https://careers.cmsa.org Latest CMSA Career Center Jobs Thu, 30 Jul 2026 06:01:28 Z https://careers.cmsa.org/jobs/rss/22449045/director-of-care-management https://careers.cmsa.org/jobs/rss/22449045/director-of-care-management Far Rockaway, New York, WittKieffer is proud to partner with Episcopal Health Services (EHS) in the search for the next Director of Care Management. The role presents a compelling opportunity to lead care management within a mission-driven, community-focused health system serving one of New York City’s most diverse and underserved populations. Episcopal Health Services (EHS) includes St. John's Episcopal Hospital, a 257-bed acute care facility and the only hospital providing emergency and ambulatory care on the Rockaway Peninsula. St. John’s plays an essential role in ensuring access to high-quality, culturally sensitive care for a densely populated community with significant medical and socioeconomic needs. Supported by a network of outpatient sites, behavioral health services, and a robust medical group, EHS delivers comprehensive care across the continuum while maintaining strong partnerships with community organizations, elected officials, and labor groups. With more than 2,000 employees and a longstanding reputation for clinical excellence, education, and community outreach, the organization continues to expand its impact through facilities such as the Walsh Ambulatory Pavilion and a broad array of specialty and primary care services. Reporting to the Assistant Vice President of Case Management, the Director of Care Management will have the opportunity to lead and advance a critical function that directly influences patient outcomes, operational performance, and financial sustainability. This role is central to optimizing care coordination, strengthening utilization management, and ensuring regulatory compliance in a complex, high-volume environment. The Director will oversee a multidisciplinary team responsible for discharge planning, utilization review, and care transitions, with a focus on improving throughput, reducing length of stay and readmissions, and enhancing the overall patient and family experience. Partnering closely with physician leadership, nursing, finance, and external providers, the Director will help drive a more integrated, patient-centered model of care while aligning departmental priorities with broader organizational goals, including value-based care initiatives. This is a highly visible leadership position offering the ability to shape strategy and care protocol and to standardize care management practices across settings, including the implementation of data-driven performance improvement initiatives. The Director will be instrumental in strengthening relationships across the continuum of care, expanding post-acute networks, and leveraging technology and analytics to improve decision-making and outcomes. Ideal candidates will be energized by the opportunity to lead in a safety-net environment, where innovation, collaboration, and a deep commitment to community health are essential. EHS's Director of Care Management will play a pivotal role in advancing both the mission of the organization and delivery of coordinated high-quality care to the populations they serve. The expected salary range is $185,000 to $200,000. The salary range for this role may vary above or below the posted range. Compensation takes into account several factors including, but not limited to, a candidate's experience, education, skills, licensure and certifications, department equity, training, and organizational needs. Expressions of interest, nominations, and applications should be directed to Stephanie Odorisio via email: sodorisio@wittkieffer.com . All inquiries, applications and nominations will be held in the highest confidence. Thu, 23 Jul 2026 15:29:19 -0400 https://careers.cmsa.org/jobs/rss/22431717/rn-care-manager https://careers.cmsa.org/jobs/rss/22431717/rn-care-manager Glen Burnie, Maryland, RN Care Manager – Population Health  Maryland Primary Care Physicians, LLC  Position Summary  Maryland Primary Care Physicians (MPCP) is seeking a highly motivated and patient focused Registered Nurse (RN) Care Manager to support the organization’s Population Health and Value-Based Care initiatives. This role is responsible for coordinating comprehensive care management services for high-risk, medically complex, and chronically ill patients attributed to the Maryland Primary Care Program (MDPCP)/AHEAD model and other value-based care contracts, across multiple payer programs and population health models.  The RN Care Manager plays a critical role in improving clinical outcomes, reducing avoidable healthcare utilization, supporting care transitions, closing gaps in care, and enhancing the overall patient experience. Working collaboratively within an interdisciplinary team, the RN Care Manager provides patient education, care coordination, chronic disease management, motivational interviewing, and community resource support to promote patient engagement and long-term wellness. This position requires strong clinical judgment, organizational skills, population health knowledge, and the ability to effectively manage multiple priorities in a fast-paced primary care environment.  Key Responsibilities  Population Health & Value-Based Care: Support organizational initiatives related to population health, value-based care, and alternative payment models, including the Maryland Primary Care Program (MDPCP)/AHEAD model, other value-based care contracts, Medicaid, Medicare EQIP, and other payer-based programs. Utilize predictive analytics, population health reports, registries, and payer data to identify and proactively manage high-risk, high-utilization, and medically complex patients. Review and act on CRISP and other population health reporting tools, including predictive analytics related to avoidable hospital events, severe diabetes complications, hospice eligibility, and advanced care planning. Monitor and support site and provider performance related to quality metrics, preventive care, chronic disease management, and gap closure initiatives. Collaborate with Population Health leadership and analytics teams on monthly, quarterly, and annual reporting, quality improvement initiatives, patient engagement strategies, and performance optimization. Participate in Quality Improvement (QI), Safety, and Infection Control initiatives as directed by the Population Health team. Identify common patient needs and barriers among attributed patient populations and assist in developing interventions and resource strategies to improve outcomes. Care Management & Care Coordination: Provide longitudinal care management services for patients with chronic conditions, complex medical needs, and behavioral or social barriers to care. Conduct comprehensive patient assessments and develop individualized care plans, action plans, and goals in collaboration with patients, caregivers, and providers. Coordinate transitions of care following hospitalizations, emergency department visits, and skilled nursing facility discharges to reduce readmissions and improve continuity of care. Utilize motivational interviewing techniques and patient-centered communication strategies to support self-management and patient engagement. Assist patients with scheduling appointments, follow-up care, medication adherence, and coordination of specialty referrals and home-based services. Collaborate closely with physicians, advanced practice providers, pharmacists, behavioral health providers, care managers, and community organizations to ensure coordinated, team-based care. Facilitate referrals to internal and external resources, including social work, behavioral health, specialty care, durable medical equipment (DME), and community support services. Maintain and utilize current community resource directories and EMR-based resource tools to address social determinants of health and support patient needs. Documentation & Program Compliance: Maintain accurate, timely, and compliant documentation within the electronic medical record (EMR), including care plans, care management episodes, and patient outreach activities. Document care alerts and interventions appropriately within the EMR to support continuity of care. Monitor and maintain required program participation metrics and documentation standards for attributed patient populations. Navigate and effectively utilize EPIC, population health dashboards, CRISP reports, payer portals, and other web-based platforms used in patient care management. Attend interdisciplinary meetings, educational sessions, and community outreach events as required. Organize, schedule, and lead Patient and Family Advisory Council (PFAC) meetings as required. Perform additional duties and responsibilities as assigned. Qualifications Education Graduate of an accredited school of nursing with a minimum of an Associate Degree in Nursing required. Bachelor of Science in Nursing (BSN) preferred. Licensure & Certifications Active Registered Nurse (RN) license in the State of Maryland required. Active nationally recognized Care Manager certification (e.g., Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or Certified in Care Coordination and Transition Management (CCCTM)) required, or willingness to obtain certification within one (1) year of hire. Experience Active clinical nursing background in inpatient, ambulatory, or chronic disease management settings required, in addition to the case management experience noted below. Three (3) to five (5) years of case management experience required, preferably in care coordination, population health, or value-based care settings. Experience working with Epic EHR, quality reporting systems, and population health platforms (eg, CRISP) strongly preferred. Knowledge, Skills & Abilities Strong understanding of population health, chronic disease management, transitional care management, and value-based care principles. Knowledge of clinical quality measures, preventive care guidelines, and healthcare utilization management. Ability to interpret and utilize population health data, registries, dashboards, and predictive analytics reports. Excellent patient assessment, care planning, communication, and motivational interviewing skills. Ability to establish and maintain effective working relationships with patients, families, providers, staff, and community partners. Strong organizational and time management skills with the ability to manage multiple ongoing priorities independently. Proficiency in Microsoft Office applications, including Excel, Word, Outlook, and web-based healthcare platforms. Ability to communicate professionally and effectively through phone, email, written correspondence, and in-person interactions. Commitment to patient-centered, culturally competent, team-based care. Work Environment & Physical Requirements Work is performed primarily in a clinical office environment with frequent use of computers, telephones, and office equipment. Requires prolonged periods of sitting with occasional standing and walking. Requires manual dexterity, eye-hand coordination, and the ability to operate office and clinical equipment. May involve exposure to communicable diseases and bodily fluids. Ability to manage multiple priorities and work effectively in a fast-paced healthcare environment. Occasional schedule flexibility may be required for meetings, educational sessions, or community events. Reporting Structure  Reports to: Practice Manager, Site Clinical Director, and Population Health Director  Supervisory Responsibilities: None  Additional Requirements  MMR and annual influenza vaccination required unless approved for medical or religious exemption.  PPD screening required.  Successful completion of background screening and drug testing required. Thu, 16 Jul 2026 16:07:57 -0400 https://careers.cmsa.org/jobs/rss/22412238/case-manager-rn https://careers.cmsa.org/jobs/rss/22412238/case-manager-rn Nationwide, Our Client, a Health Insurance company, is looking for a Case Manager-RN for their Remote location.   Responsibilities: Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally. The multidisciplinary team is inclusive of Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff and Medical Directors. Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members’ health across the care continuum. Assess the member's health, psychosocial needs, cultural preferences, and support systems. Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes. Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services and disease-specific services). Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family. Advocate for members and promote self-advocacy. Deliver education to include health literacy, self-management skills, medication plans, and nutrition. Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary. Accurately document interactions that support management of the member. Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care. Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care. Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency. Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals. Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM). Why Should You Apply? Health Benefits Referral Program Excellent growth and advancement opportunities Requirements: Nursing Diploma or Associates degree in nursing required. Bachelor’s degree in nursing strongly preferred. 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required. 1 year of case management experience in a managed care setting strongly preferred. Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred Certificates, licenses, registrations Certification in Case Management (CCM) preferred Certification in Chronic Care Professional (CCP) preferred Other Skills And Abilities: Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member’s outcomes. Empathetic, supportive and a good listener. Proficient in motivational interviewing skills. Demonstrated time management skills. Organizational skills with the ability to manage multiple systems/tools, while simultaneously interacting with a member. Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.). Must embrace teamwork but can also work independently. Excellent interpersonal and communication skills both written and verbal Thu, 09 Jul 2026 10:23:54 -0400 https://careers.cmsa.org/jobs/rss/22465152/prn-case-manager-inpatient-rehabilitation-unit https://careers.cmsa.org/jobs/rss/22465152/prn-case-manager-inpatient-rehabilitation-unit Daytona Beach, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: PRN Shift: Day (United States of America) Address: 301 MEMORIAL MEDICAL PKWY City: DAYTONA BEACH State: Florida Postal Code: 32117 Job Description: Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned. Knowledge, Skills, and Abilities: Leadership skills [Required] Process and Outcome data analysis skills [Required] Critical thinking and problem-solving skills [Required] Ability to manage multiple tasks and prioritize levels of importance [Required] Customer service skills [Required] Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required] Effective organizational skills [Required] Computer proficiency with Outlook e-mail and electronic medical records [Required] Flexible in a complex and changing healthcare environment [Required] Knowledge of community resources and post-acute care programs across the continuum [Required] Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required] Knowledge of CMS Conditions of Participation for Discharge Planning [Required] Conflict management and resolution skills [Required] Teamwork principles [Required] Education: Associates of Nursing [Required] Bachelors of Nursing [Preferred] Field of Study: N/A Work Experience: 2+ medical/hospital nursing experience [Required] Prior Care Management/Utilization Management experience [Preferred] Additional Information: N/A Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support (BLS) [Preferred] Certified Case Manager (CCM) [Preferred] Accredited Case Manager (ACM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $32.76 - $57.47 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22464979/director-care-management https://careers.cmsa.org/jobs/rss/22464979/director-care-management Calhoun, Georgia, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 1035 RED BUD RD NE City: CALHOUN State: Georgia Postal Code: 30701 Job Description: Work Schedule: Monday - Friday 8:30am - 5pm Directs daily operations of the care management department, including discharge planning, care coordination, progression of care, and social services while ensuring compliance with CMS and regulatory standards. Oversees recruitment, retention, and staffing strategies to maintain strong care management leadership and team performance. Collaborates with interdisciplinary hospital leaders and executives to achieve organizational and patient care goals. Identifies improvement opportunities and leads operational, technology, and workflow initiatives to improve efficiency, patient outcomes, and reduce readmissions. Develops, implements, and ensures compliance with care management policies, standard work, and operational strategies across the department. Knowledge, Skills, and Abilities: Understanding of medical necessity for appropriate patient status and level of care Understanding of Care Management best practices Ability to research and reason best practices to support process improvement Strong verbal and electronic communication skills Ability to analyze, evaluate and monitor data in addition to provide action plans Supports positive employee relations and customer experience Understanding of Microsoft Office Products and other appropriate software platforms Understanding of CMS Conditions of Participation for Discharge Planning Understanding of Managed Care and Value Based Programs Ability to work autonomously with self-direction Ability to work as a collaborative partner of a diverse leadership team Ability to lead and sustain change Knowledge of change management principles, methodologies, and tools [Required] Education: Bachelor's in Nursing [Required] Work Experience: 5+ direct care management experience [Required] 3+ care management leadership experience [Required] 2+ frontline nursing experience [Required] Licenses and Certifications: Registered Nurse (RN) [Required] Pay Range: $89,916.80 - $167,252.91 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22464761/case-manager-rn-acute-care https://careers.cmsa.org/jobs/rss/22464761/case-manager-rn-acute-care TULSA, Oklahoma, Join our team as a day shift, full-time, Acute Care Registered Nurse (RN) Case Manager in Tulsa, OK.    Why Join Us?   Thrive in a People-First Environment and Make Healthcare Better Thrive:  We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being. People-First:  We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better:  We use advanced technology to support our team and enhance patient care. Get to Know Your Team: Hillcrest Medical Center is a 656-bed hospital that includes The Alexander Burn Center, The Peggy V. Helmerich Women?s Health Center, Kaiser Rehabilitation Center, the latest technology for the treatment of cancer, and the Oklahoma Heart Institute. The RN case manager is responsible for assessing and coordinating patient care across the continuum, utilizing accepted criteria and guidelines to manage benefits and determine the medical necessity of the services provided. This position functions to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Case Manager reports to the Director of Case Management or designee.   Job Requirements: RN, Associates degree in nursing or higher Preferred Job Requirements: Two (2) years acute hospital-based nursing experience Certification in case management (ACM or CCM) Experience in acute care hospital case management Thu, 30 Jul 2026 01:09:56 -0400 https://careers.cmsa.org/jobs/rss/22464532/care-manager-ii-case-management https://careers.cmsa.org/jobs/rss/22464532/care-manager-ii-case-management Corpus Christi, Texas, Description CHRISTUS Spohn Hospital Corpus Christi - Shoreline overlooking Corpus Christi Bay is the largest and foremost acute care medical facility in the region, with a full range of diagnostic and surgical specialty services in cardiac, cancer, and stroke care. It is the leading emergency facility in the area with a Level II Trauma Center in the Coastal Bend, staffed with physicians and nurses specially trained in emergency services.  