disclosed
Title RN Case Manager- Visiting Hospice Nurse | NJ, Newton
EOE Statement
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
Description
Compensation: $87,750.00 per year
Bonus: $8,000.00 sign on bonus, paid over 1 year.
Medical/Medical stipend, Dental Vision, benefit time, 401K, Tuition reimbursement.
Schedule M-F 830a-430p. Ocassional on call.
- Explains, and interprets and coordinates patients' rights and advanced directives; explains Medicare Hospice Benefit when indicated.
- Performs ongoing physical and psychosocial assessment of Hospice patients.
- Follows established plan of care for each patient and reports observations to team leader or primary nurse.
- Collaborates with IDT with regards to new nursing diagnoses and need for changes in plan of care.
- Instructs and supervises the activities of hospice aides/LPN staff.
- Assists patient/family in obtaining durable medical equipment and supplies essential to care.
- Observes and records signs and symptoms of disease process.
- Communicates with the physician, the family and other health team personnel, and others to report changes in the patient's physical and/or emotional condition and identify patient needs.
- Performs patient/family teaching; utilizes teaching tools and handouts; documents all teaching and patient response.
- Facilitates and supports patient and family self-direction and independence.
- Prepares and administers medications according to policy and documents same.
- Provide support and relief for the primary care person while participating in Hospice “at-home respite@ program and provide direct care to the patient.
- Completes chart documentation within 48 hours.
- Documents vital signs, measurements, nursing interventions, treatments and patient responses; completes flow sheets, narratives, and verbal orders, as per agency policy.
- Maintains a caseload with productivity in compliance with agency standards.
- Communicates with the Nursing Supervisor and other health team members in the planning, implementing, evaluating and coordinating of services to the patient and family in order to insure completeness and continuity of services.
- Rotates through the on-call system as scheduled for scheduled revisits.
- Incorporates the physiological and developmental age of patients into the overall plan for the delivery of patient care.
- Maintains appropriate infection control practices.
- Holds in strictest confidence all patient information and discloses information and data only to persons authorized by patient/family/representative or Hospice personnel.
- Participates in all required in service education programs and meetings. Participates in 9 out of 12 nursing meetings annually.
- Demonstrates compliance with the dress code policy by appearing well groomed, wearing ID badge while on duty and maintaining a professional appearance.
- Performs other duties as assigned.
Position Requirements
Required Skills/Abilities:
- Strong nursing assessment and documentation skills.
- Clinical knowledge to support the dying process.
- Ability to serve as a resource to patients and families during times of high stress and volatility.
- Excellent interpersonal and communication skills
- Ability to comprehend the spoken and written English language, to communicate with clarity both verbally and in writing.
- Well organized to manage patient/family needs, provide clinical and oversight of the inpatient Hospice operation.
- Proficiency in operating a computer; including a working knowledge of Microsoft applications (Word, Excel, and Outlook) and an electronic medical record.
Education and Expterience:
Required Education: Diploma, Associate or Bachelor of Science in Nursing; BSN preferred. Licensed to practice as a Registered Nurse in the State of New Jersey; licensure in Pennsylvania if practicing in PA.
Preferred Education: CPR certification preferred.
Required Experience: Minimum one-year adult, pediatric or medical/surgical clinical experience.
Preferred Experience: Prior home care or hospice experience preferred.
Fulltime/Part-timeFull-Time
Shift Days Exempt/Non-ExemptNon-Exempt LocationKaren Ann Quinlan Memorial Fdn
PIfc741dbc7b55-362
EOE Statement
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
Description
Compensation: $87,750.00 per year
Bonus: $8,000.00 sign on bonus, paid over 1 year.
Medical/Medical stipend, Dental Vision, benefit time, 401K, Tuition reimbursement.
Schedule M-F 830a-430p. Ocassional on call.
- Explains, and interprets and coordinates patients' rights and advanced directives; explains Medicare Hospice Benefit when indicated.
- Performs ongoing physical and psychosocial assessment of Hospice patients.
- Follows established plan of care for each patient and reports observations to team leader or primary nurse.
