Professional Case Management Remote Jobs in Usa

Case Management Director

Ottumwa, IA

Full Time

Must-Haves

Graduate of a program of Registered Nursing.

Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost / quality management program.

Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa

The Director of Case Management’s primary responsibilities include: The manager of case management is responsible and accountable for the implementation of the case management program at the hospital level. The components/roles of the inpatient case management program consist of the following: care facilitation, utilization management, case management and discharge planning.

SUPERVISES – Case Managers and Social Workers

DUTIES INCLUDE BUT ARE NOT LIMITED TO

• Provide leadership, education and supervision for the day to day workflow of Case Managers and Social Workers.
• Monitor Case Management Department’s documentation to ensure meets regulatory compliance.
• Collaborate with Chief Financial Officer and Quality Department to develop and maintain quality improvement programs and trending of data (e.g. Avoidable Days , Readmissions) .
• Maintain skills in case management and utilization review to allow for coverage of patient caseload to cover staffing needs of all areas of hospital.
• Communicate with physicians concerning patient needs and aid with development of appropriate plan of treatment and assist with level of care and bed placement assignments .
• Directly responsible for personnel actions including hiring, performance appraisals ,employee schedules, and maintain payroll records and time reports in KRONOS.
• Facilitate daily Multidisciplinary Rounds to provide collaboration with other disciplines to provide holistic patient care.
• Participate in discharge planning. Provides necessary education and resources to meet the discharge needs of individual patients and families.
• Active participant of Utilization Review Committee and Revenue Recycle Committee.
• Promote efficient utilization of clinical resources.
• Promotes the appropriate amount of resources are used based on patient acuity.
• Assures appropriate level of understanding, awareness and compliance with all applicable Joint Commission, CMS, state and local agency laws, internal/external regulations, guidelines, policies, procedures and professional standards.
• Other duties as assigned.

KNOWLEDGE, SKILLS & ABILITIES

• Working knowledge of payer requirements and discharge planning regulations that support the effect for the development of departmental policies, procedures and standards .
• Working knowledge of Medicare, managed care, inpatient, outpatient and home health continuum, as well as utilization management , discharge planning and case management .
• Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes.
• Working knowledge of concepts of associated with performance improvement.
• Self-motivated, proven communication skills, assertive, able to work independently and as a team member.
• Demonstrated effective working relationships with physicians.

EDUCATION

• Graduate of a program of Registered Nursing.
• Bachelor of Science in Nursing degree preferred.

EXPERIENCE

• Minimum of two years of Case Management experience in utilization management, case management, discharge planning or other cost/quality management program.
• Two to three years previous management experience is preferred with minimum of two years’ experience in hospital- based nursing.

CERTIFICATE / LICENSE

• Iowa Mandatory Reporter – Child and Dependent Adult Abuse Certificates
• Current RN license in the state of Iowa or a multistate license allowing to work in the state of Iowa

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.

Job Summary

Reports to and is under direct supervision of Case Management Department. Provides ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. Promotes continuity of care and cost effectiveness through the integrating and functions of case management.

• Coordinates discharge planning to assure that the patient progresses through the continuum of care and is discharged to the least restrictive environment.
• Coordinate the hospital activities concerned with case management and discharge planning.
• Ensure compliance with quality patient care and regulatory compliance.

Required: 

• Minimum of two (2) years utilization review/case management experience or social work experience.

Preferred: 

• Associate degree in healthcare related filed.
• Bachelor’s degree is preferred.
• Licensed professional nurse may be considered.
• Bachelors or Masters Degree in related healthcare field (such as respiratory therapy or social work) may be considered.

Required: 

• Maintain current professional licensure in nursing or professional filed of certification.

Preferred: 

• Appropriate certification in the case management preferred (e.g. Commission for Case Management Certification (CCMC) or Association of Rehabilitation Nurses).

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.

Successful candidates might be required to undergo a background verification with an external vendor.