The Pavilion and North Tower house a state-of-the-art emergency department, ICU, Cardiac Cath Lab and surgical suites  A teaching facility in affiliation with the Texas A&M University System Health and Science Center College of Medicine  Accredited Chest Pain Center  Accredited Joint Commission Stroke Team  Summary: The Care Manager (CM) II works in collaboration with the patient/family, physicians and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge. The CM is responsible for identifying, initiating and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Care Coordination and Discharge Planning are both responsibilities of this role. The CM assesses and responds to patient/family needs by coordinating efforts of other team members and identifies and resolves barriers that hinder effective patient care. The CM adheres to departmental and organizational goals, objectives, standards of performance, policies and procedures, and continually assures regulatory compliance. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Coordinates the integration of case management functions into the patient care and discharge planning processes in collaboration with other hospital departments, external service organizations, agencies, and healthcare facilities. Coordinates/facilitates patient care progression throughout the continuum of care in an efficient and cost-effective manner. Serves as resource, provides support, and advocates on behalf of the patient related to treatment decisions and end of life issues. Closely monitor patient length of stay in regard to the geometric mean length of stay and communicate/collaborate with appropriate interdisciplinary team members to remove barriers and expedite discharge. Implements and monitors the patient?s plan of care to ensure effectiveness and appropriateness of services. Identifies and escalates local and system barriers that are impeding diagnostic or treatment progress and issues related to quality and risk as appropriate in a timely manner. Proactively identifies and resolves delays and obstacles to discharge. Uses advanced conflict resolution skills as necessary to ensure timely resolution of issues. Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting. Interviews patients/families to obtain information about social, emotional, and financial factors which impact health status to develop comprehensive discharge planning assessment and care plan. Assesses needs for discharge planning and continuing care/resource support following discharge; independently makes recommendations to patients and families regarding post-acute level of care needs and options including: Acute Rehabilitation Placement Nursing Home or Skilled Nursing placement Psychiatric or Substance Abuse placement New Dialysis Child/Adult/Domestic Abuse Home Health/Hospice Referrals Legal issues (adoptions, guardianship) Assistance with Advance Directives Community Resource needs Financial Issues/Funding options DME Referrals and Coordination Social Determinants of Health Initiates discharge planning at the time of admission and makes post-hospital service referrals based upon information gathered during assessment and interactions with physicians, multidisciplinary care team, and payors as indicated. Acts as patient advocate by negotiating for, and coordinating, resources with payors, agencies, and vendors. Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care. Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population. Assesses the patient?s formal and informal support system as well as available benefits and/or community resources. Meets directly with patient/family to assess needs and develop and individualized care plan in collaboration with the physician. Ensures and maintains plan consensus from patient/family, physician and payor. Provides education, information, direction, and support related to patient?s goals of care. Acts as patient advocate to develop treatment plan and coordinate patient care and to transition patient to the appropriate next level of care. Demonstrates and promotes respect for the dignity and rights of every patient while adhering to the safety standards and practices of the organization and the nursing profession. Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources. Provides information and support to patients and families, helping them access needed resources within the medical center and community. Actively participates in clinical performance improvement activities involving length of stay, resource utilization, avoidable days, cost per case, and readmissions. Measures effectiveness of interventions through direct communication with post-acute care providers, patients, and caregivers. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency. Actively participates in Multidisciplinary/Patient Care Progression Rounds. Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director. Documents in the medical record per regulatory and department guidelines. May be asked to assist with special projects. May serve a preceptor or orienter to new associates. Assumes responsibility for professional growth and development. Must have excellent verbal and written communication and ability to interact with diverse populations. Must have critical and analytical thinking skills. Must have demonstrated clinical competency. Must have the ability to Multitask and to function in a stressful and fast paced environment. Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Must have understanding of pre-acute and post-acute levels of care and community resources. Must have ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families. Must be understanding of internal and external resources and knowledge of available community resources. Must have the ability to move around the hospital to all areas for the majority of the workday while in office the rest of the day; general office and hospital environment. Job Requirements: Education/Skills Graduate of an accredited school of nursing (BSN preferred) or Masters Degree in Social Work (MSW) required or demonstrated success in CHRISTUS Care Manager I Position for at least 5 years on top of the required experience in lieu of education required. Experience Two or more years clinical experience with one year in the acute care setting preferred. Licenses, Registrations, or Certifications RN or LMSW in the state of employment is required for new hires. LBSW accepted for associates with 5+ years of demonstrated success and experience in CHRISTUS Care Manager I role. Certification in Case Management preferred. BLS preferred.   Work Schedule: MULTIPLE SHIFTS AVAILABLE Work Type: Part Time Thu, 30 Jul 2026 01:04:48 -0400 https://careers.cmsa.org/jobs/rss/22464175/utilization-management-assistant-director-rn https://careers.cmsa.org/jobs/rss/22464175/utilization-management-assistant-director-rn Los Angeles, California, Description Join a world-class healthcare organization and play a key leadership role in delivering high-quality, patient-centered care. UCLA Health is seeking a dynamic and experienced Utilization Management Assistant Director to oversee Intensive Case Management (ICM) and Utilization Management (UM) operations focused on high-risk and complex patient populations.   In this leadership role, you will supervise a multidisciplinary team supporting patients across the continuum of care while driving operational excellence, regulatory compliance, and improved patient outcomes. This is an exciting opportunity for a collaborative healthcare leader passionate about care coordination, utilization management, and value-based care.   Key Responsibilities Provide day-to-day leadership and oversight of Intensive Case Management (ICM) and Utilization Management (UM) programs Supervise and mentor a multidisciplinary team including Registered Nurses, Social Workers, and care coordination staff Oversee care coordination activities for high-risk, high-utilizer, oncology, Medicare Advantage, and specialty patient populations Lead transitions of care, discharge planning, readmission prevention, and emergency department tracking initiatives Ensure compliance with CMS, NCQA, and organizational policies related to utilization management and case management Monitor operational and clinical performance metrics including readmission rates, ED utilization, and length of stay Conduct staff coaching, onboarding, training, and performance evaluations Collaborate with physicians, hospital leadership, post-acute providers, and community agencies to ensure seamless patient care transitions Support utilization review activities for hospital, rehabilitation, skilled nursing, and home health settings Partner with revenue cycle and appeals teams to support denial prevention and medical necessity documentation Drive process improvement initiatives focused on quality outcomes, patient experience, and cost-effective care delivery Promote patient-centered, culturally competent, and holistic care across all care settings Salary Range: $116,300 - $264,600/Annually Qualifications All items are required: Current unrestricted RN licensure in CA required Bachelors of Science, Nursing (BSN) degree required  Experience Minimum 5-7 years of clinical experience, with at least 3 years in case management or utilization management Minimum 3-5 years in a leadership or supervisory role  Experience in Managed Care Organization, Medical Group or Health Plan Strong knowledge of CMS guidelines, utilization management, and care coordination Ability to multi-task, work with frequent interruptions, and meet deadlines. Must be detailed, oriented, attentive, organized, and able to follow directions.  Proficient computer skills including working knowledge of Microsoft Excel, Visio, Power P and Word. Ability to operate a wide variety of office equipment, including computers, printers, copy machines, facsimile receiver/transmitter, scanners and mailing equipment.  Ability to communicate thoughts and information clearly and succinctly in writing as well as verbally. Highly organized, reliable, consistently seeking learning opportunities and new challenges, High EQ, communication skills, problem solving ability, and teamwork, humble yet confident, peers feel comfortable requesting your assistance.  Preferred: Experience in Medicare Advantage or value-based care models Thu, 30 Jul 2026 00:56:10 -0400 https://careers.cmsa.org/jobs/rss/22464747/case-manager-rn https://careers.cmsa.org/jobs/rss/22464747/case-manager-rn Westwood, New Jersey, Overview Join our team as a day shift, PRN, Case Manager Registered Nurse in Westwood, NJ.   Why Join Us?   Thrive in a People-First Environment and Make Healthcare Better Thrive:  We empower our team with career growth opportunities and resources that support your wellness, education, and financial well-being. People-First:  We prioritize your well-being with a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better:  We use advanced technology to support our team and enhance patient care.   Get to Know Your Team: Hackensack Meridian Pascack Valley Medical Center is a 128-bed, full-service, acute-care community hospital with a new emergency department, a state-of-the-art maternity center, a women's imaging center, and an ICU. Responsibilities The  Case Manager RN  is responsible for assessing and coordinating patient care across the continuum, utilizing accepted criteria and guidelines to manage benefits and determine the medical necessity of the services provided. This position functions to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization.  The  Case Manager RN  reports to the Director of Case Management or designee.    Qualifications Job Requirements:  RN, Associates degree in nursing or higher.   Preferred Job Requirements:  2 +  years ?  acute hospital-based nursing experience.    Experience in acut e care hospital case management .     Certification in case management (ACM or CCM ).   Rate of pay is determined based on experience and education and may include other pay components such as differentials and call pay based on role. Thu, 30 Jul 2026 01:09:56 -0400 https://careers.cmsa.org/jobs/rss/22465086/care-manager https://careers.cmsa.org/jobs/rss/22465086/care-manager Land O Lakes, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 9441 HEALTH CENTER DR City: LAND O LAKES State: Florida Postal Code: 34637 Job Description: Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Provides patient and family advocacy, and support patient’s choice and patient rights during hospitalization. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Other duties as assigned. Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Work Experience: 1+ year of nursing experience [Required] Licenses and Certifications: Registered Nurse (RN) [Required] Driver's License (DL) [Required] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay Range: $68,132.50 - $119,520.35 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22464891/rn-care-manager https://careers.cmsa.org/jobs/rss/22464891/rn-care-manager Port Charlotte, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day-Weekend (United States of America) Address: 2500 HARBOR BLVD City: PORT CHARLOTTE State: Florida Postal Code: 33952 Job Description: Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned. Knowledge, Skills, and Abilities: Leadership skills [Required] Process and Outcome data analysis skills [Required] Critical thinking and problem-solving skills [Required] Ability to manage multiple tasks and prioritize levels of importance [Required] Customer service skills [Required] Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required] Effective organizational skills [Required] Computer proficiency with Outlook e-mail and electronic medical records [Required] Flexible in a complex and changing healthcare environment [Required] Knowledge of community resources and post-acute care programs across the continuum [Required] Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required] Knowledge of CMS Conditions of Participation for Discharge Planning [Required] Conflict management and resolution skills [Required] Teamwork principles [Required] Education: Associates of Nursing [Required] Bachelors of Nursing [Preferred] Field of Study: N/A Work Experience: 2+ medical/hospital nursing experience [Required] Prior Care Management/Utilization Management experience [Preferred] Additional Information: N/A Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support (BLS) [Preferred] Certified Case Manager (CCM) [Preferred] Accredited Case Manager (ACM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $32.76 - $57.47 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22464686/rn-registered-nurse-hospital-case-manager https://careers.cmsa.org/jobs/rss/22464686/rn-registered-nurse-hospital-case-manager Danville, Pennsylvania, Job Summary Geisinger is proud to announce a salary increase for RN Hospital Case Managers - making this the perfect time to join us! We’re committed to supporting your success as you’ll play a vital role in ensuring patients receive the right care, at the right time, in the right place. Apply today and become part of a team that’s making a meaningful impact every day.This is an in-person RN position based at Geisinger Medical Center (GMC), providing on-site support to inpatient care teams. Job Duties We’re excited to share the recent salary increase for our Hospital Case Managers - and are dedicated to elevating your nursing career.  Our culture empowers you to act with purpose and urgency - providing today’s care now and enhancing the patient experience by delivering timely, compassionate care.   Join a team where innovation, collaboration, and responsiveness are at the heart of everything we do. A typical workweek is Monday through Friday, from 8:00 AM to 4:30 PM. You’ll occasionally cover weekends as part of a shared rotation-approximately every fourth weekend. At least two (2) years of prior RN experience is required.  The ideal candidate will have prior RN experience in a hospital setting.  Case Management experience is preferred and not required. The successful candidate must be available to work on-site at Geisinger Medical Center (GMC). Benefits of working in Case Management Strong team culture Consistent scheduling Meaningful mission-driven work Benefits of working at Geisinger:  Full benefits (health, dental and vision) starting on day one  Three medical plan choices, including an expanded network for out-of-area employees and dependents   Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA)   Company-paid life insurance, short-term disability, and long-term disability coverage   401(k) plan that includes automatic Geisinger contributions   Generous paid time off (PTO) plan that allows you to accrue time quickly   Up to $5,000 in tuition reimbursement per calendar year   MyHealth Rewards wellness program to improve your health while earning a financial incentive   Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones   Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.   Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance   Position Details Assesses, plans, implements, coordinates, monitors and evaluates all options and services with the goal of optimizing the patient or member's health status. Manages utilization and practice metrics to further refine the delivery of care model to maximize clinical, quality, and fiscal outcomes. Integrates evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare for the identified population. Develops systems of care that monitor progress and promote early intervention in acute care situations. Assists with the design, implementation, and evaluation of the advanced patient centered care model. Assesses the healthcare, educational and psychosocial needs of patients or members. Designs an individualized plan of care and fosters a team approach by working collaboratively with the patient or member, family, primary care provider, and other members of the health care team to ensure coordination of services. Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population. Works to appropriately apply benefits and utilization management serving as a resource to the patient or member and healthcare team. Maintains required documentation for all case management activities. Collects required data and utilizes this data to adjust the treatment plan when indicated. Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position. Education Graduate from Specialty Training Program-Nursing (Required), Bachelor's Degree-Nursing (Preferred) Experience Minimum of 3 years-Related work experience (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status. Thu, 30 Jul 2026 01:08:29 -0400 https://careers.cmsa.org/jobs/rss/22465069/care-management-registered-nurse-rn-prn https://careers.cmsa.org/jobs/rss/22465069/care-management-registered-nurse-rn-prn Shawnee Mission, Kansas, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. Schedule: PRN Shift: Day (United States of America) Address: 9100 W 74TH ST City: SHAWNEE MISSION State: Kansas Postal Code: 66204 Job Description: Care Management Registered Nurse (RN) – PRN Location: AdventHealth Shawnee Mission Schedule: PRN | As Needed | Must be available to work some weekend shifts Coordinate Care. Advocate for Patients. Transform Outcomes. At AdventHealth, as a Care Management Registered Nurse (RN) , you'll play a vital role in helping patients safely transition through the continuum of care by coordinating services, advocating for patient needs, and collaborating with interdisciplinary teams to achieve exceptional outcomes. If you're passionate about care coordination, patient advocacy, and improving the healthcare experience for patients and families, we'd love to have you join our team. The Care Management Registered Nurse (RN) evaluates patients for discharge planning needs and collaborates with physicians, nurses, and interdisciplinary team members to coordinate safe, timely, and effective transitions of care. This role provides patient advocacy, discharge planning, utilization support, care progression, and post-acute care coordination while addressing social drivers of health and connecting patients with appropriate community resources. The Care Management RN ensures compliance with CMS Conditions of Participation (CoPs) for Discharge Planning , federal and state regulations, and organizational standards while supporting length of stay goals, reducing avoidable readmissions, and enhancing the patient experience. Key Responsibilities Coordinate comprehensive discharge planning for patients throughout the acute care hospitalization. Evaluate patients for post-acute care needs and develop individualized transition of care plans in collaboration with the interdisciplinary healthcare team. Receive and respond to referrals for patients requiring care coordination, discharge planning, patient advocacy, or other case management interventions. Participate in multidisciplinary rounds to review patient progression, level of care, discharge readiness, and barriers to timely discharge. Identify and escalate delays in patient progression and discharge planning to appropriate leadership. Educate patients and families regarding the emotional, social, financial, and healthcare impacts of illness while empowering them to participate in healthcare decision-making. Connect patients and families with community resources , social programs, and post-acute services to address social drivers of health. Assess readmitted patients to identify contributing factors and opportunities to reduce future avoidable readmissions. Organize and facilitate patient and family care conferences with physicians and interdisciplinary team members. Monitor medical necessity, care progression, and utilization to support appropriate length of stay and resource utilization. Document discharge planning evaluations, ongoing assessments, multidisciplinary rounds, barriers to care progression, avoidable days, patient needs, and discharge plans in accordance with departmental standards. Maintain compliance with CMS Conditions of Participation , regulatory requirements, and AdventHealth policies governing discharge planning and care coordination. Collaborate with physicians, nurses, social workers, case managers, and post-acute providers to promote safe, efficient, and patient-centered transitions of care. Knowledge, Skills & Abilities Leadership and patient advocacy skills Critical thinking and complex problem-solving abilities Knowledge of care coordination, discharge planning, and care progression Knowledge of CMS Conditions of Participation (CoPs) for Discharge Planning Knowledge of community resources and post-acute care services across the continuum of care Understanding of clinical, psychosocial, and social factors that influence safe discharge planning Ability to analyze clinical, process, and outcome data to support quality patient care Strong organizational skills with the ability to prioritize multiple responsibilities in a fast-paced environment Excellent communication and interpersonal skills with patients, families, physicians, and interdisciplinary healthcare teams Conflict resolution and relationship-building skills Commitment to patient-centered care and interdisciplinary collaboration Ability to work effectively with individuals from diverse social, cultural, and economic backgrounds Computer proficiency with Microsoft Outlook and Electronic Medical Record (EMR) systems Ability to adapt to a dynamic and changing healthcare environment Education Associate Degree in Nursing (ADN) — Required Bachelor of Science in Nursing (BSN) — Preferred Experience Two years of acute care or hospital nursing experience — Required Previous Care Management or Utilization Management experience — Preferred Licensure & Certifications Registered Nurse (RN) — Required Certified Case Manager (CCM) — Preferred Accredited Case Manager (ACM) — Preferred Why Join AdventHealth? At AdventHealth, you'll find more than a job—you'll discover a career with purpose. As part of our faith-based, mission-driven organization , you'll help patients navigate complex healthcare journeys while working alongside a collaborative team dedicated to improving outcomes through compassionate, whole-person care. Flexible PRN scheduling Opportunity to make a meaningful impact on patient outcomes and care transitions Collaborative interdisciplinary care team Mission-driven culture focused on whole-person healing Professional growth and continuing education opportunities Supportive leadership and team environment The opportunity to positively impact patients, families, and the communities we serve Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $33.70 - $62.69 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22464322/hematology-case-manager https://careers.cmsa.org/jobs/rss/22464322/hematology-case-manager Nashville, Tennessee, Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: VISTA Job Summary: Assists in developing and meeting key Pillar outcomes and system improvement goals including financial, satisfaction, and clinical as the nursing component of the care coordination model. This position Improves outcomes by reducing all cause hospital readmissions and coordinating episodes of care among patients in a defined population or disease process. Participates in identification of appropriate patients; encourage patient and family engagement in self-care management; promote warm handovers to the next level of care by providing timely, pertinent information in a standardized way; conduct patient and family education on key elements of the patients' personal care plan by using the "teach-back" methodology and follow up phone calls; and assists the patient in navigating the healthcare system. . KEY RESPONSIBILITIES Coordinates the evaluation process of the defined patient population. May complete and document portions of the evaluation process, collaborating with other team members to ensure completion of all required information. Supports patient access by serving as a liaison between the referring provider's office and Vanderbilt provider. Interacts routinely and effectively with the clinical team to develop a collaborative plan for the coordination of patient care from the anchor hospitalization through the defined care episode. Develops and manages the processes related to pre-admission and post-discharge care transitions; establishes relationships/clinical pathways with providers/agencies to optimize care for defined patient population. Assists in the development and dissemination of patient education materials/information to include creation of customized medication grids with input from the pharmacist/team as needed. Assists with discharge/transition planning in collaboration with the multi-disciplinary team, actively engaging outpatient care providers by sharing hospital course, concerns, pending test results, learning needs, partnership opportunities etc. Coordinates handovers including outpatient care coordinators (disease management teams), home health care nurses, cardiac rehab, skilled nursing facilities, etc. Demonstrates reflective practice by constantly evaluating care coordination and supports the development of protocols for practice based on evidence The responsibilities listed are a general overview of the position and additional duties may be assigned. TECHNICAL CAPABILITIES Trend Analysis (Intermediate): Demonstrates mastery of trend analyses. Can recognize the impact and take into consideration the effect of seasonality and randomness. Has analyzed trends in detecting patterns that could lead to future problems and in forecasting future demand periods. Has worked in several areas that might include sales, marketing, quality, finance and manufacturing. Evidence-Based Practice (Advanced): Recognizes, Implements, and evaluates practice changes based on published research. Demonstrates expertise in applying evidence-based practices to challenging and complex situations. RN Access Patient Education (Advanced): Demonstrates uppermost levels of patient education in practical applications of a complex nature. Possesses mastery of knowledge, training, and expertise to be capable of successfully delivering treatment planning services across the care continuum. Takes a lead role in complex situations when there is a need to achieve results. Actively participates in outside professional organizations and forums. Nursing Patient Assessment & Evaluation (Advanced): Demonstrates the uppermost levels of expertise in patient assessment and evaluations in challenging and complex situations. Conducts primary care patient interviews and physical examination. Often takes a lead role in complex patient care situations. Possesses expert knowledge, training and experience to mentor less experienced peers. Our Nursing Philosophy: We believe highly skilled and specialized nursing care is essential to Vanderbilt University Medical Center's mission of quality in patient care, education and research. We believe nursing is an applied art and science focused on helping people, families and communities reach excellent health and well-being. As a Vanderbilt University Medical Center employee, you make a difference to our patients and their families by bringing compassion and care to those in need of hope and healing. Please see our current employee benefits offered: Affordable High Quality Health Plan Options Dental and /or vision plan 403 (b) retirement plan Paid Time off (flex PTO) Tuition Reimbursement and adoption assistance (maximums applied) Short-Long term disability Subsidized backup childcare And many more... Ask us about our current inpatient nursing supplemental Pay Program! Achieve the Remarkable: Learn more about VUMC Nursing here . Core Accountabilities: Organizational Impact: Executes job responsibilities with the understanding of how output would affect and impact other areas related to own job area/team with occasional guidance. Problem Solving/ Complexity of work: Analyzes moderately complex problems using technical experience and judgment. Breadth of Knowledge: Has expanded knowledge gained through experience within a professional area. Team Interaction: Provides informal guidance and support to team members. Core Capabilities : Supporting Colleagues:- Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas.- Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.- Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services:- Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.- Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.- Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.- Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.- Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.- Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation:- Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.- Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.- Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements. Position Qualifications: Responsibilities: Certifications: LIC-Registered Nurse - Licensure-Others Work Experience: Relevant Work Experience Experience Level: 5 years Education: Bachelor's This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your well-being and professional growth. Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled. Thu, 30 Jul 2026 01:00:11 -0400 https://careers.cmsa.org/jobs/rss/22465010/care-manager-rn-nonexempt-prn https://careers.cmsa.org/jobs/rss/22465010/care-manager-rn-nonexempt-prn New Smyrna Beach, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: PRN Shift: Day (United States of America) Address: 401 PALMETTO ST City: NEW SMYRNA BEACH State: Florida Postal Code: 32168 Job Description: Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned. Knowledge, Skills, and Abilities:   Leadership skills [Required] Process and Outcome data analysis skills [Required] Critical thinking and problem-solving skills [Required] Ability to manage multiple tasks and prioritize levels of importance [Required] Customer service skills [Required] Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required] Effective organizational skills [Required] Computer proficiency with Outlook e-mail and electronic medical records [Required] Flexible in a complex and changing healthcare environment [Required] Knowledge of community resources and post-acute care programs across the continuum [Required] Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required] Knowledge of CMS Conditions of Participation for Discharge Planning [Required] Conflict management and resolution skills [Required] Teamwork principles [Required] Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Field of Study: Nursing Work Experience: 2+ medical/hospital nursing experience [Required] Prior Care Management/Utilization Management experience [Preferred] Licenses and Certifications: Registered Nurse (RN) [Required] Certified Case Manager (CCM) [Preferred] Accredited Case Manager (ACM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $32.76 - $57.47 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22462495/manager-care-management https://careers.cmsa.org/jobs/rss/22462495/manager-care-management Tampa, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 3100 E FLETCHER AVE City: TAMPA State: Florida Postal Code: 33613 Job Description: Oversees the daily operations of the Care Management department in inpatient, observation, and emergency department settings. Ensures documentation and compliance for discharge planning, patient choice, and other regulatory requirements. Ensures staff participation in daily multidisciplinary rounds and actively participates to optimize the interdisciplinary care coordination. Monitors staff documentation, reports, and dashboards to ensure adherence to the company-wide standard processes and quality care. Oversees care manager's providing the full discharge planning from admission to discharge, assuring high quality and timely care management interventions to avoid delays and unnecessary readmissions. Collaborates with hospital leadership and executives to escalate pace of care delays and ensure daily progression of care and throughput. Identifies process improvement opportunities and actively participates in interdisciplinary meetings to drive care coordination improvements. Manages the care management staff's escalations of delays and complicated cases and collaborate with care providers within and outside of the hospital to find solutions to avoid unnecessary days in the hospital. Educates and reinforces standard work with staff, ensuring orientation and competencies are completed effectively and efficiently. Accountable for hiring, onboarding, and retaining staff, ensuring a highly productive and engagement team. Oversees the coordination of family and care team meetings and ensures effective transitions of care and patient and family needs are met. Performs other duties as assigned Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Work Experience: 3+ direct care management experience [Required] 2+ frontline nursing experience [Required] Licenses and Certifications: Registered Nurse (RN) [Required] Accredited Case Manager (ACM) [Preferred] Certified Case Manager (CCM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay Range: $77,758.69 - $144,624.32 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22460890/care-management-nurse-rn https://careers.cmsa.org/jobs/rss/22460890/care-management-nurse-rn Houston, Texas, Job Number: 179211, Job Title: Care Management Nurse RN, Salary: $80,000.00 - $100,000.00 CHC Loop Central - Hybrid, Houston, TX, 77081, US --> Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: ' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women ' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR ' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. ' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more. Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve. Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers. JOB SUMMARY: Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will participate as a team member in Community Care Management programs, which are designed to assist members with chronic diseases in self-management skills. Care Manager will work collaboratively with utilization review, member services and the quality improvement department. MINIMUM QUALIFICATIONS: 1. Education/Specialized Training/Licensure: RN, current Texas License CCM required or must receive within 18 months of employment. 2. Work Experience (Years and Area): Three years of clinical experience 3. Management Experience (Years and Area): N/A 4. Software Operated: Microsoft Office (Word, Excel, Outlook). SPECIAL REQUIREMENTS: (Check Applicable Areas) 1. Communication Skills: Above Average Verbal (Heavy Public Contact) Writing /Composing: Correspondence / Reports 2. Other Skills: Analytical, Medical Terminology, Research, MS Word, MS Excel 3. Advanced Education: Advanced Training Specialty: CCM Preferred 4. Work Schedule: Flexible RESPONSIBLE TO: Supervisor/Manager Thu, 30 Jul 2026 00:37:57 -0400 https://careers.cmsa.org/jobs/rss/22461619/population-health-care-manager-complex-care-management https://careers.cmsa.org/jobs/rss/22461619/population-health-care-manager-complex-care-management Durham, North Carolina, Duke Connected Care , a community-based, physician-led network, includes a group of doctors, hospitals and other healthcare providers who work together to deliver high-quality care to Medicare Fee-for-Service patients in Durham and itssurrounding areas.   Responsible for Complex Care patients in a variety of areas at Duke University Hospital. Also, manage a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of discharge plans and care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health System's resources and perform these duties within the requirements of CMS and other external review agencies.   Work Performed Monitor daily census and assignment to assure all patients are assessed.  Perform other related duties incidental to the work described herein. Case management needs including care coordination/transition and discharge planning, consultations, advocacy, education. Maintain effective communication with health care team members related to assessment findings, discharge planning needs and provider orders needed to arrange Homecare, Durable Medical Equipment, Transportation, Skilled Nursing or Acute Rehab Facility placement, Substance Abuse Treatment and outpatient follow-up. Maintain working knowledge of specific benefits and reimbursement guidelines, the discharge planning process and applicable federal, state and local regulations. Provide education and guidance on these topics to providers, patients and families as needed. Work with Utilization Management partners to provide information and feedback that will enhance negotiations and denial prevention with payers. Maintain timely documentation of assessment findings, discharge arrangements and actions taken according to departmental guidelines; prepare reports and maintain records as requested and/or required. Participate in Quality Assurance/Performance Improvement (QAPI) activities as requested. Job responsibilities may include site specific duties, weekend/holiday or after hours coverage as designated at each entity. Develop and maintain positive working relationships with customers internal and external to Duke Health System.   Knowledge, Skills and Abilities Ability to work effectively in a self-directed role Ability to multi-task, capable of daily problem-solving complex issues Excellent written and verbal skills Basic computer skills necessary   Level Characteristics N/A   Minimum Qualifications Education BSN or MSW required   Experience 3 years of relevant experience; Hospital Case Management preferred   Degrees, Licensures, Certifications Requires Case Management Certification (ACM, CCM or ANCC) within 2 years or of hire. BSN required and must have current or compact RN licensure in state of NC. MSW       POPULATION HEALTH CARE MANAGER  Job Level: G2 Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, itis essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. Thu, 30 Jul 2026 00:59:18 -0400 https://careers.cmsa.org/jobs/rss/22461860/icpr-clinical-case-manager-part-time https://careers.cmsa.org/jobs/rss/22461860/icpr-clinical-case-manager-part-time Saint Louis, Missouri, Additional Information About the Role ICPR = Intensive Community -Based Psychiatric Rehabilitation Requires traveling throughout the St. Louis city and county to meet with clients in their homes to provide crisis-based therapy services, family therapy, and behavioral based interventions for families, youth, and young adults This is a PT shift position that requires flexibility to meet with clients.  