What Does A Case Manager Do For The Elderly Jobs in Usa
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Company Description
Lakeside Manor is a health care assisted living facility located in Staten Island, NY. Our facility is dedicated to providing high-quality care and support to our residents. We are committed to creating a warm and welcoming environment where individuals can thrive and recover.
Role Description
This is a part-time on-site role for a Case Manager at Lakeside Manor in Staten Island, NY. The Case Manager will be responsible for coordinating care plans, conducting assessments, writing notes and ensuring quality care delivery.
Qualifications
- Case Management, Care Coordination, and Assessments skills
- Excellent communication and interpersonal skills
- Ability to advocate for patients and work in a team environment
- Knowledge of healthcare regulations and patient rights
- Bachelor's degree in Social Work, Psychology, or related field a plus
- Experience in a healthcare or long-term care setting is a plus
$20-$25 an hour depending on experience and education.
Flexible hours
Certification Details
- BLS
- California RN License
Job Details
- Utilization Review Nurse II represents the fully experienced level in utilization review and discharge planning activities.
- Obtains and evaluates medical records for in-patient admissions to determine if required documentation is present.
- Obtains appropriate records as required by payor agencies and initiates Physician Advisories as necessary for unwarranted admissions.
- Conducts on-going reviews and discusses care changes with attending physicians and others.
- Formulates and documents discharge plans.
- Provides on-going consultation and coordination with multiple services within the hospital to ensure efficient use of hospital resources.
- Identifies pay source problems and provides intervention for appropriate referrals.
- Coordinates with admitting office to avoid inappropriate admissions.
- Coordinates with clinic areas in scheduling specialized tests with other health care providers, assessing pay source and authorizing payment under Medically Indigent Adult program as necessary.
- Reviews and approves surgery schedule to ensure elective procedures are authorized.
- Coordinates with correctional facilities to determine appropriate use of elective procedures, durable medical goods and other services.
- Answers questions from providers regarding reimbursement, prior authorization and other documentation requirements.
- Learns the documentation requirements of payor sources to maximize reimbursement to the hospital.
- Keeps informed of patient disease processes and treatment modalities.
- Level II teaches providers the documentation requirements of payor sources to maximize reimbursement to the hospital.
- Level II may assist in training Utilization Review Nurse I's.
- Knowledge of payor source documentation requirements and governmental regulations affecting reimbursement; knowledge of acute care nursing principles, methods and commonly used procedures; knowledge of common patient disease processes and the usual methods for treating them; knowledge of medical terminology, hospital routine and commonly used equipment; knowledge of acute hospital organization and the interrelationships of various clinical and diagnostic services.
- Ability to effectively evaluate the medical records of hospital admissions regarding continuing stay necessity, appropriateness of setting, delivered care, use of ancillary services and discharge plans.
- Ability to assess and judge the clinical performance of physicians and other health professionals.
- Ability to communicate documentation needs in an effective and tactful manner that promotes cooperation.
- Ability to teach co-workers what is needed and required in the medical record for reimbursement and audit purposes.
- Ability to gather and analyze data and prepare reports and recommendations based thereon.
- Ability to get along with physicians, other health providers, outside payor sources and the general public.
- Performs other job related duties as assigned.
Job Requirements
- Possession of a valid license as a Registered Nurse in the State of California.
- Level I: two (2) years of experience or its equivalent as a registered nurse in an acute care hospital, at least one (1) of which was on a medical/surgical ward or unit.
- Level II: one (1) year of utilization review/discharge planning experience in an acute care hospital or as a Case Manager in an alternate medical setting such as a clinic or physician’s office performing utilization review or discharge planning.
- Alternatively, possession of a valid license as a Registered Nurse in the State of California and five (5) years of experience as a Case Manager in an alternate medical setting such as a clinic or physician’s office performing utilization or discharge planning.
- Incumbents may be required to possess and maintain specific certificates competency based on unit specific requirements as a condition of employment.
Additional Details
- Case management experience in California (excluding Kaiser), preferably more than 1 assignment.
- Able to do both Utilization review and Care Coordination/Discharge planning.
- Experience in acute care/ICU/ED units.
- Extra: Trauma facilities experience.
- Experience with teaching facilities.
We are committed to empowering those we serve to live as independently as possible, be included in their communities, and reach their full potential.
This mission extends to our employees, who bring our mission to life each day.
We actively strive to be a workplace that honors the unique experiences, perspectives, and strengths of our employees.
We believe we are stronger, better, and more effective in our pursuits when we create space for everyone to be their authentic selves.
Benchmark Human Services has grown to become one of the most respected leaders in the country in the areas of intellectual and developmental disabilities (IDD) and behavioral health.