Req Id  97256 
Department  CASE MGMT 
Shift Days
Shift Hours Worked  7.50
FTE 0.94 
Work Schedule  NYSNA - 7.5 HR
Employee Status A1 - Full-Time 
Union 2004 - NYSNA
Pay Range $40.19 - $50.61/Hourly

Day-to-Day:

The Manager of Case Management is responsible for overseeing the daily operations of case management services, with a strong focus on discharge planning, staff leadership, and operational performance. This role requires strong leadership and communication skills, as the Senior Manager regularly collaborates with patients, physicians, executive leadership, and the case management team to ensure alignment, high‑quality outcomes, and effective patient flow. The Senior Manager ensures policy compliance, achievement of key performance metrics, and provides hands‑on support when operational demands require it.

Key Responsibilities

• Oversee the daily operations of discharge planning, ensuring timely, safe, and efficient patient transitions
• Manage staff scheduling and coverage, adjusting resources based on census, acuity, and operational needs
• Lead the implementation and ongoing adherence to policies and procedures, ensuring compliance with organizational and regulatory standards
• Partner with leadership and HR on hiring, onboarding, and performance management of case management staff
• Monitor, track, and analyze key performance indicators (KPIs) to drive operational efficiency, quality outcomes, and continuous improvement
• Collaborate with physicians, clinical teams, and executive leadership to address barriers to discharge and optimize patient flow
• Provide direct support on the floor as needed, stepping in during high‑volume or high‑acuity periods to ensure continuity of care and team support

Qualifications:

• RN OR a LSCW License
• 1+ years of formal leadership experience (nurse manager, director of nursing, etc..)
• 1+ years of hospital experience
• Professional presence, can present themselves in front of a board of executives

Registered Nurse - Case Management

Ashland, WI

Specialty: Case Management

Position Type: Travel

Contract Length: 13 weeks

Pay: $2498 - $3009 | Shift: 5x8 Days

Are you a skilled Case Management RN looking for your next adventure? Do you thrive in an acute care setting, providing exceptional patient support? Our healthcare partner in Ashland, WI, is seeking a dedicated Registered Nurse to join their team on a travel assignment. This is your chance to make a meaningful impact while exploring a new community.

As a Case Management RN, you will play a crucial role in coordinating patient care and ensuring the best outcomes. Your responsibilities will include:

• Utilizing InterQual criteria to assess and plan patient care
• Collaborating with interdisciplinary teams to develop comprehensive care plans
• Facilitating patient transitions and discharge planning
• Documenting patient information using the EPIC charting system
• Maintaining BLS (AHA) certification
• Need 1 year experience in setting

Apply today and let Capstone Health help you reach your full potential! At Capstone, we know that when healthcare professionals feel supported, they provide the best care for their patients. That's why we offer personalized recruiter support and comprehensive benefits to help you build a fulfilling career while maintaining a healthy work-life balance. Our travelers enjoy a range of traditional and modern benefits, including:

• Dedicated Recruiter
• $1,000 Unlimited Referral Bonus
• Medical, Dental, and Vision Insurance
• Complementary Life Insurance
• 401(k)
• Lodging and Meals & Incidental Reimbursement (with qualified tax home)
• Licensure/Certification Reimbursement
• Voluntary Insurance Benefits
• Completion Bonus
• Equal Employment Opportunity
• And more!

Stroke response times nearly half of the national average. Cutting-edge SPOT Technology that detects sepsis earlier than the human eye. An Enhanced Surgical Recovery program that reduces opioid prescriptions and post-surgical readmissions. As a national learning health system, we're transforming care delivery, advancing clinical outcomes, and empowering our nursing teams in a collaborative effort to give people a healthier tomorrow. Join us! 

Job Summary and Qualifications 

Responsible for providing high quality critical care including assessment, triage, and treatment utilizing standards and guidelines established by HCA Houston Healthcare AirLife Medical Director(s). The Flight Nurse assess the nature and extent of illness or injury to establish and prioritize the care needed for safe transport of the critical patient to the appropriate facility and are responsible for carrying out the mission and goals of HCA Houston Healthcare AirLife assuring that safety remains the highest priority throughout the transport continuum.