Day, afternoon, or evening shift flexibility. Shift: PT 24 hours/week - benefits eligible Services Provided during day time hours but there is also a standard on-call system in place Team and supervisor provides coverage when employee is on PTO There is a maximum case load of 3-4 clients. Every client is seen a minimum three times per week. A typical day will usually consist of one - two therapy sessions, coordination with case management team, and session note writing. MUST be Fully licensed in MO - LPC or LCSW Overview BJC Behavioral Health is a community health center that provides and coordinates behavioral health services for more than 8,000 seriously mentally ill adults and seriously emotionally disturbed children in St. Louis City, St. Louis County, St. François, Iron and Washington counties.  As an Administrative Agent of the Missouri Department of Mental Health (DMH), BJC Behavioral Health serves as a major point of entry for people eligible for mental health services funded by DMH and is responsible for serving as gatekeeper to the public mental health system.     Preferred Qualifications Role Purpose Responsible for providing case management services to maximize opportunities available to people living in the community who are trying to recover from the catastrophic effects of a serious mental illness.   Responsibilities Authorizes, coordinates, monitors, and adjusts services with contract providers. Identifies, develops, and maintains good relationships and linkages with a wide range of community resources. Ensures follow through with appointments by assisting clients to keep appointments. Provides collaborative clinical case management services. Minimum Requirements Education Master's Degree - Social Work Experience 2-5 years Supervisor Experience No Experience Licenses & Certifications Valid Driver's License LCSW or LPC Preferred Requirements Education Master's Degree - Social Work Experience 5-10 years Benefits and Legal Statement BJC Total Rewards At BJC we?re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date Disability insurance* paid for by BJC Annual 4% BJC Automatic Retirement Contribution 401(k) plan with BJC match Tuition Assistance available on first day BJC Institute for Learning and Development Health Care and Dependent Care Flexible Spending Accounts Paid Time Off benefit combines vacation, sick days, holidays and personal time Adoption assistance To learn more, go to our Benefits Summary . *Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer Thu, 30 Jul 2026 01:02:22 -0400 https://careers.cmsa.org/jobs/rss/22461613/case-manager-monday-through-friday https://careers.cmsa.org/jobs/rss/22461613/case-manager-monday-through-friday Raleigh, North Carolina, At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.   About Duke Raleigh Hospital, A Campus of Duke University Hospital Pursue your passion for caring with the Duke Raleigh Campus in Raleigh, North Carolina. With 204-beds, it is the third largest of the four Duke Health hospitals and offers a comprehensive array of services, including cancer, cardiovascular, neuroscience, advanced gastrointestinal, and wound healing care. Duke Nursing Highlights:   Duke University Health System is designated as a Magnet organization Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. Duke University Health System has 6000 + registered nurses Quality of Life: Living in the Triangle! Relocation Assistance (based on eligibility)   Monday - Friday with One weekend day/month The Case Manager is responsible for managing an assigned caseload to ensure timely assessment, planning, implementation, and evaluation of discharge plans and care transitions across the continuum of care. This role supports optimal patient outcomes, effective resource utilization, and compliance with CMS and other regulatory agencies. The Case Manager collaborates closely with interdisciplinary teams, patients, families, and community partners to coordinate safe, efficient care transitions. Key Responsibilities Care Coordination & Discharge Planning Assess all assigned patients for case management needs, including discharge planning, care transitions, advocacy, consultations, and patient/family education. Develop, implement, and evaluate individualized discharge plans ensuring timely and appropriate transitions of care. Coordinate services such as Home Health, Durable Medical Equipment (DME), transportation, Substance Abuse Treatment, outpatient follow-up, Skilled Nursing Facility (SNF) placement, and Acute Rehab referrals. Monitor daily census to ensure all patients are evaluated for case management needs. Collaboration & Communication Maintain effective communication with the healthcare team regarding assessment findings, discharge needs, and provider orders. Provide education to patients, families, and care teams regarding benefits, reimbursement guidelines, and regulatory requirements. Collaborate with Utilization Management to support payer negotiations, reduce denials, and promote appropriate resource use. Documentation & Compliance Maintain timely, accurate documentation of assessments, interventions, discharge arrangements, and all actions taken. Ensure compliance with federal, state, and local regulations, as well as organizational policies. Prepare reports and maintain records as required. Quality & Professional Development Participate in Quality Assurance/Performance Improvement (QAPI) activities. Represent the department with professionalism while fostering positive working relationships across Duke Health and external partners. Provide weekend, holiday, or after-hours coverage as assigned based on entity needs. Knowledge, Skills & Abilities Ability to work independently in a self-directed role. Strong problem-solving skills and ability to manage complex situations. Excellent written and verbal communication skills. Basic computer proficiency. Minimum Qualifications Education BSN or MSW required Experience Minimum of 3 years of relevant experience License and Certification Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire For BSN-prepared candidates:  Must hold a current RN license (or compact license) in the state of North Carolina.   Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. Thu, 30 Jul 2026 00:59:18 -0400 https://careers.cmsa.org/jobs/rss/22461607/case-manager-prn-weekends https://careers.cmsa.org/jobs/rss/22461607/case-manager-prn-weekends Durham, North Carolina, At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.   About Duke University Hospital Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of Duke Health's four hospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more. Duke Nursing Highlights:   Duke University Health System is designated as a Magnet organization Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. Duke University Health System has 6000 + registered nurses Quality of Life: Living in the Triangle! Relocation Assistance (based on eligibility)   Manage a designated caseload to coordinate and complete timely assessment, planning, implementation and evaluation of discharge plans and care transitions across the continuum of care. Ensure optimum utilization of the patient's and the Health System's resources and perform these duties within the requirements of CMS and other external review agencies.   Work Performed Monitor daily census and assignment to assure all patients are assessed.  Perform other related duties incidental to the work described herein. Case management needs including care coordination/transition and discharge planning, consultations, advocacy, education. Maintain effective communication with health care team members related to assessment findings, discharge planning needs and provider orders needed to arrange Homecare, Durable Medical Equipment, Transportation, Skilled Nursing or Acute Rehab Facility placement, Substance Abuse Treatment and outpatient follow-up. Maintain working knowledge of specific benefits and reimbursement guidelines, the discharge planning process and applicable federal, state and local regulations. Provide education and guidance on these topics to providers, patients and families as needed. Work with Utilization Management partners to provide information and feedback that will enhance negotiations and denial prevention with payers. Maintain timely documentation of assessment findings, discharge arrangements and actions taken according to departmental guidelines; prepare reports and maintain records as requested and/or required. Participate in Quality Assurance/Performance Improvement (QAPI) activities as requested. Job responsibilities may include site specific duties, weekend/holiday or after hours coverage as designated at each entity. Develop and maintain positive working relationships with customers internal and external to Duke Health System.   Knowledge, Skills and Abilities Ability to work effectively in a self-directed role Ability to multi-task, capable of daily problem-solving complex issues Excellent written and verbal skills Basic computer skills necessary   Level Characteristics N/A   Minimum Qualifications Education BSN or MSW required   Experience 3 years of relevant experience   Degrees, Licensures, Certifications Requires Case Management Certification (ACM, CCM or ANCC) within 3 years of hire. MSW or BSN required. If BSN must have current or compact RN licensure in state of NC.   CASE MANAGER  Job Level: G2 Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, genderidentity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential thatall members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. Thu, 30 Jul 2026 00:59:18 -0400 https://careers.cmsa.org/jobs/rss/22462149/hospital-case-management-team-coordinator https://careers.cmsa.org/jobs/rss/22462149/hospital-case-management-team-coordinator Danville, Pennsylvania, Job Summary Provides administrative, operational, and coordination support to the Inpatient Care Management team by promoting and maintaining throughput, supporting staff, problem solving, driving quality, and ensuring patients move safely and efficiently through the hospital system. Job Duties Assesses, plans, implements, coordinates, monitors and evaluates all options and services with the goal of optimizing the patient or member’s health status. Manages utilization and practice metrics to further refine the delivery of care models to maximize clinical, quality, and fiscal outcomes. Facilitates communication among care managers, social workers, physicians, nurses, patients, and external providers to ensure efficient patient care transitions, timely discharge, and compliance with hospital policies and regulatory requirements. Coordinate daily activities for the Case Management team, including scheduling meetings, patient care conferences, and interdisciplinary rounds. Assist, educate, and guide care managers and social workers with patient referrals, authorizations, and care transition processes. Communicate with internal departments and external agencies regarding patient services and post-acute care arrangements. Supervises, orients and trains all assigned personnel, while acting as a resource to answer questions and resolve problems. Monitors and maintains accurate Case Management documentation and departmental databases. Supports compliance with CMS, Joint Commission, and organizational standards, including but not limited to ensuring patients are offered choice for post-hospital needs. Supports quality improvement initiatives and departmental audits. Assists with addressing performance problems and initiating the disciplinary process as appropriate. Communicates significant issues within the Case Management department to leadership Creates and environment of participation, feedback, and escalation pathway. Work is typically performed in a clinical environment. Accountable to satisfy all job specific obligations and comply with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent elements considered necessary to successfully perform job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position. Position Details Education Bachelor's Degree-Related Field of Study (Required), Master's Degree-Social Work (Preferred) Experience Minimum of 3 years-Related work experience (Required) Certification(s) and License(s) OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status. Thu, 30 Jul 2026 01:08:29 -0400 https://careers.cmsa.org/jobs/rss/22462426/registered-nurse-rn-case-manager-home-health https://careers.cmsa.org/jobs/rss/22462426/registered-nurse-rn-case-manager-home-health Fletcher, North Carolina, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 895 Howard Gap Rd City: Fletcher State: North Carolina Postal Code: 28732 Job Description: Schedule: Monday-Friday 8am-5pm with on call. Location: Covering Fletcher and surrounding area doing home visits. ​ Evaluates the home environment for safety, infection control, and community resource needs.  Reviews patient history, physical diagnostics, and laboratory data, and reports abnormal results to the physician. Implements care plans through direct patient care, coordination, delegation, and supervision of healthcare team activities. Provides skilled nursing care, preventative rehabilitative procedures, and prescribed treatments in various home situations. Uses motivational interviewing and health coaching techniques to engage stakeholders in care management. Informs the physician, clinical manager, and healthcare team of changes in the patient’s condition and needs. Maintains updated clinical records, meeting documentation deadlines for certification, re-certification, and care plan updates. Provides comprehensive assessment, planning, implementation, and evaluation for a caseload of home patients. Optimizes daily schedules to support productivity, efficiency, and best practice visit utilization. Assesses physical, functional, psychosocial, cultural, cognitive status, and discharge planning needs of home care patients.  Formulates patient-specific care plans with the patient, family, and physician, establishing individualized, realistic, measurable goals. Other duties as assigned. Knowledge, Skills, and Abilities: Functions with a high degree of independence [Required] Ability to delegate tasks to appropriate personnel as indicated by skill level and professional standing [Required] Strong computer and technology skills [Required] A working knowledge of community resources and an ability to refers patients and families appropriately [Preferred] Home Care Regulations and Third-Party Reimbursement as it impacts care delivery [Preferred] Current IV Therapy skills [Preferred] Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Field of Study: N/A Work Experience: 1+ relevant clinical nursing experience [Required] Recent, relevant experience in a Medicare-certified home health agency as a case-manager [Preferred] Additional Information: N/A Licenses and Certifications: Registered Nurse (RN) [Required] Driver's License (DL) [Required] Auto Insurance (AL) [Required] Basic Life Support - CPR Cert (BLS) [Required] Certified for Oasis Specialist-Clinical (COSC) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/yde4bfwx Pay Range: $31.64 - $50.13 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22461601/cased-manager-neuro https://careers.cmsa.org/jobs/rss/22461601/cased-manager-neuro Durham, North Carolina, At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.   About Duke University Hospital Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more. Duke Nursing Highlights:   Duke University Health System is designated as a Magnet organization Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. Duke University Health System has 6000 + registered nurses Quality of Life: Living in the Triangle! Relocation Assistance (based on eligibility)   The Case Manager is responsible for managing an assigned caseload to ensure timely assessment, planning, implementation, and evaluation of discharge plans and care transitions across the continuum of care. This role supports optimal patient outcomes, effective resource utilization, and compliance with CMS and other regulatory agencies. The Case Manager collaborates closely with interdisciplinary teams, patients, families, and community partners to coordinate safe, efficient care transitions. Key Responsibilities Care Coordination & Discharge Planning Assess all assigned patients for case management needs, including discharge planning, care transitions, advocacy, consultations, and patient/family education. Develop, implement, and evaluate individualized discharge plans ensuring timely and appropriate transitions of care. Coordinate services such as Home Health, Durable Medical Equipment (DME), transportation, Substance Abuse Treatment, outpatient follow-up, Skilled Nursing Facility (SNF) placement, and Acute Rehab referrals. Monitor daily census to ensure all patients are evaluated for case management needs. Collaboration & Communication Maintain effective communication with the healthcare team regarding assessment findings, discharge needs, and provider orders. Provide education to patients, families, and care teams regarding benefits, reimbursement guidelines, and regulatory requirements. Collaborate with Utilization Management to support payer negotiations, reduce denials, and promote appropriate resource use. Documentation & Compliance Maintain timely, accurate documentation of assessments, interventions, discharge arrangements, and all actions taken. Ensure compliance with federal, state, and local regulations, as well as organizational policies. Prepare reports and maintain records as required. Quality & Professional Development Participate in Quality Assurance/Performance Improvement (QAPI) activities. Represent the department with professionalism while fostering positive working relationships across Duke Health and external partners. Provide weekend, holiday, or after-hours coverage as assigned based on entity needs. Knowledge, Skills & Abilities Ability to work independently in a self-directed role. Strong problem-solving skills and ability to manage complex situations. Excellent written and verbal communication skills. Basic computer proficiency. Minimum Qualifications Education BSN or MSW required Experience Minimum of 3 years of relevant experience License and Certification Case Management Certification (ACM, CCM, or ANCC) required within 3 years of hire For BSN-prepared candidates:  Must hold a current RN license (or compact license) in the state of North Carolina.   Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department. Thu, 30 Jul 2026 00:59:18 -0400 https://careers.cmsa.org/jobs/rss/22459653/registered-nurse-rn-care-manager-medicine https://careers.cmsa.org/jobs/rss/22459653/registered-nurse-rn-care-manager-medicine Orlando, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 601 E ROLLINS ST City: ORLANDO State: Florida Postal Code: 32803 Job Description: Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned. Status: Full-Time/Days Education: • Associate's of Nursing [Required] • Bachelor's of Nursing [Preferred] Work Experience: • 2+ medical/hospital nursing experience [Required] • Prior Care Management/Utilization Management experience [Preferred] Licenses and Certifications: • Registered Nurse (RN) [Required] • Certified Case Manager (CCM) [Preferred] • Accredited Case Manager (ACM) [Preferred] Knowledge, Skills, and Abilities: • Leadership skills [Required] • Process and Outcome data analysis skills [Required] • Critical thinking and problem-solving skills [Required] • Ability to manage multiple tasks and prioritize levels of importance [Required] • Customer service skills [Required] • Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required] • Effective organizational skills [Required] • Computer proficiency with Outlook e-mail and electronic medical records [Required] • Flexible in a complex and changing healthcare environment [Required] • Knowledge of community resources and post-acute care programs across the continuum [Required] • Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required] • Knowledge of CMS Conditions of Participation for Discharge Planning [Required] • Conflict management and resolution skills [Required] • Teamwork principles [Required] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $32.76 - $57.47 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22458877/rn-case-manager-complex-cases https://careers.cmsa.org/jobs/rss/22458877/rn-case-manager-complex-cases Santa Monica, California, Description There’s nothing more exciting and rewarding than being able to make a significant, positive difference in someone’s life. At UCLA Health, you’ll experience this joy every day while also enjoying the positive, supportive, and collaborative environment that makes ours one of the most loved workplaces. Join us and find out for yourself.   