We work with people of all ages at home, at work, and in the community through residential programs, employment services, crisis response, early intervention, and more.
View our 65 Years of Stories campaign to learn more about the impact Benchmark employees have made across the country.
Benchmark is looking for a Case Manager to work in the Southeast Region of SD.
Position is remote -- candidates must live in South Dakota.
GENERAL RESPONSIBILITIES Provide resources and support to individuals with intellectual and developmental disabilities, their families and guardians in order for the individual to be included in society, live as independently as possible and function at their maximum potential.
The focus of the position is to provide services to individuals with intellectual disabilities with the goal of linking individuals and their families to resources to ensure the individuals overall health, safety and well-being.
BENEFITS Health, vision and dental insurance Life Insurance 401k plan with company match Profit sharing Tuition Reimbursement Paid Time Off and Sick Time Pay Flexible Spending Accounts (FSA) Advancement Opportunities ESSENTIAL FUNCTIONS AND RESPONSIBILITIES Follow all policies and procedures set forth by the company, South Dakota Department of Human Services, Division of Developmental Disabilities, Home and Community Based Services (HCBS) rules.
Perform evaluations and assessments to meet the needs of individuals served.
Assist individuals served with applying for financial assistance, residential planning, vocational, recreational and educational desires, healthcare, in home supports, day services, legal, nutrition, transportation, social, and other related services and resources.
Advocate for services that will support the individual’s success.
Maintain all case records.
Prepare, update and monitor person centered plans including utilization of discovery through Charting the Life Course and Person-Centered Thinking (PCT) Tools.
Provide support to individuals so they can participate in and direct the person-centered plan development process.
Coordinate meetings with individual, families and guardians, and members of the interdisciplinary team as required.
Establish and maintain positive relationships with individual, families, guardians, state officials and team members.
Record work and billing time in accordance with company policies.
Track, monitor and enter specified data points.
Report any suspected abuse, neglect or exploitation immediately to supervisor or department head.
Comply with all standards to assure the health and safety of all individuals.
QUALIFICATION A degree in the human services field is preferred or a minimum of 2 years working in health or human services.
The candidate must have a valid driver's license and maintain auto insurance.
The candidate must demonstrate excellent communication skills.
Candidates must live in South Dakota Interested candidates can apply online at /Careers Benchmark Human Services is an EOE/AAP Employer.
Veterans, women, and individuals with disabilities are encouraged to apply.
Candidates selected for hire will be required to complete a background check in accordance with company policy and applicable laws.
INDMGR
Company Description
Homecare Hub offers a unique solution for people with caregiving needs, focusing on small shared care and co-living environments to help individuals stay out of large institutional nursing facilities. Whether in existing care homes or customized on-demand setups, Homecare Hub provides superior, safe, and affordable care options. The innovative approach allows individuals to age with dignity in their community. Homecare Hub also partners with Health Systems to discharge patients from hospitals who are unable be safely cared for in their existing home environment.
Homecare Hub is arriving in Eastern Tennessee, and will partner with Ballad Health to discharge patients from their health system into Homecare Hub's network of personalized, small, residential assisted living homes.
Here are examples of other hospital partnerships: Description
This is a hybrid role for a case manager & care coordination position at Homecare Hub. This individual will help with placement of patients into small homes, and as well oversee a cohort of patients and assuring their clinical healthcare and non-clinical needs are met.
This hybrid role is located in Johnson City, TN with occasional travel across the state. Most in person work will be local, and there will be a component of work from home as well.
Qualifications
- We are seeking a social worker, Nurse, PT, or OT.
- Experience in the healthcare or caregiving industry
- Knowledge of Medicaid and Medicare and various plans
- Knowledge of Support and Social Services in the Johnson City Region
- Excellent bedside patient communication, interpersonal, and leadership skills.
- Technology skills
- Financial Counseling skills are advantageous
- Bachelor's or Master's degree in Nursing or Social work or OT/PT
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
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.
The RN Acute Care Inpatient Case Manager would be working for a Major Hospital System and has career growth potential.
RN Acute Care Inpatient Case Manager Highlights: Schedule: M-F 8:00 AM
- 4:00 PM (may require weekend coverage) Pay Range: $55-60 Hourly Registered Nurse Acute Care Inpatient Case Manager Responsibilities: Coordinates patients through the acute care hospitalization Manages all aspects of discharge planning and transition process Performs utilization management and quality screenings Registered Nurse Acute Care Inpatient Case Manager Qualifications: 2 years of recent inpatient acute care experience Recent Inpatient Case Management experience BSN degree Active NJ RN license in good standing CCMC preferred If you are interested in this Registered Nurse Acute Care Inpatient Case Manager position, please apply to this posting with Luke H.
at A-Line!