 What you will do in this role:

• Provides nursing care within his/her scope of practice from the initial contact until patient care is relinquished to the accepting medical facility; maintains thorough patient care documentation.
• Maintains competency in knowledge and psychomotor skills by participating in ongoing laboratory and clinical experiences. Communicates educational needs to the Clinical Director, Medical Transport. Maintains documentation of required licensure, certifications, continuing education, aviation and safety training, OSHA and HIPAA training, clinical rotations, and advanced procedures and attends continuing education programs pertinent to his/her area of practice.
• Knowledgeable in use and routine maintenance of all equipment and supplies used by HCA Houston Healthcare AirLife. Responsible for reporting medical equipment failures and taking initial steps to ensure repair of equipment as directed. Maintains adequate supplies onboard aircraft to deliver safe patient care. Keeps aircraft clean and orderly to ensure rapid response to all transport requests.
• Functions as a medical flight member by attending pre-mission briefings and mission debriefings and completing necessary documentation. Assists in pre-mission liftoff checklist and assists pilot as requested, i.e., radio, navigational, and visual observation activities. Complies with safety standards to assure safety of self, medical personnel, patient, and equipment and conducts aircraft safety briefings as needed.
• Participate in patient and referring institution follow-up and in planned outreach marketing and education activities
• Acts as a preceptor and/or participates in orientation of new employees and students as assigned and communicates program goals and objectives
• Participates regularly in HCA Houston Healthcare AirLife meetings, activities, projects and committees (to include research and publishing opportunities).
• Other Duties as assigned.

What qualifications you will need: 

• Graduate of an accredited school of nursing with a B.S.N or Master’s Degree
• Current licensure in Texas as an RN
• Five years professional nursing experience desirable.
• Certification in Case Management desirable. 

Benefits

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

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services 
• Wellbeing support, including free counseling and referral services 
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence 
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling 
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing 
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts 

Learn more about Employee Benefits 

Note: Eligibility for benefits may vary by location. 

HCA Houston Healthcare Medical Center is a 445+ bed acute care hospital located in the heart of central Houston, adjacent to the Medical Center and Museum District, and provides quality care for the greater Houston area. Established in 1975, our hospital has been serving Houston for more than 40 years. We provide a wide range of medical services, including cardiology, bariatrics, orthopedics, neurology, emergency care and more. Our comprehensive medical specialties are here to offer individualized care to every individual that walks through our doors. We also offer 24/7 emergency services and two intensive care units: surgical intensive care unit (SICU) and medical intensive care unit (MICU). We are an accredited Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Center and an accredited Chest Pain Center with Primary PCI. We are members of HCA Houston Healthcare, the most comprehensive family of hospitals in the region and part of the leading provider of healthcare in the country, HCA Healthcare. Together we are stronger, smarter and more accessible in providing the patient-centered care you need close to home.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder 

Join a family that cares about every stage in your career! We are interviewing candidates for our Supv Case Management RN opening. Apply today and a member of our Talent Acquisition team will reach out. 

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.

JOB DESCRIPTION

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

Required Qualifications

#PJHS

#LI-AC1

Pay Range: $25.08 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Make a Difference on Your Own Schedule and Terms!

PCM is looking for a Senior Case Manager who is as passionate about delivering care as we are to come join our amazing team!

A few of our perks:

• Great Work/Life balance!

• $42 per hour (including 100% of Hourly Wage Paid for Drive Time)

• Benefits Available:

  • Medical, Vision and Dental Insurance

  • Accrued Paid Time Off

  • Annual Bonus Eligible

  • Health Savings Account (HSA)

  • Flexible Savings Account (FSA)

  • 401(K) with Company Match

  • Paid Parental Leave

  • Unlimited Peer Referral Program

  • Employee Discount Program

We provide in-home care to former Nuclear Weapons Workers who are suffering from chronic and terminal illnesses, as a result of their previous work environment.

Our Senior RN-Case Managers Direct assigned team members of RN Case Managers in the provision of care in accordance with Agency policy and with state-specific nurse practice act, and regulatory requirements.

Qualifications

• Graduate of a state approved school of professional registered nursing

• BSN preferred

• Current, unrestricted RN license in the state(s) of practice

• Minimum of two (2) years nursing experience including one (1) year in home care or closely related field

• One (1) year of supervisory and/or case management experience preferred

• Current CPR certification

Essential Functions/Areas of Accountability

• Responsible for functions and accountabilities as contained in the case manager job description

• Provide direct care and case management of assigned clients

• Assist and collaborate with the regional director and other personnel to identify and correct issues and/or improve services.

