Mphc Case Status Jobs in Usa

Medical Surgical RN for Emergency Room

We are a recognized hospital based in San Antonio, Texas that offers its employees excellent benefits, RN Loan Repayment, continuing education.

The Company: University Health is the first and only hospital in San Antonio and South Texas to earn Magnet® status from the American Nurses Credentialing Center (ANCC). As the primary teaching hospital for The University of Texas Health Science Center at San Antonio, University Hospital is a regional Level I Trauma Center and a leader in Organ Transplantation.

- We believe in providing hope and healing to our patients and families.

- University Health has earned recognition as a 2023 Top U.S. Workplace.

The Position: University Health has opportunities for Med Surg Registered Nurses to work in an ER environment. Our ER Hold cares for patients that have been admitted to the hospital but are still cared for in the ER area.

- We are now offering higher pay rates

- We also offer advancement opportunities

Requirements:

- Texas RN License

- BSN preferred

- An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement.

- American Heart Association Healthcare Provider card

The Location: University Health is based in San Antonio, Texas. This is a great place to live because of the warm climate and diverse population. We enjoy a lower cost of living.

Why Should You Apply?

- Excellent medical and dental insurance

- Robust PTO accrual

- Vision Plan

- Life insurance

- FSA accounts

- Retirement plans

- Pet Insurance

Employment Type:Full timeShift:12 Hour Night ShiftDescription:Join the MercyOne Family! We are looking to hire a Pediatric RN!Our inpatient pediatric unit can accommodate 8-10 pediatric patients who present with a variety of general medical conditions and those who are in need of post-surgical care.

At MercyOne, health care is more than just a doctor’s visit or a place to go when you’re in need of medical attention. Our Mission is based on improving the health of our communities – that means not only when you are sick but keeping you well. With more than 2,500 colleagues, MercyOne is one of the largest employers in Northeast Iowa. 

As a Pediatric RN at MercyOne, you will provide evidence-based, outcome-focused care to pediatric patients in a variety of settings. Using critical thinking, you will assess, plan, implement, and evaluate individualized care, while supervising and coordinating the nursing team. You will collaborate with pediatricians, families, and other team members to ensure clear communication and optimal outcomes for each patient. By conducting thorough assessments, identifying patient needs, and developing goal-oriented care plans, you will guide both the child and family through their healthcare journey. Ongoing evaluation and adjustment of care plans will ensure the best possible outcomes for every pediatric patient.

Schedule:

• Nights 7 p - 7 a

• 36 hours per week

• Every third weekend rotation

Education:

Associate degree required, BSN preferred. No prior experience required.  Current Iowa RN license, BLS, Mandatory Reporter. PALS

Colleagues of MercyOne Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout the system!

Visit MercyOne Careers to learn more about the benefits, culture, and career development opportunities available to you at MercyOne Health System circle of care.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide.

As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve.

Find a home for your career here.

Join us and embrace a culture of Caring.

Connecting.

Growing together.

As the Home Health Patient Care Manager, you are responsible for the overall supervision and coordination of clinical services.

Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high quality care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and regulations.

Primary Responsibilities: Provides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team Receives referrals, ensures appropriate clinician assignments, evaluate patient orders, and plot start of care visits Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications: Current unrestricted RN licensure in state of practice Current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation Preferred Qualifications: Current CPR certification or ability to complete within 90 days of hire Home care experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

The salary for this role will range from $72,800 to $130,000 annually based on full-time employment.

We comply with all minimum wage laws as applicable.

LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.

We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes
- an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug
- free workplace.

Candidates are required to pass a drug test before beginning employment.

Explore opportunities with Saint Mary's Home Care, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide.

As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve.

Find a home for your career here.

Join us and embrace a culture of Caring.

Connecting.

Growing together.

Primary Responsibilities: Provides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team Receives referrals, ensures appropriate clinician assignments, evaluate patient orders, and plot start of care visits Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications: Current unrestricted RN licensure in state of practice Current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: Home care experience Current CPR certification Able to work independently Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

The salary for this role will range from $72,800 to $130,000 annually based on full-time employment.

We comply with all minimum wage laws as applicable.

LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.

We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes
- an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug
- free workplace.

Candidates are required to pass a drug test before beginning employment.

Explore opportunities with Beauregard Home Health, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide.

As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve.

Find a home for your career here.

Join us and embrace a culture of Caring.

Connecting.