- Collaborates with IDT with regards to new nursing diagnoses and need for changes in plan of care.
- Instructs and supervises the activities of hospice aides/LPN staff.
- Assists patient/family in obtaining durable medical equipment and supplies essential to care.
- Observes and records signs and symptoms of disease process.
- Communicates with the physician, the family and other health team personnel, and others to report changes in the patient's physical and/or emotional condition and identify patient needs.
- Performs patient/family teaching; utilizes teaching tools and handouts; documents all teaching and patient response.
- Facilitates and supports patient and family self-direction and independence.
- Prepares and administers medications according to policy and documents same.
- Provide support and relief for the primary care person while participating in Hospice “at-home respite@ program and provide direct care to the patient.
- Completes chart documentation within 48 hours.
- Documents vital signs, measurements, nursing interventions, treatments and patient responses; completes flow sheets, narratives, and verbal orders, as per agency policy.
- Maintains a caseload with productivity in compliance with agency standards.
- Communicates with the Nursing Supervisor and other health team members in the planning, implementing, evaluating and coordinating of services to the patient and family in order to insure completeness and continuity of services.
- Rotates through the on-call system as scheduled for scheduled revisits.
- Incorporates the physiological and developmental age of patients into the overall plan for the delivery of patient care.
- Maintains appropriate infection control practices.
- Holds in strictest confidence all patient information and discloses information and data only to persons authorized by patient/family/representative or Hospice personnel.
- Participates in all required in service education programs and meetings. Participates in 9 out of 12 nursing meetings annually.
- Demonstrates compliance with the dress code policy by appearing well groomed, wearing ID badge while on duty and maintaining a professional appearance.
- Performs other duties as assigned.
Position Requirements
Required Skills/Abilities:
- Strong nursing assessment and documentation skills.
- Clinical knowledge to support the dying process.
- Ability to serve as a resource to patients and families during times of high stress and volatility.
- Excellent interpersonal and communication skills
- Ability to comprehend the spoken and written English language, to communicate with clarity both verbally and in writing.
- Well organized to manage patient/family needs, provide clinical and oversight of the inpatient Hospice operation.
- Proficiency in operating a computer; including a working knowledge of Microsoft applications (Word, Excel, and Outlook) and an electronic medical record.
Education and Expterience:
Required Education: Diploma, Associate or Bachelor of Science in Nursing; BSN preferred. Licensed to practice as a Registered Nurse in the State of New Jersey; licensure in Pennsylvania if practicing in PA.
Preferred Education: CPR certification preferred.
Required Experience: Minimum one-year adult, pediatric or medical/surgical clinical experience.
Preferred Experience: Prior home care or hospice experience preferred.
Fulltime/Part-timeFull-Time
Shift Days Exempt/Non-ExemptNon-Exempt LocationKaren Ann Quinlan Memorial Fdn
PIfc741dbc7b55-362
Not Specified
M
RN Case Manager (Fee For Service)
🏢 MJHS
12.50
Our groundbreaking hospice and palliative care programs offer a broad range of services in facilities and the community to help patients and their families ease the burden of managing a life-limiting illness or end-of- life care.
In this field based position, you will visit MJHS Hospice and Palliative Care patients to perform both physical and psychosocial assessments and electronically document visit occurrences. Patient visits will be made in both community and facility settings. As the Hospice Field Case Manager, you will develop and implement nursing plans of care and make recommendations for care based on patients' needs. As needed, you will contact the patient's physician to request written orders to facilitate plan of care changes. In addition, you will also supervise, train and evaluate home health aides and homemakers working with our hospice patients.
Rate is $100/visit
- Associates/Diploma from an accredited school of Nursing; BSN preferred
- At least two years experience in medical-surgical, community health, and/or oncology nursing preferred
- Proficiency with Word and Excel preferred
- New York State RN licensure and valid NYS driver's license required
- Experience working within an interdisciplinary team environment
- Effective communication, listening and teaching skills
- Ability to input clinical data proficiently
- Mandarin/Cantonese is a must
permanent
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