• Plan, implement, and evaluate care provided Participate, coordinate and manage client care conferences as needed.

• Serve as a local on-site clinical resource as needed and provides support to ensure client's home care needs are met.

• Assist and collaborate with staffing coordinators regarding the appropriateness of staffing and scheduling of personnel within scope of practice, competencies, client needs and complexity of home care.

• Adhere to nursing delegation guidelines as described in Agency Scope of Practice policy.

• Ensure adherence to Agency policies.

• Perform other functions as requested by the regional director which may include the following:

• Participate in interviewing, selection, and ongoing evaluation of clinical personnel as requested by the Regional Director

• Personnel training, education, and competency validation

• Review and evaluate clinical documentation for accuracy and completeness

• Participate in all Agency performance improvement initiatives including but not limited to quarterly medical record review

• Collect, document, and submit data on infections, occurrences, complaints and grievances, and performance improvement activities

• Perform and document supervisory visits as indicated to facilitate problem resolution

• Review nurse shift reports for adherence to policy and for opportunities for performance improvement

• Home chart completeness

• Timeliness of staffing cases post referral

• Equipment tracking

• Assist with marketing activities such as visiting with clients or physicians to discuss Agency programs as requested

• The senior case manager, or similarly qualified alternate, shall be available at all times during operating hours and participate in all activities relevant to the professional services furnished, including the development of qualifications and the assignment of personnel.

• Perform additional duties and responsibilities as deemed necessary

Professional Case Management is an Equal Opportunity Employer.

POSITION SUMMARY AND RESPONSIBILITIES

Conducts comprehensive clinical reviews of adverse determinations related to medical necessity. Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making.  Provides support for claim appeals in relation to medical necessity.  Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards.  Facilitates member second level appeal process.

EDUCATION/EXPERIENCE

Graduate from an accredited school of professional nursing is required.  BSN preferred.  Minimum 2 years acute care experience or managed care experience is required.  Basic knowledge of Medicaid, Medicare preferred.  Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.

LICENSURE

Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required.  Active Certification in Case Management (CCM) is preferred.

 

Location Address:

Compensation Pay Range:

Summary:

How you grow, learn and thrive matters here.
• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
• Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
• Malpractice liability insurance
• Loan forgiveness through the New Mexico Higher Education Department
• EPIC electronic charting system

Responsibilities:

• Identifies cases appropriate for case management. Educates providers and other PHS/PHP departments on case management services. Screens new referrals for case management appropriateness.
• Conducts in-depth assessment which includes, but is not limited to, psychosocial, physical, medical, environmental and financial parameters. Advocates for members in caseload
• Identifies cases appropriate for case management. Educates providers and other PHS/PHP departments on case management services. Screens new referrals for case management appropriateness.
• Conducts in-depth assessment which includes, but is not limited to, psychosocial, physical, medical, environmental and financial parameters. Advocates for members in caseload.
• Formulates, implements, coordinates, monitors, and evaluates strategies for patients and families collaboratively with members, families and health care teams. Develops, documents and implements plans which provide appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs.
• Actively participates in the development of clinical guidelines and pathways and incorporates processes into the role of case managers.
• Educates providers on health management strategies which can reduce need for one-on-one case management services. Educate physicians, nurses, ancillary support staff, patients, and families regarding case management role.
• Refers patients to appropriate inpatient, outpatient, and community resources.
• Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and patient satisfaction. Collect clinical path variance data that indicate potential areas for improvement of case and services provided within the system. Generates reports, which demonstrate efficacy through direct cost-savings and outcome measures.
• Complies with Case management Society of America Standards for Case Management Practice and with CCMC code of Professional Conduct for Case Managers.
• Performs other functions as required.

Qualifications:

*Associates Degree in Nursing

*State of New Mexico or Compact State Nursing License

*BLS certification REQUIRED at at time or hire

*Five years of experience in clinical nursing with a minimum of three to five in case management, utilization management, quality assurance, home care, community health, or occupational health.