Growing together.

As the Home Health Patient Care Manager, you are responsible for the overall supervision and coordination of clinical services.

Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high quality care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and regulations.

Primary Responsibilities: Provides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team Receives referrals, ensures appropriate clinician assignments, evaluate patient orders, and plot start of care visits Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications: Current unrestricted RN licensure in state of practice Current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation State Specific Requirements CA: One year prior professional nursing experience.LA: At a minimum, one year of clinical experience.

Preferred Qualifications: Current CPR certification or ability to complete within 90 days of hire Home care experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.

In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

The salary for this role will range from $72,800 to $130,000 annually based on full-time employment.

We comply with all minimum wage laws as applicable.

LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.

We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.

We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes
- an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug
- free workplace.

Candidates are required to pass a drug test before beginning employment.

Job Title: Clinical Case Manager II (ICM CCM) – Hybrid-167888 Location: Illinois (Candidates may reside anywhere in Illinois; hybrid role with occasional local member visits as needed) Pay: $35.87 per hour Schedule: Monday – Friday | 8:00 AM – 5:00 PM CST Overview We are seeking a Clinical Case Manager II to join a leading healthcare organization supporting members enrolled in Medicare and Medicaid.

This hybrid role allows candidates to work primarily from home while completing occasional in-person member visits in their local area as needed.

As part of the Integrated Care Management (ICM) team, the Case Manager works with members who have complex health and social needs.

Through collaboration, the Case Manager helps coordinate services and advocate for appropriate care to improve health outcomes and promote cost-effective care solutions.

Key Responsibilities Conduct comprehensive assessments of members’ health, social, and care coordination needs.

Develop and implement individualized case management plans based on member needs, benefit plans, and available resources.

Collaborate with members, healthcare providers, and community organizations to coordinate services and support care plans.

Apply clinical guidelines, policies, and regulatory standards to ensure appropriate benefit utilization and care management.

Utilize clinical tools and data review to evaluate member eligibility and determine appropriate care strategies.

Advocate for members by identifying resources and coordinating services to address medical and social determinants of health.

Maintain accurate documentation while navigating multiple systems and case management platforms.

Participate in care management and quality management processes in compliance with regulatory and accreditation standards.

Caseload Information Telephonic/Hybrid Case Managers: Caseloads typically range from 250–500 members , depending on stratification and complexity of member needs.

Field-Based Case Managers: Caseloads typically range from 30–100 members , depending on market needs and complexity.

Required Skills & Qualifications Active, unrestricted Illinois license required: RN, LCSW, or LCPC.

Minimum 3–5 years of clinical experience required.

2–3 years of care management, discharge planning, or home health coordination experience preferred.

Experience working with case management processes and care coordination programs preferred.

Experience with Illinois waiver services preferred.

Ability to work independently in a remote/home-based environment while collaborating with teams virtually.

Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint) and ability to navigate multiple systems.

Education Active Illinois licensure required as one of the following: Registered Nurse (RN) Licensed Clinical Social Worker (LCSW) Licensed Clinical Professional Counselor (LCPC) Keywords: case management, care coordination, discharge planning, RN case manager, LCSW case manager, LCPC case manager, managed care, Medicare, Medicaid, integrated care management, telephonic case management, hybrid case manager, population health, healthcare coordination, care management
Remote working/work at home options are available for this role.

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.

Location: Saddle Brook, NJ 07663 (Covering Bergen County) Pay: $56.19 per hour (Mileage reimbursement provided at $0.43 per mile) Schedule: Monday – Friday | 8:00 AM – 5:00 PM Weekend: On-Call Rotation Overview We are seeking an experienced Registered Nurse (RN) Case Manager to support care coordination for high-risk patients in Bergen County, NJ.

In this role, you will perform comprehensive patient assessments, develop individualized care plans, and collaborate with providers and care teams to ensure members receive appropriate, cost-effective care.

The RN Case Manager plays a key role in supporting patient transitions, coordinating services, and advocating for patient needs while ensuring compliance with treatment plans and promoting positive health outcomes.

Key Responsibilities Perform comprehensive assessments of high-risk patients to evaluate clinical and social care needs.

Develop and implement individualized care plans in collaboration with primary care providers and healthcare teams.

Coordinate care transitions between providers, facilities, and community resources.

Collaborate with physicians, social workers, discharge planners, and claims professionals to ensure appropriate levels of care.