Make a Difference on Your Own Schedule and Terms!
Hiring Case Managers in WashingtonCome join our growing team! A few of our perks:
Create your own schedule!
Great Work/Life balance!
$42/hr. (including 100% of Hourly Wage Paid for Drive Time)
Benefits Available (Paid Time Off, Medical, Dental, Vision, Matching 401k)
We provide in-home care to former Nuclear Weapons Workers who are suffering from chronic and terminal illnesses, as a result of their previous work environment.
Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with chronic/terminal illness due to exposure to toxic substances while working for the Government. The nursing visits are conducted weekly and typically last 1-2 hours per visit. During the visits, the RN-Case Managers do physical assessments including vitals, ensure home safety with medical equipment and supplies, fill weekly medication planners and oversee skilled and non-skilled caregivers providing care in the client's home.
Benefit from one-on-one patient relationships and from the satisfaction of enhancing clients' health, quality of life and peace of mind. You make your own schedule - that leaves you with time to attend school, travel, volunteer or to enjoy activities with your family and friends.
Qualifications
Graduate of a state approved school of professional registered nursing
BSN preferred
Current, unrestricted RN license in the state(s) of practice
Minimum of two (2) years nursing experience including one (1) year in home care or closely related field
One (1) year of supervisory and/or case management experience preferred
Current CPR certification
Essential Functions/Areas of Accountability
Responsible for functions and accountabilities as contained in the case manager job description
Provide direct care and case management of assigned clients
Assist and collaborate with the regional director and other personnel to identify and correct issues and/or improve services.
Plan, implement, and evaluate care provided Participate, coordinate and manage client care conferences as needed.
Serve as a local on-site clinical resource as needed and provides support to ensure client's home care needs are met.
Assist and collaborate with staffing coordinators regarding the appropriateness of staffing and scheduling of personnel within scope of practice, competencies, client needs and complexity of home care.
Adhere to nursing delegation guidelines as described in Agency Scope of Practice policy.
Ensure adherence to Agency policies.
Perform other functions as requested by the regional director which may include the following:
Participate in interviewing, selection, and ongoing evaluation of clinical personnel as requested by the Regional Director
Personnel training, education, and competency validation
Review and evaluate clinical documentation for accuracy and completeness
Participate in all Agency performance improvement initiatives including but not limited to quarterly medical record review
Collect, document, and submit data on infections, occurrences, complaints and grievances, and performance improvement activities
Perform and document supervisory visits as indicated to facilitate problem resolution
Review nurse shift reports for adherence to policy and for opportunities for performance improvement
Home chart completeness
Timeliness of staffing cases post referral
Equipment tracking
Assist with marketing activities such as visiting with clients or physicians to discuss Agency programs as requested
The senior case manager, or similarly qualified alternate, shall be available at all times during operating hours and participate in all activities relevant to the professional services furnished, including the development of qualifications and the assignment of personnel.
Perform additional duties and responsibilities as deemed necessary
Available Benefits Include
Medical
Dental
Vision
401(k)
Company Paid Short Term Disability
Flexible Spending Account (FSA)
Health Savings Account (HSA)
Paid Time Off
Voluntary Benefits
Professional Case Management is an Equal Opportunity Employer.
Make a Difference on Your Own Schedule and Terms!
Hiring Senior Case Managers in WashingtonPCM is looking for a Senior Case Manager who is as passionate about delivering care as we are to come join our amazing team!
A few of our perks:
Great Work/Life balance!
$44-$46 per hour (including 100% of Hourly Wage Paid for Drive Time)
Benefits Available:
Medical, Vision and Dental Insurance
Accrued Paid Time Off
Annual Bonus Eligible
Health Savings Account (HSA)
Flexible Savings Account (FSA)
401(K) with Company Match
Paid Parental Leave
Unlimited Peer Referral Program
Employee Discount Program
We provide in-home care to former Nuclear Weapons Workers who are suffering from chronic and terminal illnesses, as a result of their previous work environment.
Our Senior RN-Case Managers Direct assigned team members of RN Case Managers in the provision of care in accordance with Agency policy and with state-specific nurse practice act, and regulatory requirements.
Qualifications
Graduate of a state approved school of professional registered nursing
BSN preferred
Current, unrestricted RN license in the state(s) of practice
Minimum of two (2) years nursing experience including one (1) year in home care or closely related field
One (1) year of supervisory and/or case management experience preferred
Current CPR certification
Essential Functions/Areas of Accountability
Responsible for functions and accountabilities as contained in the case manager job description
Provide direct care and case management of assigned clients
Assist and collaborate with the regional director and other personnel to identify and correct issues and/or improve services.