*CCM certification within 3 years of hire. 

*Employee Health experience preferred. 

We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

Learn more about our employee benefits.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

Do you currently have an opportunity to make a real impact with your work? With over 2,000 sites of care and serving over 31.2 million patient interactions every year, nurses at Valley Regional Medical Center have the opportunity to make a real impact. As a(an) Registered Nurse RN Case Manager you can be a part of change.

Valley Regional Medical Center, 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.

It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential and see how rewarding it can be to reach your personal and professional goals. Help to advance the practice of nursing and improve positive outcomes for your patients as a (an) Registered Nurse RN Case Manager. We want your knowledge and expertise!

We are seeking a RN Case Managerfor our facility to ensure that we continue to provide all patients with high quality, efficient care. We are an amazing team that works hard to support each other, and we are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply now!

What You Will Do In Your Role:

• You will be responsible for promoting patient-centered care by coordinating all aspects of hospital-based case management for his/her assigned area of responsibility in alignment with the goals of the Case Management Department
• You will be accountable for the overall day-to-day oversight and management of the case management program including coordination, supervision, and administrative oversight of the case management team
• You will function as an expert clinical practitioner, case management subject-matter expert, resource, advisor and leader for the members of the case management team
• You will supervise and monitor professional and support staff and ensures that effective care coordination and case management practices are consistent with hospital policies, and applicable regulations and guidelines
• You will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization

• Basic Cardiac Life Support must be obtained within 30 days of employment start date
• (RN) Registered Nurse
• Masters Degree, or Bachelors Degree, or Associate Degree
• 3+ years of RN experience in an acute care setting
• Case Management experience preferred

Founded as Valley Community Hospital in 1975, Valley Regional Medical Center proudly serves Brownsville, TX and the surrounding communities in the Rio Grande Valley. Valley Regional Medical Center is a licensed 215+ bed facility with over 200 physicians representing 25+ specialties. From emergency medicine, to diagnostic imaging services, and caring for newborn babies, Valley Regional Medical Center is the hospital that families count on when they are looking for quality healthcare close to home. We are a designated Advanced Level III Trauma Center and an Advanced Primary Stroke Center. Our Heart and Vascular services include a full-range of cardiac services including minimally invasive and open-heart surgery, cardiac cath lab, heart imaging services and more. Our women’s department includes labor, delivery and recovery in a home-like setting. We also have a C-section operating room on standby 24 hours a day and a Level III Neonatal Intensive Care Unit equipped with specially trained staff. Innovation and an unwavering commitment to patient care are the cornerstones of our hospital. Come experience our family centered culture at Valley Regional.

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.

Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our Registered Nurse RN Case Manager opening. Submit your application today and help advance the practice of nursing.

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.

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

• 
  
• Ensures consistent care along the entire health care continuum by assessing and closely monitoring members’ needs and status.
  
• Authorizes covered services and coordinates care regardless of payer.
  
• Collaborates and communicates with member/family/caregivers, primary care practitioners, and the interdisciplinary team.
  
• Works with member/family to maintain the most independent living situation possible
  
• Assesses, plans and provides continuous care management across all venues of care, including hospital, sub-acute, long-term and home settings.
  
• Regularly assesses members for ongoing eligibility for services based on the specific plan’s eligibility criteria.
  
• Performs home visits as required to assess members’ living situation, cultural influences, functional and cognitive needs.
  
• Collaborates with the primary care physician and Inter-Disciplinary Team (IDT) to develop the Patient Centered Service Plan for the member.
  
• Ensures appropriate, safe plan for members’ discharge from their plan.
  
• Identifies same day grievances, investigates and documents accordingly. Documents any grievance according to plan policy.
  
• Identifies and presents members with complex care management needs or in difficult to manage situations at Intensive Care management meetings (ICM).
  
• Responds to members’ requests in the designated timeframes and completes Initial Adverse Determinations (IAD) as indicated
  
• Identifies members requiring Care Management Review (CMR), evaluates documentation provided by the IDT including hospital or nursing home discharges planners, and formulates appropriate plan of care.
  