Identify and coordinate non-medical support services such as housing or transportation to support treatment compliance.

Engage specialty resources and community services as needed to improve patient outcomes.

Maintain detailed documentation of clinical, functional, and financial outcomes throughout the case management process.

Identify opportunities for health promotion and illness prevention.

Prevent adverse patient events whenever possible and intervene quickly to minimize negative outcomes.

Performance Expectations Case management benchmark of 30 cases per week (Monday-Friday).

Required Qualifications Current, unrestricted Registered Nurse (RN) license.

Associate’s or Bachelor’s Degree in Nursing or related field.

Experience with Home Care Home Base (HCHB), PointCare, or PointClickCare systems.

Case Management Certification preferred.

Proficiency with Microsoft Teams and other technology platforms.

Keywords: RN case manager, nurse case manager, care coordination, patient advocacy, discharge planning, care transitions, population health, home health case management, utilization management, HCHB, PointClickCare, PointCare, clinical case management, healthcare coordination

Job Title: Nurse Case Manager II (Telephonic)-{167908} Location: Michigan (Must reside in Macomb or Wayne County) Pay: $44.14 per hour Schedule: Monday – Friday | 8:00 AM – 5:00 PM EST Work Setting: Remote (Telephonic – No field work required) Overview We are seeking a Nurse Case Manager II to support care coordination for members with complex and chronic health conditions.

This is a fully remote, telephonic role requiring candidates to work from a quiet, dedicated home office environment.

In this role, the RN Case Manager will conduct comprehensive member assessments, develop individualized care plans, and collaborate with providers and care teams to promote optimal, cost-effective health outcomes.

The position focuses on managing member needs through clinical review, care coordination, and patient engagement.

Key Responsibilities Conduct comprehensive telephonic assessments of member health needs and eligibility using clinical tools and data review.

Develop, implement, and monitor individualized care plans in collaboration with members and interdisciplinary care teams.

Coordinate care and services based on member benefit plans and available internal/external resources.

Apply clinical guidelines, policies, and regulatory standards to ensure appropriate care and benefit utilization.

Provide coaching, education, and support to promote member engagement and healthy lifestyle choices.

Perform crisis intervention and follow-up for members experiencing medical or behavioral health concerns.

Required Qualifications Active, unrestricted Registered Nurse (RN) license in the state of Michigan required.

Minimum 3+ years of clinical practice experience (hospital, home health, or ambulatory care).

Experience in healthcare and/or managed care industry required.

Strong computer skills with the ability to navigate multiple system.

Ability to work independently in a remote environment and adapt to a fast-paced, metrics-driven setting.

Preferred Qualifications Case management experience preferred.

Experience managing chronic conditions (e.g., diabetes, hypertension, asthma).

Experience working with Children’s Special Health Care Services (CSHCS) population preferred.

Experience with motivational interviewing and patient engagement strategies.

Keywords: RN case manager, telephonic case manager, nurse case manager, managed care, care coordination, chronic disease management, utilization management, population health, remote RN, healthcare coordination, patient advocacy, case management, Michigan RN

A-Line Staffing is now hiring Case Manager RN in the Dayton, Ohio area.

The Case Manager RN would be working for a Fortune 500 company and has career growth potential.

This would be full time / 40 hours per week.
**Must reside in the Montgomery, Greene, or Clark County, Ohio area
- Position will be hybrid and F2F, Home visits are required (2 times a week); mileage reimbursement is provided
** Case Manager RN Compensation: The pay for this position is $38
- $45 hourly plus mileage reimbursement Benefits are available to full-time employees after 90 days of employment A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates Case Manager RN Highlights: The required availability for this position is as follows: Monday
- Friday 8am ??? 5pm Must reside in Montgomery, Greene, or Clark County, Ohio
- Position will be hybrid and F2F, Home visits are required (2 times a week); mileage reimbursement is provided Case Manager RN Responsibilities: Assessments, visits, obtaining home care, DME???s, work with delegated vendor, and computer work.

Performance expectations/metrics: Must meet productivity of 200 notes a month and must-see members face to face Case Manager RN Requirements: Must have an active and clear license in Ohio as a Registered Nurse 2+ years of Case Management experience Experience with electronic medical health records, and Microsoft office programs Valid driver's license and reliable transportation Case Manager RN Preferred Qualifications: Managed care experience Home health, discharge planning, or long-term care experience preferred If you are interested in this Case Manager RN position, please apply to this posting!