Plan, implement, and evaluate care provided Participate, coordinate and manage client care conferences as needed.
Serve as a local on-site clinical resource as needed and provides support to ensure client's home care needs are met.
Assist and collaborate with staffing coordinators regarding the appropriateness of staffing and scheduling of personnel within scope of practice, competencies, client needs and complexity of home care.
Adhere to nursing delegation guidelines as described in Agency Scope of Practice policy.
Ensure adherence to Agency policies.
Perform other functions as requested by the regional director which may include the following:
Participate in interviewing, selection, and ongoing evaluation of clinical personnel as requested by the Regional Director
Personnel training, education, and competency validation
Review and evaluate clinical documentation for accuracy and completeness
Participate in all Agency performance improvement initiatives including but not limited to quarterly medical record review
Collect, document, and submit data on infections, occurrences, complaints and grievances, and performance improvement activities
Perform and document supervisory visits as indicated to facilitate problem resolution
Review nurse shift reports for adherence to policy and for opportunities for performance improvement
Home chart completeness
Timeliness of staffing cases post referral
Equipment tracking
Assist with marketing activities such as visiting with clients or physicians to discuss Agency programs as requested
The senior case manager, or similarly qualified alternate, shall be available at all times during operating hours and participate in all activities relevant to the professional services furnished, including the development of qualifications and the assignment of personnel.
Perform additional duties and responsibilities as deemed necessary
Professional Case Management is an Equal Opportunity Employer.
Make a Difference on Your Own Schedule and Terms!
Hiring Case Managers in WashingtonCome join our growing team! A few of our perks:
Create your own schedule!
Great Work/Life balance!
$42/hr. (including 100% of Hourly Wage Paid for Drive Time)
Benefits Available (Paid Time Off, Medical, Dental, Vision, Matching 401k)
We provide in-home care to former Nuclear Weapons Workers who are suffering from chronic and terminal illnesses, as a result of their previous work environment.
Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with chronic/terminal illness due to exposure to toxic substances while working for the Government. The nursing visits are conducted weekly and typically last 1-2 hours per visit. During the visits, the RN-Case Managers do physical assessments including vitals, ensure home safety with medical equipment and supplies, fill weekly medication planners and oversee skilled and non-skilled caregivers providing care in the client's home.
Benefit from one-on-one patient relationships and from the satisfaction of enhancing clients' health, quality of life and peace of mind. You make your own schedule - that leaves you with time to attend school, travel, volunteer or to enjoy activities with your family and friends.
Qualifications
Graduate of a state approved school of professional registered nursing
BSN preferred
Current, unrestricted RN license in the state(s) of practice
Minimum of two (2) years nursing experience including one (1) year in home care or closely related field
One (1) year of supervisory and/or case management experience preferred
Current CPR certification
Essential Functions/Areas of Accountability
Responsible for functions and accountabilities as contained in the case manager job description
Provide direct care and case management of assigned clients
Assist and collaborate with the regional director and other personnel to identify and correct issues and/or improve services.
Plan, implement, and evaluate care provided Participate, coordinate and manage client care conferences as needed.
Serve as a local on-site clinical resource as needed and provides support to ensure client's home care needs are met.
Assist and collaborate with staffing coordinators regarding the appropriateness of staffing and scheduling of personnel within scope of practice, competencies, client needs and complexity of home care.
Adhere to nursing delegation guidelines as described in Agency Scope of Practice policy.
Ensure adherence to Agency policies.
Perform other functions as requested by the regional director which may include the following:
Participate in interviewing, selection, and ongoing evaluation of clinical personnel as requested by the Regional Director
Personnel training, education, and competency validation
Review and evaluate clinical documentation for accuracy and completeness
Participate in all Agency performance improvement initiatives including but not limited to quarterly medical record review
Collect, document, and submit data on infections, occurrences, complaints and grievances, and performance improvement activities
Perform and document supervisory visits as indicated to facilitate problem resolution
Review nurse shift reports for adherence to policy and for opportunities for performance improvement
Home chart completeness
Timeliness of staffing cases post referral
Equipment tracking
Assist with marketing activities such as visiting with clients or physicians to discuss Agency programs as requested
The senior case manager, or similarly qualified alternate, shall be available at all times during operating hours and participate in all activities relevant to the professional services furnished, including the development of qualifications and the assignment of personnel.
Perform additional duties and responsibilities as deemed necessary
Available Benefits Include
Medical
Dental
Vision
401(k)
Company Paid Short Term Disability
Flexible Spending Account (FSA)
Health Savings Account (HSA)
Paid Time Off
Voluntary Benefits
Professional Case Management is an Equal Opportunity Employer.