Using your advanced practice nursing skills, you will be responsible for assessing and coordinating care for a diverse group of patients. You will collaborate and consult with a multi-disciplinary health care team as well as with patients and their families to ensure safe and effective coordination of care. This involves developing and implementing individualized care plans utilizing evidence-based tools for risk stratification to ensure delivery of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital care. We’re also looking to you to help drive performance improvement efforts.   At UCLA Health, our passion for delivering the highest quality patient care has enabled us to become a world-renowned health system with four award-winning hospitals and more than 270 community clinics throughout Southern California. We’re also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. If you’re looking to experience greater challenge and fulfillment in your career, come to UCLA Health.   Salary Range:  $68.81- $88.99 hourly   Qualifications We’re seeking a self-directed, creative problem solver with a: BSN or MSN (ASN accepted for current UCLA Health Nursing staff) CA RN License and BLS certification  Recent experience in case management, utilization management and discharge planning  Minimum of three years of acute hospital experience; or the equivalent of education and experience Strong leadership abilities Systems planning and patient care management experience in a high-volume work environment Excellent communication, interpersonal, organizational and analytical skills Ability to work effectively and collaboratively with interdisciplinary teams Knowledge of a large university teaching hospitals   Experience in an academic hospital and experience with complex case management preferred. Thu, 30 Jul 2026 00:56:10 -0400 https://careers.cmsa.org/jobs/rss/22459702/market-director-care-management https://careers.cmsa.org/jobs/rss/22459702/market-director-care-management Davenport, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 40100 HWY 27 City: DAVENPORT State: Florida Postal Code: 33837 Job Description: Oversees the departments recruitment and retention activities, taking action to ensure adequate staff and leadership in care management. Actively engages with post-acute care entities to improve patient care transitions and decrease readmissions. Leverages and leads technology change management to improve staff efficiencies, drive positive patient outcomes, and maximize the tools care managers utilize to perform their roles. Directs daily operations of the care management department, including discharge planning, care coordination, progression of care, and social services. Ensures compliance with CMS CoPs for Discharge Planning as well as related federal and state regulations. Responsible to participate in Corporate Care Management meetings, cascade information, and implement strategies with standard work and processes. Develops and oversees the implementation and compliance with Care Management policies and standard operating procedures. Collaborates with interdisciplinary hospital leaders and executives to achieve organizational goals. Develops and meets operational budget performance with oversight to assure capital and fiscal accountability. Partners with Utilization Management for the Utilization Review Committee as well as day-to-day operations. Identifies improvement opportunities and develops, implements, and monitors action plans. Educates and mentors facility Care Management staff and the interdisciplinary teams on data, outcomes, and opportunities. Knowledge, Skills, and Abilities: Understanding of medical necessity for appropriate patient status and level of care Understanding of Care Management best practices Ability to research and reason best practices to support process improvement Strong verbal and electronic communication skills Ability to analyze, evaluate and monitor data in addition to provide action plans Supports positive employee relations and customer experience Understanding of Microsoft Office Products and other appropriate software platforms Understanding of CMS Conditions of Participation for Discharge Planning Understanding of Managed Care and Value Based Programs Ability to work autonomously with self-direction Ability to work as a collaborative partner of a diverse leadership team Ability to lead and sustain change Knowledge of change management principles, methodologies, and tools [Required] Sustained goals of Care Management metrics, voice of the customer experience, employee engagement, and quality outcome viability of a Care Management program [Preferred] Education: Bachelor's in Nursing [Required] Master's in Nursing [Preferred] Work Experience: 5+ direct care management experience [Required] 3+ care management leadership experience [Required] 2+ frontline nursing experience [Required] Licenses and Certifications: Registered Nurse (RN) [Required] Accredited Case Manager (ACM) [Preferred] Certified Case Manager (CCM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay Range: $90,771.44 - $168,842.62 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22459684/mgr-care-management-rn https://careers.cmsa.org/jobs/rss/22459684/mgr-care-management-rn Tavares, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 1000 WATERMAN WAY City: TAVARES State: Florida Postal Code: 32778 Job Description: Oversees the daily operations of the Care Management department in inpatient, observation, and emergency department settings. Ensures documentation and compliance for discharge planning, patient choice, and other regulatory requirements. Ensures staff participation in daily multidisciplinary rounds and actively participates to optimize the interdisciplinary care coordination. Monitors staff documentation, reports, and dashboards to ensure adherence to the company-wide standard processes and quality care. Oversees care manager's providing the full discharge planning from admission to discharge, assuring high quality and timely care management interventions to avoid delays and unnecessary readmissions. Collaborates with hospital leadership and executives to escalate pace of care delays and ensure daily progression of care and throughput. Identifies process improvement opportunities and actively participates in interdisciplinary meetings to drive care coordination improvements. Manages the care management staff's escalations of delays and complicated cases and collaborate with care providers within and outside of the hospital to find solutions to avoid unnecessary days in the hospital. Educates and reinforces standard work with staff, ensuring orientation and competencies are completed effectively and efficiently. Accountable for hiring, onboarding, and retaining staff, ensuring a highly productive and engagement team. Oversees the coordination of family and care team meetings and ensures effective transitions of care and patient and family needs are met. Performs other duties as assigned Knowledge, Skills, and Abilities: N/A Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Field of Study: N/A Work Experience: 3+ direct care management experience [Required] 2+ frontline nursing experience [Required] Additional Information: N/A Licenses and Certifications: Registered Nurse (RN) [Required] Accredited Case Manager (ACM) [Preferred] Certified Case Manager (CCM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay Range: $77,758.69 - $144,624.32 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22459080/registered-nurse-discharge-planner-peds-case-management-prn https://careers.cmsa.org/jobs/rss/22459080/registered-nurse-discharge-planner-peds-case-management-prn Nashville, Tennessee, Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: MCJCHV Case Mgmt 10 Job Summary: Collaborates with the health care team to coordinate patient and family interventions across the continuum of care, removing barriers and promoting efficient and effective use of resources. Assists patients and families in establishing patient specific goals, both long term and short term. Facilitates appropriate follow up care and/or refers patients (within the designated patient population) to the appropriate next level or site of care. Serves in an advocacy role on behalf of patients, families, and caregivers to ensure safe, equitable healthcare provision. Assists in developing and meeting key Pillar outcomes and system improvement goals including financial, satisfaction, and clinical as the nursing component of the care coordination model. Assists in the nursing component of developing and meeting key Pillar goals including finance, satisfaction, clinical quality of care, innovation, and growth across the continuum of care. Conducts initial and/or concurrent utilization review medical necessity criteria. http://www.vanderbilt.edu/work-at-vanderbilt/requirements/nursing4.pdf . Position Shift: PRN (minimum 3 shifts per six-week schedule) 8 am - 4:30 pm KEY RESPONSIBILITIES Assesses and identifies patients with complex clinical needs that require a coordinated plan of care. Facilitates optimal reimbursement through certification process. Leads health care team in outcomes based practice in accordance with VUMC/PCC/TMO strategic initiatives. Develops case management plan that includes strategies or alternative interventions required to attain optimal patient and family specific outcomes. Analyzes progress on the plan of care, identifies variances, and intervenes utilizing process improvement methodologies to remove barriers and progress care. Participates as an active partner with multidisciplinary team members to ensure that patients receive care timely, according to their plan of care and at the appropriate level of care. Consistently demonstrates a sense of urgency in their work, especially related to escalation/removal of barriers, facilitating an appropriate (timely) LOS and reduction in inappropriate and unnecessary admissions and readmissions. Demonstrates leadership skills and acts as the key information and education resource for the interdisciplinary team as related to caring for complex needs and securing appropriate services. TECHNICAL CAPABILITIES Our Nursing Philosophy: We believe highly skilled and specialized nursing care is essential to Vanderbilt University Medical Center's mission of quality in patient care, education and research. We believe nursing is an applied art and science focused on helping people, families and communities reach excellent health and well-being. As a Vanderbilt University Medical Center employee, you make a difference to our patients and their families by bringing compassion and care to those in need of hope and healing. Please see our current employee benefits offered: Affordable High Quality Health Plan Options Dental and /or vision plan 403 (b) retirement plan Paid Time off (flex PTO) Tuition Reimbursement and adoption assistance (maximums applied) Short-Long term disability Subsidized backup childcare And many more... Ask us about our current inpatient nursing supplemental Pay Program! Achieve the Remarkable: Learn more about VUMC Nursing here . Core Accountabilities: Organizational Impact: Executes job responsibilities with the understanding of how output would affect and impact other areas related to own job area/team with occasional guidance. Problem Solving/ Complexity of work: Analyzes moderately complex problems using technical experience and judgment. Breadth of Knowledge: Has expanded knowledge gained through experience within a professional area. Team Interaction: Provides informal guidance and support to team members. Core Capabilities : Supporting Colleagues:- Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas.- Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.- Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services:- Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.- Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.- Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.- Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.- Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.- Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation:- Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.- Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.- Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements. Position Qualifications: Responsibilities: Certifications: LIC-Registered Nurse - Licensure-Others Work Experience: Relevant Work Experience Experience Level: 2 years Education: Bachelor's: Nursing (Required) Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled. Thu, 30 Jul 2026 01:00:11 -0400 https://careers.cmsa.org/jobs/rss/22456808/case-manager-rn-acute-care https://careers.cmsa.org/jobs/rss/22456808/case-manager-rn-acute-care Tyler, Texas, Overview Join our team as a day shift, PRN, Acute Care Registered Nurse (RN) Case Manager in Tyler, TX.   Why Join Us?     Thrive in a People-First Environment and Make Healthcare Better   Thrive:  We empower our team with career growth opportunities and resources that support your wellness, education, and financial well-being.   People-First:  We prioritize your well-being with a supportive, inclusive culture where you are valued and cared for.   Make Healthcare Better:   We use advanced technology to support our team and enhance patient care.    Get to Know Your Team:   UT Health Tyler is the flagship hospital of the system serving hundreds of thousands annually. Specializing in advanced acute care medicine, our midtown location boasts a Level 1 trauma center and comprehensive stroke center, the region?s only EMCO program and a Level III NICU. Our medical staff includes more than 500 physicians and a full complement of subspecialty groups. Responsibilities The Case Manager RN is responsible for assessing and coordinating patient care across the continuum, utilizing accepted criteria and guidelines to manage benefits and determine the medical necessity of the services provided. This position functions to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization. The RN Case Manager reports to the Director of Case Management or designee. Qualifications Job Requirements: RN, Associates degree in nursing or higher Preferred Job Requirements: 2+ years? acute hospital-based nursing experience Experience in acute care hospital case management Certification in case management (ACM or CCM) Thu, 30 Jul 2026 01:09:56 -0400 https://careers.cmsa.org/jobs/rss/22456755/care-manager-prn-case-management https://careers.cmsa.org/jobs/rss/22456755/care-manager-prn-case-management Alexandria, Louisiana, Description Summary: The Care Manager (CM) PRN works in collaboration with the patient/family, physicians, and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge. The CM is responsible for identifying, initiating, and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Care Coordination and Discharge Planning are both responsibilities of this role. The CM assesses and responds to patient/family needs by coordinating the efforts of other team members and identifies and resolves barriers that hinder effective patient care. The CM adheres to departmental and organizational goals, objectives, standards of performance, policies, and procedures, and continually assures regulatory compliance. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Interviews patients/families to obtain information about social, emotional, and financial factors which may impact health status both prior to, and after, discharge and assess the patient?s current formal and informal support system as well as available benefits and resources. Works with the CMII or CMIII to develop and monitor the patient?s plan of care to ensure effectiveness and appropriateness of services. Coordinates/facilitates patient care progression throughout the continuum of care in an efficient and cost-effective manner. Serves as resource, provides support, and acts as an advocate on behalf of the patient related to treatment decisions and end of life issues. Closely monitors patient length of stay and communicates/collaborates with appropriate interdisciplinary team members to remove barriers and expedite discharge. Identifies and escalates local and system barriers that are impeding diagnostic or treatment progress and issues related to quality and risk as appropriate in a timely manner. Works to resolve identified delays to discharge. Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting. Assesses needs for discharge planning and continuing care/resource support following discharge; independently makes recommendations to patients and families regarding post-acute level of care needs and options including: Acute Rehabilitation Placement Nursing Home or Skilled Nursing placement Psychiatric or Substance Abuse placement New Dialysis Child/Adult/Domestic Abuse Home Health/Hospice Referrals Legal issues (adoptions, guardianship) Assistance with Advance Directives Community Resource needs Financial Issues/Funding options DME Referrals and Coordination Social Determinants of Health Ensures appropriate communication and updates are provided to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care. Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population. Provides information and support to patients and families, helping them access needed resources within the medical center and community. Ensures and maintains plan consensus from patient/family, physician, and payor. Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources. Actively participates in Multidisciplinary/Patient Care Progression Rounds. Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director. Documents in the medical record per regulatory and department guidelines. Assumes responsibility for professional growth and development. Must have excellent verbal and written communication and ability to interact with diverse populations. Must have critical and analytical thinking skills. Must have demonstrated clinical competency. Must have ability to Multitask and to function in a stressful and fast paced environment. Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Must have understanding of pre-acute and post-acute levels of care and community resources. Must have ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families. Must have understanding of internal and external resources and knowledge of available community resources. Must have the ability to move around the hospital to all areas for the majority of the workday while in office the rest of the day; general office and hospital environment. Job Requirements: Education/Skills One of the following education is required: Certificate, Associate, or bachelor?s degree in nursing Bachelor?s or Master?s degree in Social Work Experience Experience in the clinical or acute care setting preferred. Licenses, Registrations, or Certifications LVN/LPN, RN, LBSW, LMSW, or LCSW in the state of employment is required. BLS preferred.   Work Schedule: PRN Work Type: Per Diem As Needed Thu, 30 Jul 2026 01:04:48 -0400 https://careers.cmsa.org/jobs/rss/22454524/case-manager-nex https://careers.cmsa.org/jobs/rss/22454524/case-manager-nex Akron, Ohio, Akron Main NICU Part Time 24 Hours/week Days 8a-430p  Onsite Summary: The Case Manager assumes accountability and responsibility for managing the hospitalization of a caseload of patients from pre-admission through one week post-discharge. Responsibilities: Assumes accountability and responsibility for managing the hospitalization of a caseload of patients from pre-admission through one week post-discharge. Facilitates coordination of care by all members of the health care team to facilitate achievement of appropriate outcomes. Completes educational responsibilities. Performs leadership duties. Performs quality assurance and performance improvement duties. Performs communication and networking duties. Performs systems based practice duties. Demonstrates the knowledge and skills necessary to provide care for the physical, psych/social, educational, and safety needs of the patients served regardless of age. Other duties as required. Other information: Technical Expertise Experience in case management is preferred. Experience working with all levels within an organization is required. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Epic software or similar EMR software is required. Education and Experience Education: Bachelor's degree in Nursing [BSN] is required; Master's degree is preferred. Certification: Registered Nurse licensure is required. Current Health Care Provider BLS training from the American Heart Association is required. CCM or CCCTM Certification is preferred. Years of relevant experience: 3 to 5 years is required. Years of experience supervising: None Part Time FTE: 0.600000 Status: Onsite Thu, 30 Jul 2026 00:36:51 -0400 https://careers.cmsa.org/jobs/rss/22455638/part-time-rn-care-manager https://careers.cmsa.org/jobs/rss/22455638/part-time-rn-care-manager Ocala, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Part time Shift: Day (United States of America) Address: 1500 SW 1ST AVE City: OCALA State: Florida Postal Code: 34471 Job Description: Schedule: Part Time 3 x 8's Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned. Knowledge, Skills, and Abilities: Leadership skills [Required] Process and Outcome data analysis skills [Required] Critical thinking and problem-solving skills [Required] Ability to manage multiple tasks and prioritize levels of importance [Required] Customer service skills [Required] Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required] Effective organizational skills [Required] Computer proficiency with Outlook e-mail and electronic medical records [Required] Flexible in a complex and changing healthcare environment [Required] Knowledge of community resources and post-acute care programs across the continuum [Required] Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required] Knowledge of CMS Conditions of Participation for Discharge Planning [Required] Conflict management and resolution skills [Required] Teamwork principles [Required] Education: Associates of Nursing [Required] Bachelors of Nursing [Preferred] Field of Study: N/A Work Experience: 2+ medical/hospital nursing experience [Required] Prior Care Management/Utilization Management experience [Preferred] Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support (BLS) [Preferred] Certified Case Manager (CCM) [Preferred] Accredited Case Manager (ACM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $32.76 - $57.47 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22455566/registered-nurse-rn-care-management-surgical-transplant https://careers.cmsa.org/jobs/rss/22455566/registered-nurse-rn-care-management-surgical-transplant Orlando, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 601 E Rollins St City: Orlando State: Florida Postal Code: 32803 Job Description: Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned. Education: Associates of Nursing [Required] Bachelors of Nursing [Preferred] Work Experience: 2+ medical/hospital nursing experience [Required] Prior Care Management/Utilization Management experience [Preferred] Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support (BLS) [Preferred] Certified Case Manager (CCM) [Preferred] Accredited Case Manager (ACM) [Preferred] Knowledge, Skills, and Abilities: Leadership skills [Required] Process and Outcome data analysis skills [Required] Critical thinking and problem-solving skills [Required] Ability to manage multiple tasks and prioritize levels of importance [Required] Customer service skills [Required] Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required] Effective organizational skills [Required] Computer proficiency with Outlook e-mail and electronic medical records [Required] Flexible in a complex and changing healthcare environment [Required] Knowledge of community resources and post-acute care programs across the continuum [Required] Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required] Knowledge of CMS Conditions of Participation for Discharge Planning [Required] Conflict management and resolution skills [Required] Teamwork principles [Required] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $32.76 - $57.47 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22455653/rn-care-manager-acute-care https://careers.cmsa.org/jobs/rss/22455653/rn-care-manager-acute-care Ocala, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 1500 SW 1ST AVE City: OCALA State: Florida Postal Code: 34471 Job Description: $10,000 Sign on Bonus available for eligible candidates Relocation incentive from $5,000 available for eligible candidates Schedule: Mon - Friday with rotational weekends Shift(s) available: 8AM - 4:30PM (5 x 8's) and 10AM - 8:30PM (4 x 10's) Provides patient and family advocacy, and support patient’s choice and patient rights during hospitalization. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Other duties as assigned Knowledge, Skills, and Abilities: N/A Education: Associate's of Nursing [Required] Work Experience: RN acute care experience required RN Case Management experience preferred Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support (BLS) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay Range: $68,132.50 - $119,520.35 Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/ This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22455024/case-manager-prn https://careers.cmsa.org/jobs/rss/22455024/case-manager-prn Indianapolis, Indiana, Overview Location: On-site at university Hospital Shift: Monday - Friday 8:00a - 4:30p Position: RN - Case Manager - PRN The Case Manager plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the necessary services, and transition smoothly to the appropriate post-discharge setting. Performs accurate, timely, and effective discharge planning. Works with third-party payers to ensure coverage and administer education and prevention programs. ________________________________________ Position Overview: The RN-Case Manager plays a critical role in ensuring seamless patient transitions across care settings. This position involves assessment, care coordination, and communication with patients, families, providers, and payers. The nurse develops individualized discharge plans, manages insurance coverage, and facilitates patient education and safety. ________________________________________ Key Responsibilities: * Plan and coordinate patient care from pre-admission through post-discharge, ensuring appropriate levels of care and services. * Perform accurate and timely discharge planning, including documentation and communication. * Collaborate with the multidisciplinary team to develop comprehensive care plans. * Work with third-party payers to verify coverage and facilitate authorization for services. * Educate patients and families on post-discharge care, safety, and prevention strategies. * Assist with third-party denials, appeals, and understanding contractual arrangements. * Ensure compliance with Medicare, Medicaid, insurance, and regulatory guidelines. * Utilize various software applications including Windows, Cerner, MCCM, and SMS for documentation and communication. ________________________________________ Qualifications & Requirements: * Education: - Associate's Degree in Nursing required. - RNs hired after January 1, 2013, must complete their BSN within 5 years of hire. * Licensure: - Active RN license in Indiana or Nurse Licensure Compact (NLC). * Certifications: - Case Management certification preferred. * Experience: - 3-5 years of clinical experience in acute care required. * Knowledge & Skills: - Knowledge of InterQual Acute Level of Care Criteria and federal coverage guidelines is preferred. - Familiarity with Medicare/Medicaid, insurance, and regulatory guidelines is preferred. - Ability to understand third-party contractual arrangements and denial/appeal processes is advantageous. - Proficiency with Windows, Cerner, MCCM, SMS, and other relevant software applications. - Strong clinical background with excellent assessment and communication skills. ________________________________________ Core Competencies: - Connect to Promise: Demonstrates commitment to IU Health's mission, vision, and values by exhibiting behaviors and delivering results aligned with the organization's strategic goals. Focuses on improving the health of all Hoosiers through purpose, excellence, compassion, and teamwork. - Collaboration: Coordinates activities with team members and leaders. Seeks out and shares best practices to improve performance. - Relationship Building & Customer Care: Maintains respectful, courteous, and helpful relationships with internal and external customers. Demonstrates appreciation for customer needs and expectations. Reflects an attitude of responsiveness and service. - Communication: Clearly expresses ideas and opinions both verbally and in writing. Listens attentively, responds appropriately, and follows instructions carefully. Asks relevant questions to clarify needs and information. - Training & Patient Education: Acts as a preceptor, sharing knowledge and fostering learning. Develops individualized education plans for patients and families and evaluates their effectiveness. - Ethical Practice: Upholds high confidentiality standards in handling sensitive information, including medical records and HIPAA compliance. Demonstrates trustworthiness and ethical behavior in all interactions. ________________________________________ Why IU Health? As part of Indiana's largest healthcare system, we offer: * Competitive salary and comprehensive benefits * Opportunities for professional growth and development * A collaborative, innovative environment committed to excellence To learn more about our benefits, visit: ( https://careers.iuhealth.org/pages/benefits-designed-for-you ) Thu, 30 Jul 2026 00:54:28 -0400 https://careers.cmsa.org/jobs/rss/22455826/social-worker-suicide-prevention-case-manager https://careers.cmsa.org/jobs/rss/22455826/social-worker-suicide-prevention-case-manager Spokane, Washington, Summary This position is eligible for EDRP - a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of your start date. Approval - award amount (up to $200 -000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Contact VHA.ELRSProgramSupport@va.gov for questions. Qualifications NOTE: THE 2-PAGE RESUME REQUIREMENT DOES NOT APPLY TO THIS OCCUPATIONAL SERIES. FOR MORE INFORMATION - REFER TO REQUIRED DOCUMENTS BELOW. To qualify for this position - applicants must meet all requirements within 30 days of the closing date of this announcement. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy English Language Proficiency: Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f) Education: Have a master's degree in social work from a school of social work fully accredited by the Council on Social Work Education (CSWE) Graduates of schools of social work that are in candidacy status do not meet this requirement until the School of Social Work is fully accredited A doctoral degree in social work may not be substituted for the master's degree in social work Verification of the degree can be made by going to http://www.cswe.org/Accreditation to verify that the social work degree meets the accreditation standards for a masters of social work Licensure: Persons hired or reassigned to social worker positions in the GS-0185 series in VHA must be licensed or certified by a state to independently practice social work at the master's degree level Current state requirements may be found by going to http://vaww.va.gov/OHRM/T38Hybrid/ Exception: VHA may waive the licensure or certification requirement for persons who are otherwise qualified - pending completion of state prerequisites for licensure/certification examinations This exception only applies at the GS-9 grade level For the GS-11 grade level and above - the candidate must be licensed or certified At the time of appointment - the supervisor - chief social work or social work executive will provide the unlicensed/uncertified social worker with the written requirements for licensure or certification - including the time by which the license or certification must be obtained and the consequences for not becoming licensed or certified by the deadline Failure to Obtain License or Certification: In all cases - social workers must actively pursue meeting state prerequisites for licensure or certification starting from the date of their appointment Failure to become licensed or certified within the prescribed amount of time will result in removal from the GS-0185 social worker series and may result in termination of employment Loss of Licensure or Certification: Once licensed or certified - social workers must maintain a full - valid - and unrestricted independent license or certification to remain qualified for employment Loss of licensure or certification will result in removal from the GS-0185 social worker series and may result in termination of employment May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria) Grade Determinations: Social Worker GS-9: Experience - Education - and Licensure: None beyond the basic requirements *In addition to the experience above - the candidate must demonstrate all of the following KSAs: Ability to work with Veterans and family members from various socioeconomic - cultural - ethnic - educational - and other diversified backgrounds utilizing counseling skills Ability to assess the psychosocial functioning and needs of Veterans and their family members - and to formulate and implement a treatment plan - identifying the Veterans problems - strengths - weaknesses - coping skills - and assistance needed Ability to implement treatment modalities in working with individuals - families - and groups to achieve treatment goals This requires judgment and skill in utilizing supportive - problem solving - or crisis intervention techniques Ability to establish and maintain effective working relationships and communicate with clients - staff - and representatives of community agencies Fundamental knowledge of medical and mental health diagnoses - disabilities - and treatment procedures This includes acute - chronic - and traumatic illnesses/injuries common medications and their effects/side effects and medical terminology Social Worker GS-11: Experience and Licensure: Appointment to the GS-11 grade level requires completion of a minimum of one year of post-MSW experience equivalent to the GS-9 grade level in the field of health care or other social work-related settings - (VA or non-VA experience) and licensure or certification in a state at the independent practice level OR Education: In addition to meeting basic requirements - a doctoral degree in social work from a school of social work may be substituted for the required one year of professional social work experience in a clinical setting *In addition to the experience above - the candidate must demonstrate all of the following KSAs: Knowledge of community resources - how to make appropriate referrals to community and other governmental agencies for services - and ability to coordinate services Skill in independently conducting psychosocial assessments and treatment interventions to a wide variety of individuals from various socio-economic - cultural - ethnic - educational and other diversified backgrounds Knowledge of medical and mental health diagnoses - disabilities and treatment procedures (i.e acute - chronic and traumatic illnesses/injuries - common medications and their effects/side effects - and medical terminology) to formulate a treatment plan Skill in independently implementing different treatment modalities in working with individuals - families - and groups who are experiencing a variety of psychiatric - medical - and social problems to achieve treatment goals Ability to provide consultation services to new social workers - social work graduate students - and other staff about the psychosocial needs of patients and the impact of psychosocial problems on health care and compliance with treatment Preferred Experience: Experience with suicide prevention and Veterans Reference: For more information on this qualification standard - please visit https://www.va.gov/ohrm/QualificationStandards/ The full performance level of this vacancy is GS-11 The actual grade at which an applicant may be selected for this vacancy is in the range of GS-9 to GS-11 Physical Requirements: This job requires light lifting (under 15 pounds) - use of fingers - use of fingers - both hands required - specific visual requirement -to see computer - hearing (aid may be permitted) Environmental requirements include outside and inside - working closely with others and working alone. Duties Total Rewards of a Allied Health Professional Duties will vary by grade - but at the GS-11 level: Weekly clinical contact as needed for high-risk Veterans discharged from inpatient status for the first thirty days -post-discharge while identified as high-risk - in collaboration with other treatment team members Ongoing clinical contact as needed for Veterans deemed at high risk for suicide following national guidelines - and those Veterans placed on the high-risk list Preparation and updates in conjunction with the primary mental health team of the suicide-specific assessment - treatment plan - safety plan - and follow-up notes including treatment plan updates Provision of minimum monthly clinical case management contact with all high-risk Veterans in the program Coordination of all elements of mental health and primary care including active communication with all providers involved in the provision of comprehensive care to high-risk Veterans Provision of evidence-based treatment to high-risk Veterans (i.e. - group - individual Cognitive Behavioral Therapy) and completion of specialized training and/or certification in evidence-based treatment for high-risk behavior (e.g Dialectical Behavior Therapy) Review/provision of comprehensive discharge planning and social service referrals to high-risk Veterans and families Participation in administrative committees associated with tracking and monitoring of high-risk Veterans and serving as back-up to Suicide Prevention Coordinator and other Suicide Prevention Case Managers as needed Provides case management services while utilizing professional skill - objectivity - insight - advanced clinical training - and experience to interpret data identify viable treatment options - and recognize potential high-risk factors - acuity - and needs for services Obtains any relevant HIPAA clearances to allow transmittal of facility data on suicide attempts and individuals at risk and transmitting the data following cyber security requirements as applicable for this sensitive data Ensuring that identified high-risk Veterans have a 24-hour resource number to call and ways to get assistance if an immediate crisis should occur Respond to consults from the National Veterans Crisis Line and internal facility calls regarding suicidal Veterans m Other related duties as assigned Work Schedule: Monday Thru Friday 8:00am-4:30pm Recruitment Incentive (Sign-on Bonus): Not Authorized Permanent Change of Station (Relocation Assistance): Not Authorized EDRP Authorized: Former EDRP participants ineligible to apply for incentive Contact VHA.ELRSProgramSupport@va.gov - the EDRP Coordinator for questions/assistance Learn more Pay: Competitive salary and regular salary increases When setting pay - a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade) Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave - 13 days of sick leave - 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual - based on prior work experience or military service experience Parental Leave: After 12 months of employment - up to 12 weeks of paid parental leave in connection with the birth - adoption - or foster care placement of a child Child Care Subsidy: After 60 days of employment - full time employees with a total family income below $144 -000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66 Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Telework: AD-HOC Virtual: This is not a virtual position Functional Statement #: 000000 Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not Authorized Thu, 30 Jul 2026 02:55:45 -0400 https://careers.cmsa.org/jobs/rss/22453245/rn-case-manager-barnes-jewish-hospital https://careers.cmsa.org/jobs/rss/22453245/rn-case-manager-barnes-jewish-hospital Saint Louis, Missouri, Additional Information About the Role Location : Barnes-Jewish Hospital One Barnes Jewish Hospital Plaza St. Louis, MO 63110   This position is onsite Full-time; benefits eligible Monday - Friday; days; generally 8am-4:30pm 1 weekend day per month (Saturday or Sunday) Holiday rotation Additional Preferred Requirements At least 2 years of RN experience (ideally within an inpatient environment) BSN Prior Case Management experience Overview Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center. The CM Services reports through the division of Patient Care Services lead by the Chief Nursing Executive, Vice President of Patient Care Services. The CM Service is comprised of three departments: Case Management, Utilization Management, and Social Work. Through the Triad Model of Care Delivery, the objectives of the CM Services are for all patients to have access to healthcare through the BJH continuum and appropriate, safe discharge plans. The SW department is open 24 hours/day while the CM department is open 20 hours/day. Both departments provide coverage throughout the hospital including the Emergency Department, Outpatient Clinics, Registration sites, and Health Information Management. The Service employs registered nurses, social workers, a license practical nurse, a customer service representative, and administrative assistants. Preferred Qualifications Role Purpose Coordinates, negotiates, procures and manages the care of patients to facilitate achievement of quality cost-effective outcomes. Works collaboratively with physicians and interdisciplinary staff, internal and external to the organization, to identify and resolve issues. Performs and provides consultation regarding Utilization Management and Performance Improvement programs in order to obtain optimum value for the patient and the reimbursement source.   