• Documents care management/coordination according to company policy to the specific plan the member is enrolled in, which may include monthly telephonic and in person recertification notes.
  
• Develops efficient plans of care, authorizing only needed services at the most appropriate levels, utilizing network providers and ensuring that services are based on members’ needs.
  
• Perform any other job related duties as requested.
  

• 
  
• Associates degree in Nursing from an accredited nursing program required
  
• Bachelor's degree in Nursing preferred
  
• Three (3) years of experience as a registered nurse required
  
• Clinical experience in geriatrics and/or managed long-term care experience preferred
  
• Experience using multiple languages may be required based on operational needs
  

• 
  
• Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
  
• Ability to communicate effectively with a diverse group of individuals
  
• Ability to multi-task and work independently within a team environment
  
• Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
  
• Adhere to code of ethics that aligns with professional practice
  
• Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management practice
  
• Strong advocate for members at all levels of care
  
• Strong understanding and sensitivity of all cultures and demographic diversity
  
• Ability to interpret and implement current research findings
  
• Awareness of community & state support resources
  
• Critical listening and thinking skills
  
• Decision making and problem-solving skills
  
• Strong organizational and time management skills
  
• Bilingual speaking and writing skills are preferred
  

• 
  
• Current, unrestricted Registered Nurse licensure in the state of New York required
  
• Case Management Certification preferred
  

• 
  
• General office environment; may be required to sit or stand for extended periods of time
  
• Up to 25% (regular) travel may be required to travel to different locations, including homes, offices, or other public settings, to perform work duties
  

• 
  
• Medical: Multiple plan options.
  
• Dental: Delta Dental or reimbursement account for flexible coverage.
  
• Vision: Affordable plan with national network.
  
• Pre-Tax Savings: HSA and FSAs for eligible expenses.
  
• Retirement: Competitive retirement package to secure your future.
  

The Registered Nurse (RN) Case Manager works within an interdisciplinary team to facilitate the patient plan of care throughout the continuum of care by ensuring appropriate utilization management, care coordination, resource utilization, and clinical documentation. The RN Case Manager will function within the Mayo Clinical Nursing Professional Practice Model, which includes accountability for assessing, planning, implementing, evaluating, and communicating the patient care plan progression. The RN Case Manager utilizes the principles of mutual respect, patient/family advocacy and provides leadership within the team of internal partners and outside agencies to facilitate best practices that achieve quality clinical, financial, and patient satisfaction outcomes. The RN Case Manager provides leadership through education on case management/utilization management concepts, committee work, research, and community involvement. The RN Case Manager bridges communication between providers, patients and families, members of the interdisciplinary team, and outside agencies to assure high-quality care that meets the patient's needs and is delivered in a cost-effective and timely manner. The ANA Nursing: Scope and Standards of Practice and Code of Ethics provide a basis for the practice of the RN. The American Case Manager Association Standards of Practice and Scope of Services for Health Care Delivery System Case Management and Transitions of Care Professionals (2013) are reflected. 

This role is eligible for TN sponsorship. 

Arizona: Graduate of an accredited, or those in the candidacy process, baccalaureate nursing program, as recognized by the Accreditation Commission for Education in Nursing (ACEN), Commission on Collegiate Nursing Education (CCNE), National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). If graduated from a nursing program that was not accredited by ACEN,CCNE, and NLN CNEA, at least one year of RN experience in an applicable care setting is required. If graduation did not occur within the last two years, one year of RN experience in an applicable care setting is required or, effective October 1st, 2017 one year of current LPN experience at Mayo Clinic is required. One year of RN Case Management experience or successful completion of the MCSHS RN Case Manager Fellowship within six months of hire required.

 

• 3 years of acute nursing preferred; 1 year of Case Management experience preferred. Certification (CCM or ACM-RN) preferred. 
• Current RN license by applicable state requirements. 
• Arizona - Maintains Basic Life Support (BLS) competency. 
• Positions that are not on campus may not require current Basic Life Support (BLS) competency as determined by the work area.
• Additional state licensure(s) and/or specialty certification/training as required by the work area.
• Previous hospital case management experience preferred.                        
   

We are seeking a FORGE Lead Case Manager/Co-Facilitator to join our team.

Starting Salary: $56,000 (Salary)

Contingent Upon Funding- External Research Project. Employment is contingent upon its continued grant support.

We are seeking a FORGE Lead Case Manager/Co-Facilitator to join our team. The University of Kansas School of Social Welfare (KUSSW) and its partner, Cornerstones of Care, will develop and deliver the project, Family Opportunity, Resilience, Grit, Engagement - Fatherhood (Kansas FORGE Fatherhood). Kansas FORGE Fatherhood will serve fathers and father-figures raising a child by improving outcomes in healthy relationships, parenting practices, economic stability, and receive support in accessing community resources to long-term success.

The FORGE Lead Case Manager/Co-Facilitator works under the direction of the Manager of FORGE Fatherhood Project and is responsible for delivering the proposed program model, which includes the evidence-based Strengthening Father Involvement (SFI) curriculum, the evidence-informed financial program Money Habitudes (MH), and individualizing training based on participant's goals and needs as identified in case management. Additionally, the FORGE Lead Case Manager/Co-Facilitator provides case management to fathers and works closely with the Case Managers to ensure participants build relationship skills, gain positive parenting skills, and move towards economic stability.

WHAT YOU WILL DO:

• 
  
• Facilitate workshops, creating a supportive, culturally responsive, and flexible learning environment for fathers
  
• Ensure program implementation supports methods for fathers to work collaboratively with spouses or co-parents.
  
• Provide oversight and guidance to FORGE Case Managers.
  
• Manage a case load of father participants, developing individualized plans to assist them in obtaining healthy relationships, positive parenting skills, and economic stability.
  
• Connect fathers with community resources to assist them in meeting personalized goals.
  

WHAT YOU WILL BRING:

Our ideal candidate will have 2-5 years of child and families services experience and the following:

• 
  
• Bachelor's degree in social work or other human service-related field.
  

• 
  
• Master's degree in social work or other human service-related field and 2-5 years of work experience in child and family services. Licensed by the Behavioral Sciences Regulatory Board to practice in Kansas (LBSW, LMSW, LSCSW, Professional Counselor, LMFT, and/or Alcohol and Drug Counselor) preferred.
  

• 
  
• A valid driver's license in the state you reside in, proof of current vehicle insurance, and reliable transportation.
  

WHO WE ARE:

Cornerstones of Care is a mental and behavioral health nonprofit certified in trauma-informed care that provides evidence-based prevention, intervention, treatment, and support services to help children and families improve their safety and health by making positive changes in their lives. Each year, our team empowers children and families in Kansas, Missouri, and beyond through three key service areas:

• 
  
• Youth & Family Support - We help youth gain independence through social and living support programs while empowering families with the skills and resources they need to become resilient and successful.
  
• Foster Care & Adoption - We reunify and unite families while recruiting and providing support to foster parents and youth in foster care.
  
• Education & Community Trainings - We help students achieve academic success while giving educators the tools to create safe learning environments to improve their students' behaviors and offer innovative learning opportunities to build and improve knowledge in the community.
  

CORNERSTONES OF CARE'S ORGANIZATIONAL COMMITMENTS:

• 
  
• Nonviolence - helping to build safety skills and a commitment to a higher purpose.
  
• Emotional Intelligence - helping to teach emotional management skills.
  
• Social Learning - helping to build cognitive skills.
  
• Open Communication - helping to overcome barriers to healthy communication, learn conflict management.
  
• Democracy - helping to create civic skills of self-control, self-discipline, and administration of healthy authority.
  
• Social Responsibility - helping to rebuild social connection skills, establish healthy attachment relationships.
  
• Growth and Change - helping to work through loss and prepare for the future.
  

OUR BENEFITS:

Cornerstones of Care offers a competitive benefits package, which includes:

• 
  
• 9 Paid Holidays, Unlimited Paid Time Off, and Paid Sick Leave
  
• Team members who work at least 30 hours per week are eligible for
  
  • 
    
  • Health insurance benefits (medical, prescription, dental, vision)
    
  • Cafeteria plans (Health Savings Account (HSA) and Medical and Dependent Care Flexible Spending Accounts)
    
  • Ancillary insurance benefits (accident insurance, critical illness insurance, hospital indemnity insurance, short-term disability insurance, voluntary life)
    
  • Cornerstones of Care provides long-term disability insurance and basic term life/AD&D insurance at no cost to the team member
    
  
  
  
• Retirement savings plan (401K) with employer match
  
• Pet Insurance
  
• Employee assistance program (EAP)
  
• Tuition reimbursement program
  
• Public Service Loan Forgiveness.
  
• To view more information on our benefits, please visit our Job Openings page at Join Our Team - Cornerstones of Care to download the current benefits guide.
  

Questions?

Please contact: Cornerstones of Care, People Experience Team

8150 Wornall Rd., Kansas City, MO 64114

Phone: Fax:

Like us on Facebook at: cornerstonescareers

Employment Conditions:

Contingent Upon Funding - External Research Project. The project is supported by grant number 90ZJ0128 from the Children's Bureau within the Administration of Children and Families, a division of the U.S. Department of Health and Human Services. Employment is contingent upon its continued grant support[1][PN1] .

Cornerstones of Care is an Equal Opportunity Employer

We are an equal employment opportunity employer without regard to a person's race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status, or genetic information.

[1] The production of this job posting was supported by Grant Number 90ZJ0128-1 from the Administration for Children and Families (ACF). Its contents are solely the responsibility of the University of Kansas and do not necessarily represent the official view of ACF.

General Summary of Position

Serves as a member of the Case Management Team and applies RN clinical expertise and medical appropriateness to care coordination and discharge planning. Facilitates the delivery of quality cost effective patient-centered care from pre-admission through post-discharge timeframe. Ensures the care is designed to meet individualized patient outcomes. Monitors the care and services delivered to selected patient populations during the acute hospital stay promotes effective case management and utilization of resources and works to achieve optimal clinical and resource outcomes for the acute and post-hospital phases of care.

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.
• Collaborates with the multidisciplinary health care team to develop and coordinate the plan of care.
• Communicates with patient family and/or significant other health care team external case manager community resources and facility to address appropriate issues and patient/family goals.
• Demonstrates the ability to develop a plan of care that addresses needs across the continuum; have an intervention for problems identified; develop long- and short-term goals with specific time frames for resolution; identify specific services to be provided in the care plan; include the family/care-giver in the plan of care; and show life planning contingencies such as power of attorney and/or advance directives.
• Evaluates and documents the patient's response to the plan of care and achievement of outcomes. Makes recommendations for modifications to the plan of care as indicated. Adheres to all policies and procedures regarding documentation and confidentiality of information.
• Maintains knowledge of regulatory agencies' requirements necessary criteria for admission to various care settings and Medicare's/Medicaid's reimbursement methods for different levels of care.
• Manages a caseload of patients. Identifies essential resources needed to implement the plan of care.
• Manages own professional growth in the area of managed care care management other health care financial trends clinical practice and research.
• Manages patient care according to multidisciplinary plan of care and/or managed care contracts by directing decision making and identifying and managing barriers that impact on patient care outcomes.
• Participates in Performance and Service Improvement teams. Assists in program evaluation through customer service surveys LOS data analysis charge/discharge data comparison to state averages and best practice/benchmark data.
• Performs a comprehensive assessment in collaboration with interdisciplinary team to identify patient-specific problems and needs related to diagnosis treatment including psychosocial and financial concerns as well as medical.

Minimal Qualifications
Education

• Associate's degree in Nursing (ADN) required
• Bachelor's degree in Nursing (BSN) preferred

Experience

• Minimum of 2 years clinical experience in an acute care hospital setting required
• 1-2 years case management experience preferred

Licenses and Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure in the District of Columbia or Maryland depending on work location required
• CCM - Certified Case Manager preferred

Knowledge Skills and Abilities

• Ability to use computer to enter and retrieve data.
• Working knowledge of Microsoft Word Excel and PowerPoint applications.
• Effective verbal and written communication skills.
• Must be able to run and analyze departmental productivity reports.
• Excellent interpersonal skills required.