Responsibilities Assesses, coordinates, and evaluates each patient's plan of care. Establishes, continuously evaluates, and documents an individualized discharge plan. Ensures clinical documentation and cost-effective use of hospital resources. Minimum Requirements Education Nursing Diploma/Associate's - Nursing Experience Supervisor Experience No Experience Licenses & Certifications RN Preferred Requirements Education Bachelor's Degree - Nursing Experience 2-5 years Benefits and Legal Statement BJC Total Rewards At BJC we?re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date Disability insurance* paid for by BJC Annual 4% BJC Automatic Retirement Contribution 401(k) plan with BJC match Tuition Assistance available on first day BJC Institute for Learning and Development Health Care and Dependent Care Flexible Spending Accounts Paid Time Off benefit combines vacation, sick days, holidays and personal time Adoption assistance To learn more, go to our Benefits Summary . *Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer Thu, 30 Jul 2026 01:02:22 -0400 https://careers.cmsa.org/jobs/rss/22453186/rn-case-manager-ft-days-monroe-carell-jr-children-s-hospital-at-vanderbilt https://careers.cmsa.org/jobs/rss/22453186/rn-case-manager-ft-days-monroe-carell-jr-children-s-hospital-at-vanderbilt Nashville, Tennessee, Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniqueness is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research. Organization: MCJCHV Case Mgmt 10 Job Summary: Collaborates with the health care team to coordinate patient and family interventions across the continuum of care, removing barriers and promoting efficient and effective use of resources. Assists patients and families in establishing patient specific goals, both long term and short term. Facilitates appropriate follow up care and/or refers patients (within the designated patient population) to the appropriate next level or site of care. Serves in an advocacy role on behalf of patients, families, and caregivers to ensure safe healthcare. Assists in developing and meeting key Pillar outcomes and system improvement goals including financial, satisfaction, and clinical as the nursing component of the care coordination model. Assists in the nursing component of developing and meeting key Pillar goals including finance, satisfaction, clinical quality of care, innovation, and growth across the continuum of care. . Position Shift: Mon - Fri; 40 hrs/wk 8:00 AM - 4:30 PM some weekend coverage required KEY RESPONSIBILITIES Assesses and identifies patients with complex clinical needs that require a coordinated plan of care. Develops case management plan that includes strategies or alternative interventions required to attain optimal patient and family specific outcomes. Analyzes progress on the plan of care, identifies variances, and intervenes utilizing process improvement methodologies to remove barriers and progress care. Integrates ethical provisions in all areas of the practice. Demonstrates leadership skills and acts as the key information and education resource for the interdisciplinary team as related to caring for complex needs and securing appropriate services. The responsibilities listed are a general overview of the position and additional duties may be assigned. TECHNICAL CAPABILITIES Treatment Planning (Intermediate): Demonstrates mastery of treatment planning and possesses sufficient knowledge, training, and experience to be capable of successfully delivering treatment planning services without requiring support and instruction from others. Case Management (Intermediate): Demonstrates mastery of case management in practical applications for complex clinical care coordination. Possesses sufficient knowledge, training, and experience to be capable of successfully delivering results without requiring support and instruction from others. Able to train and educate by setting the example, giving instruction, providing leadership, and generally raising the level of performance of others while on the job. RN Access Patient Education (Intermediate): Demonstrates mastery of patient education in practical applications of a complex nature. Possesses sufficient knowledge, training, and experience to be capable of successfully delivering patient and family education services without requiring support and instruction from others. Evidence-Based Practice (Intermediate): Demonstrates ability to integrate evidence from multiple sources and determine if a practice change should occur. Shares knowledge with peers and other clinical team members independently. Nursing Patient Assessment & Evaluation (Intermediate): Demonstrates mastery of patient assessments and evaluations in practical applications of a difficult nature. Conducts primary care patient interviews and physical examinations. Conducts inquiry with a thorough series of questions when patients state an ailment or complaint in order to accurately identify and elaborate on the problem. Possesses sufficient knowledge, training, and experience to role model and coach less experienced peers. Our Nursing Philosophy: We believe highly skilled and specialized nursing care is essential to Vanderbilt University Medical Center's mission of quality in patient care, education and research. We believe nursing is an applied art and science focused on helping people, families and communities reach excellent health and well-being. As a Vanderbilt University Medical Center employee, you make a difference to our patients and their families by bringing compassion and care to those in need of hope and healing. Please see our current employee benefits offered: Affordable High Quality Health Plan Options Dental and /or vision plan 403 (b) retirement plan Paid Time off (flex PTO) Tuition Reimbursement and adoption assistance (maximums applied) Short-Long term disability Subsidized backup childcare And many more... Ask us about our current inpatient nursing supplemental Pay Program! Achieve the Remarkable: Learn more about VUMC Nursing here . Core Accountabilities: Organizational Impact: Executes job responsibilities with the understanding of how output would affect and impact other areas related to own job area/team with occasional guidance. Problem Solving/ Complexity of work: Analyzes moderately complex problems using technical experience and judgment. Breadth of Knowledge: Has expanded knowledge gained through experience within a professional area. Team Interaction: Provides informal guidance and support to team members. Core Capabilities : Supporting Colleagues:- Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas.- Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships.- Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services:- Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.- Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions.- Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly.- Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure.- Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area.- Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation:- Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches.- Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges.- Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements. Position Qualifications: Responsibilities: Certifications: LIC-Registered Nurse - Licensure-OthersLicensure-Others Work Experience: Relevant Work Experience Experience Level: 3 years Education: Bachelor's: Nursing (Required) This role offers the opportunity to make a meaningful impact within Vanderbilt Health, supported by a comprehensive benefits package which may include health, disability, retirement and/or wellness offerings to enhance your well-being and professional growth. Vanderbilt Health is committed to fostering an environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE/Vets/Disabled. Thu, 30 Jul 2026 01:00:11 -0400 https://careers.cmsa.org/jobs/rss/22452422/case-manager-i-msw-patient-case-management https://careers.cmsa.org/jobs/rss/22452422/case-manager-i-msw-patient-case-management Raleigh, North Carolina, Overview Responsible for providing patient case management services to assigned populations. They use a collaborative interdisciplinary approach to anticipate, integrate, and coordinate the patient's care plan, discharge plan, and reentry into the community. The primary goal is to meet patients' needs to optimize clinical and resource outcomes while monitoring the plan's effectiveness. In collaboration with the clinical team, identifies patients who would benefit from case management services. They perform assessments to identify patient needs and barriers, assisting in the development of the care plan. Acting as a patient and family advocate, serves as a communication link between the physician, patient, family, healthcare team, community resources, and payers to reduce redundancy and fragmentation of care. They anticipate potential delays in the healthcare process and proactively work to avoid these delays. Ensures that patients are provided with the most appropriate level of care at discharge while coordinating a smooth transition based on patient choice and availability. Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit  www.wakemed.org . EOE Licensure Not Applicable Education Master's Degree Social Work Required Experience No Experience Required Thu, 30 Jul 2026 00:38:46 -0400 https://careers.cmsa.org/jobs/rss/22453414/social-worker-msw-ii-hp-utilization-management https://careers.cmsa.org/jobs/rss/22453414/social-worker-msw-ii-hp-utilization-management Irving, Texas, Description Summary: This position is responsible for assisting in meeting the patient's needs throughout the continuum of care. Guides patients, families, physicians, and to the appropriate community and adjunct resources that foster quality of life. Interviews patients and families/support systems to obtain an age-specific psychosocial assessment. Assists patients and families in adjustments to illness, disabilities, and resolving difficulties which interfere with the care management process. Provides psychosocial assessments and develops an interdisciplinary plan of care with the patient and stakeholders to best meet the needs of patients and families. Implements/assist with discharge planning services related to the complex patient. Responsibilities: Psychosocial Assessment and Interventions: Uses preliminary risk screening to assess patient/family risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness, and ability to cope. Intervenes with patients and families regarding emotional, social, and financial consequences of illness and/or disability; access and mobilize family/community resources to meet identified needs. Provide intervention in cases involving child abuse/neglect, domestic violence, elderly abuse, institutional abuse, and sexual assault. Serves as resource and provide support related to treatment decisions and end of life issues. Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system. Provides intervention and support in domestic violence, guardianship, foster care, adoptions, surrogacy, mental health placement, and advance directives. Demonstrates competence to perform patient care responsibilities in a manner that meets the age-specific and developmental needs of the patients served by the department. Complex Discharge Planning: Participated in discharge planning activities for complex patients in order to ensure timely discharge and to provide appropriate linkage with post-discharge care providers Deals with families exhibiting complex family dynamics that impact directly on patient care and discharge. Collaborates with RN Case Managers, physicians and the patient regarding the discharge planning status Develops plan of care in collaboration with the RN case manager, physician, and patient to secure the best discharge plan available to the patient Assessment and planning for the social requirements of patient and family of patient in long term care planning Validates discharge criteria for patients and families Educates patient/family and physician regarding post-acute care options based upon criteria and addresses issues of choice. Closely monitor patient length of stay in regard to the geometric mean length of stay and communicate/collaborate with appropriate interdisciplinary team members to remove barriers and expedite discharge. Attends and actively participates in interdisciplinary patient care rounds and works with the treatment team to formulate appropriate and realistic discharge plans. Initiate referrals to pharmaceutical companies to assist patients and families with high cost medications. Initiates referral to appropriate post-actue care providers, other health care providers, and community service agencies to assist patients and families with identifying resources to enhance and improve both the patient?s state of health and quality of life.  Ensures safe care to patients adhering to policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity and accuracy of practice. Promotes individual professional growth and development by meeting requirements for mandatory and continuing education, skills competency, supports department based goals which contribute to the success of the organization. Change Management: Acts as a catalyst for change in the organization; responds to change with flexibility and adaptability to overcome organizational resistance and inertia; demonstrates the ability to focus and energize associates to work together for change; gains maximum support form others for new initiatives. Shaping the Organization: Devises systems and processes which improve the overall functioning of the organization; ensures that the organization's systems, processes and people are integrated to achieve the mission in the most efficient and effective manner. Managing Process: Translates strategies into action steps; clearly assigns responsibility for decisions and tasks; sets clear objectives. Requirements: Education/Skills Master's Degree in Social Work from accredited institution Strong interview, assessment, organizational and problem-solving skills Excellent interpersonal communication and negotiation skills Ability to work with people of all social, economic and cultural backgrounds Ability to analyze, develop and manage change Ability to work independently and to develop relationships with physicians, families, patients, interdisciplinary team and community agencies Demonstrates ability to connect patients and families with necessary services Maintain working knowledge of resources and services available in the community including options for those with limited or non-existent funding options Experience One to two years hospital social work experience or applicable social service experience preferred Licenses, Registrations, or Certifications LCSW or LMSW License in state of employment Case Management Certification preferred Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time Thu, 30 Jul 2026 01:04:48 -0400 https://careers.cmsa.org/jobs/rss/22452421/case-manager-i-rn-patient-case-management https://careers.cmsa.org/jobs/rss/22452421/case-manager-i-rn-patient-case-management Raleigh, North Carolina, Overview Responsible for providing patient case management services to assigned populations. They use a collaborative interdisciplinary approach to anticipate, integrate, and coordinate the patient's care plan, discharge plan, and reentry into the community. The primary goal is to meet patients' needs to optimize clinical and resource outcomes while monitoring the plan's effectiveness. In collaboration with the clinical team, identifies patients who would benefit from case management services. They perform assessments to identify patient needs and barriers, assisting in the development of the care plan. Acting as a patient and family advocate, serves as a communication link between the physician, patient, family, healthcare team, community resources, and payers to reduce redundancy and fragmentation of care. They anticipate potential delays in the healthcare process and proactively work to avoid these delays. Ensures that patients are provided with the most appropriate level of care at discharge while coordinating a smooth transition based on patient choice and availability. Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit  www.wakemed.org . EOE Licensure Registered Nurse Required Education Bachelor's Degree Nursing Required Experience No Experience Required Thu, 30 Jul 2026 00:38:46 -0400 https://careers.cmsa.org/jobs/rss/22453430/ed-rn-care-manager-utilization-managment https://careers.cmsa.org/jobs/rss/22453430/ed-rn-care-manager-utilization-managment Corpus Christi, Texas, Description Summary: The Emergency Department (ED) Care Manager is responsible for establishing, coordinating, and maintaining the process to increase patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the ED. The Care Manager collaborates with the patient and/or family, multidisciplinary team, physicians, community partners, and payers to ensure the patient?s progress and level of care are appropriately determined. The Care Manager has well-developed knowledge and skill in patient status in the inpatient and outpatient settings and collaborates with other care managers, social workers, Patient Access, physicians, and administrative leadership in the ED to determine the appropriate level of care. The Care Manager also has a robust understanding of services and resources outside of the hospital that would be of benefit to the patient and initiates referrals as indicated. This work includes patient assessment and management, resource management, identifying patients appropriate for admission, observation or outpatient status, care facilitation, discharge planning with referrals to all levels of care, and other duties related to the defined population. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Uses approved criteria to conduct patient assessment and admission clinical review to ensure the appropriateness of setting and timely implementation of the plan of care. Performs review of anticipated admissions, placements in Observation status, and discharges using evidence-based criteria set for appropriate level of care assignment. Provides identification of patients for whom standard of care treatments could be safely rendered at home. Screens appropriateness of admission including observation versus inpatient status. Educates ED physicians and nurses about medical necessity and admission criteria. Collaborates with physicians and other members of the treatment team on documentation needs and opportunities. Utilizes high-risk screening criteria to make appropriate community and post-ED referrals. Initiates prior authorization process when indicated for post-ED referrals and services. Escalates to physician advisor when unable to resolve discrepancies with the attending physician. Manages high-use patients and works to find alternatives for care to frequent ED visits. Plans for discharges from the ED for patients who do not require admission to include arranging for Home Health, DME, placement, and community resources as they relate to social determinants of health. Provides patient and family education and counseling about existing health problem-related care. Anticipates barriers/variances to the delivery of care and intervenes as necessary. Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes. Coordinates and facilitates patient progression throughout the continuum. Collaborates with all members of the interdisciplinary team to facilitate appropriate care coordination and care delivery. Able to analyze clinical information and accurately apply clinical criteria. Job Requirements: Education/Skills Graduate of an accredited school of nursing (BSN preferred) or Master?s degree in Social Work (MSW) required Experience 3+ years of relevant clinical case/care management experience in the acute care setting required Familiarity with evidence-based medical necessity criteria sets required Competency in prior authorization functions and software, including the application of criteria and timelines required Proficiency in medical and managed care terminology required Licenses, Registrations, or Certifications RN or LMSW in the state of employment is required Case Manager certification preferred BLS preferred   Work Schedule: 7PM - 7AM Work Type: Full Time Thu, 30 Jul 2026 01:04:48 -0400 https://careers.cmsa.org/jobs/rss/22453857/rn-care-manager-weekends-sat-sun https://careers.cmsa.org/jobs/rss/22453857/rn-care-manager-weekends-sat-sun Parker, Colorado, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Part time Shift: Day (United States of America) Address: 9395 CROWN CREST BLVD City: PARKER State: Colorado Postal Code: 80138 Job Description: Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned. Knowledge, Skills, and Abilities: Leadership skills [Required] Process and Outcome data analysis skills [Required] Critical thinking and problem-solving skills [Required] Ability to manage multiple tasks and prioritize levels of importance [Required] Customer service skills [Required] Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required] Effective organizational skills [Required] Computer proficiency with Outlook e-mail and electronic medical records [Required] Flexible in a complex and changing healthcare environment [Required] Knowledge of community resources and post-acute care programs across the continuum [Required] Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required] Knowledge of CMS Conditions of Participation for Discharge Planning [Required] Conflict management and resolution skills [Required] Teamwork principles [Required] Education: Associates of Nursing [Required] Bachelors of Nursing [Preferred] Field of Study: N/A Work Experience: 2+ medical/hospital nursing experience [Required] Prior Care Management/Utilization Management experience [Preferred] Additional Information: N/A Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support (BLS) [Preferred] Certified Case Manager (CCM) [Preferred] Accredited Case Manager (ACM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $35.04 - $65.17 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400 https://careers.cmsa.org/jobs/rss/22453415/care-manager-prn-case-management https://careers.cmsa.org/jobs/rss/22453415/care-manager-prn-case-management Lake Charles, Louisiana, Description Summary: The Care Manager (CM) PRN works in collaboration with the patient/family, physicians, and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge. The CM is responsible for identifying, initiating, and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Care Coordination and Discharge Planning are both responsibilities of this role. The CM assesses and responds to patient/family needs by coordinating the efforts of other team members and identifies and resolves barriers that hinder effective patient care. The CM adheres to departmental and organizational goals, objectives, standards of performance, policies, and procedures, and continually assures regulatory compliance. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Interviews patients/families to obtain information about social, emotional, and financial factors which may impact health status both prior to, and after, discharge and assess the patient?s current formal and informal support system as well as available benefits and resources. Works with the CMII or CMIII to develop and monitor the patient?s plan of care to ensure effectiveness and appropriateness of services. Coordinates/facilitates patient care progression throughout the continuum of care in an efficient and cost-effective manner. Serves as resource, provides support, and acts as an advocate on behalf of the patient related to treatment decisions and end of life issues. Closely monitors patient length of stay and communicates/collaborates with appropriate interdisciplinary team members to remove barriers and expedite discharge. Identifies and escalates local and system barriers that are impeding diagnostic or treatment progress and issues related to quality and risk as appropriate in a timely manner. Works to resolve identified delays to discharge. Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting. Assesses needs for discharge planning and continuing care/resource support following discharge; independently makes recommendations to patients and families regarding post-acute level of care needs and options including: Acute Rehabilitation Placement Nursing Home or Skilled Nursing placement Psychiatric or Substance Abuse placement New Dialysis Child/Adult/Domestic Abuse Home Health/Hospice Referrals Legal issues (adoptions, guardianship) Assistance with Advance Directives Community Resource needs Financial Issues/Funding options DME Referrals and Coordination Social Determinants of Health Ensures appropriate communication and updates are provided to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care. Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population. Provides information and support to patients and families, helping them access needed resources within the medical center and community. Ensures and maintains plan consensus from patient/family, physician, and payor. Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources. Actively participates in Multidisciplinary/Patient Care Progression Rounds. Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director. Documents in the medical record per regulatory and department guidelines. Assumes responsibility for professional growth and development. Must have excellent verbal and written communication and ability to interact with diverse populations. Must have critical and analytical thinking skills. Must have demonstrated clinical competency. Must have ability to Multitask and to function in a stressful and fast paced environment. Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Must have understanding of pre-acute and post-acute levels of care and community resources. Must have ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families. Must have understanding of internal and external resources and knowledge of available community resources. Must have the ability to move around the hospital to all areas for the majority of the workday while in office the rest of the day; general office and hospital environment. Job Requirements: Education/Skills One of the following education is required: Certificate, Associate, or bachelor?s degree in nursing Bachelor?s or Master?s degree in Social Work Experience Experience in the clinical or acute care setting preferred. Licenses, Registrations, or Certifications LVN/LPN, RN, LBSW, LMSW, or LCSW in the state of employment is required. BLS preferred.   Work Schedule: PRN Work Type: Per Diem As Needed Thu, 30 Jul 2026 01:04:48 -0400 https://careers.cmsa.org/jobs/rss/22452981/rn-case-manager-surgery-services https://careers.cmsa.org/jobs/rss/22452981/rn-case-manager-surgery-services Los Angeles, California, Description There’s nothing more exciting and rewarding than being able to make a significant, positive difference in someone’s life. At UCLA Health, you’ll experience this joy every day while also enjoying the positive, supportive, and collaborative environment that makes ours one of the most loved workplaces. Join us and find out for yourself.   Using your advanced practice nursing skills, you will be responsible for assessing and coordinating care for a diverse group of patients. You will collaborate and consult with a multi-disciplinary health care team as well as with patients and their families to ensure safe and effective coordination of care. This involves developing and implementing individualized care plans utilizing evidence-based tools for risk stratification to ensure delivery of safe, high quality, efficient, and cost-effective care. You will also perform utilization review while assuring the delivery of concurrent and post-hospital care. We’re also looking to you to help drive performance improvement efforts.   At UCLA Health, our passion for delivering the highest quality patient care has enabled us to become a world-renowned health system with four award-winning hospitals and more than 270 community clinics throughout Southern California. We’re also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. If you’re looking to experience greater challenge and fulfillment in your career, come to UCLA Health.   Salary Range:  $68.81- $88.99 hourly   Qualifications We’re seeking a self-directed, creative problem solver with a: BSN or MSN (ASN accepted for current UCLA Health Nursing staff) CA RN License and BLS certification  Recent experience in case management, utilization management and discharge planning  Minimum of three years of acute hospital experience; or the equivalent of education and experience Strong leadership abilities Systems planning and patient care management experience in a high-volume work environment Excellent communication, interpersonal, organizational and analytical skills Ability to work effectively and collaboratively with interdisciplinary teams Knowledge of a large university teaching hospitals   Preferred: certified case manager and acute hospital experience as a case manager. Thu, 30 Jul 2026 00:56:10 -0400 https://careers.cmsa.org/jobs/rss/22453364/care-manager-case-management https://careers.cmsa.org/jobs/rss/22453364/care-manager-case-management Santa Fe, New Mexico, Description Summary: The Care Manager (CM) PRN works in collaboration with the patient/family, physicians, and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge. The CM is responsible for identifying, initiating, and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Care Coordination and Discharge Planning are both responsibilities of this role. The CM assesses and responds to patient/family needs by coordinating the efforts of other team members and identifies and resolves barriers that hinder effective patient care. The CM adheres to departmental and organizational goals, objectives, standards of performance, policies, and procedures, and continually assures regulatory compliance. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Interviews patients/families to obtain information about social, emotional, and financial factors which may impact health status both prior to, and after, discharge and assess the patient?s current formal and informal support system as well as available benefits and resources. Works with the CMII or CMIII to develop and monitor the patient?s plan of care to ensure effectiveness and appropriateness of services. Coordinates/facilitates patient care progression throughout the continuum of care in an efficient and cost-effective manner. Serves as resource, provides support, and acts as an advocate on behalf of the patient related to treatment decisions and end of life issues. Closely monitors patient length of stay and communicates/collaborates with appropriate interdisciplinary team members to remove barriers and expedite discharge. Identifies and escalates local and system barriers that are impeding diagnostic or treatment progress and issues related to quality and risk as appropriate in a timely manner. Works to resolve identified delays to discharge. Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting. Assesses needs for discharge planning and continuing care/resource support following discharge; independently makes recommendations to patients and families regarding post-acute level of care needs and options including: Acute Rehabilitation Placement Nursing Home or Skilled Nursing placement Psychiatric or Substance Abuse placement New Dialysis Child/Adult/Domestic Abuse Home Health/Hospice Referrals Legal issues (adoptions, guardianship) Assistance with Advance Directives Community Resource needs Financial Issues/Funding options DME Referrals and Coordination Social Determinants of Health Ensures appropriate communication and updates are provided to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care. Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population. Provides information and support to patients and families, helping them access needed resources within the medical center and community. Ensures and maintains plan consensus from patient/family, physician, and payor. Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources. Actively participates in Multidisciplinary/Patient Care Progression Rounds. Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director. Documents in the medical record per regulatory and department guidelines. Assumes responsibility for professional growth and development. Must have excellent verbal and written communication and ability to interact with diverse populations. Must have critical and analytical thinking skills. Must have demonstrated clinical competency. Must have ability to Multitask and to function in a stressful and fast paced environment. Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Must have understanding of pre-acute and post-acute levels of care and community resources. Must have ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families. Must have understanding of internal and external resources and knowledge of available community resources. Must have the ability to move around the hospital to all areas for the majority of the workday while in office the rest of the day; general office and hospital environment. Job Requirements: Education/Skills One of the following education is required: Certificate, Associate, or bachelor?s degree in nursing Bachelor?s or Master?s degree in Social Work Experience Experience in the clinical or acute care setting preferred. Licenses, Registrations, or Certifications LVN/LPN, RN, LBSW, LMSW, or LCSW in the state of employment is required. BLS preferred.   Work Schedule: MULTIPLE SHIFTS AVAILABLE Work Type: Per Diem As Needed Thu, 30 Jul 2026 01:04:48 -0400 https://careers.cmsa.org/jobs/rss/22453429/rn-registered-nurse-clinical-care-coordinator-case-management https://careers.cmsa.org/jobs/rss/22453429/rn-registered-nurse-clinical-care-coordinator-case-management Santa Fe, New Mexico, Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for establishing, coordinating, and maintaining the process to increase patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum for the ED. The RN Clinical Care Coordinator collaborates with the patient and/or family, multidisciplinary team, physicians, community partners, and payers to ensure the patient?s progress and level of care are appropriately determined and evaluates or screens patients entering the CHRISTUS Health System for medical necessity. The RN Clinical Care Coordinator will collaborate with relevant providers and partners to determine the appropriate patient class and level of care of patients entering the CHRISTUS Health system to ensure the appropriate utilization of resources and maximize appropriate reimbursement opportunities. The RN Clinical Care Coordinator will utilize problem-solving and customer service skills to determine the best course of action for the patient, the physician, and the hospital by working closely with facility House Supervisors, referring physicians, ED, and inpatient staff to ensure the effective and efficient admission/placement of every patient. This job requires the full understanding and active participation in fulfilling the Mission of CHRISTUS Health. It is expected that the associate demonstrates behavior consistent with the Core Values. The associate shall support CHRISTUS Health?s strategic plan and the goals and direction of their Performance Improvement Plan (PIP). Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Reviews clinical information for patients upon entry into the health system to determine appropriate placement and patient class to maximize appropriate hospital reimbursement and positively manage length of stay. Coordinates with onsite partner providers (LTACH, Inpt Rehab) to review requests for facility services and ensure appropriate use of outpatient hospital resources for (their patients) including scheduling coordination and appropriate escort by sending provider. Review all ED patients identified by the treating physician as requiring admission to the hospital to ensure appropriate patient class and resource utilization. Educates hospital and ED providers on levels of care, resource utilization, payor practices, and documentation. Escalates to Physician Advisor or CMO when discrepancies are present. Performs the initial clinical medical necessity review utilizing evidence-based criteria and enters into the medical record for the receiving CM team. Utilizes high risk screening criteria to make appropriate community and post-ED referrals. Initiates prior authorization process when indicated for post-ED referrals and services. Escalates to physician advisor when unable to resolve discrepancies with the attending physician. Manages high-use patients and works to find alternatives for care to frequent ED visits. Plans for discharges from the ED for patients who do not require admission to include arranging for Home Health, DME, placement, and community resources as they relate to social determinants of health. Provides patient and family education and counseling about existing health problem related care. Anticipates barriers/variances to the delivery of care and intervenes as necessary. Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes. Coordinates and facilitates patient progression throughout the continuum. Collaborates with all members of the interdisciplinary team to facilitate appropriate care coordination and care delivery. Job Requirements: Education/Skills Graduate of an accredited school of nursing required Experience 2 years of experience in Case Management and/or Utilization Management required Licenses, Registrations, or Certifications RN License in the state of employment required BLS required   Work Schedule: MULTIPLE SHIFTS AVAILABLE Work Type: Part Time Thu, 30 Jul 2026 01:04:48 -0400 https://careers.cmsa.org/jobs/rss/22452974/case-manager-intensive-case-management-hybrid-x2f-remote https://careers.cmsa.org/jobs/rss/22452974/case-manager-intensive-case-management-hybrid-x2f-remote Los Angeles, California, Description Under the direction of the RN Asst. Director for Utilization Review, Intensive Case Management, you will support and perform duties to provide discharge planning/UM concurrent review of the complex cases admitted in Non Domestic Hospital. The Nurse Case Manager uses the nursing process to identify and advocate for patient issues. You will work  collaboratively with the patient, Faculty Practice Group, community resources, other providers, managed care operations,  the UCLA Health System, and health plans to implement, identify, coordinate, and monitor options and services to meet at-risk patients' healthcare needs.   The Nurse Case Manager/Clinical Advisor aims to foster continuity of care and reduce unnecessary utilization of healthcare services by coordinating and providing health services to meet individuals’ health needs. This is achieved by connecting key individuals involved in the care of the patient and decreasing fragmentation and duplication of care, the Nurse Case Manager/Clinical Advisor is able to enhance the quality and cost effectiveness of the care that is delivered across all settings and levels of care. Salary range: $143,675 - $185,811/Annual Qualifications Minimum of 2 years’ experience in utilization management, Health Plan or Medical Group CM or equivalent clinical Experience.    Must have strong problem solving skills.  Ability to analyze problems and formulate plans, solutions and a course of action given changing circumstances. Excellent organizational and time management skills, including the ability to handle multiple conflicting priorities simultaneously. Strong ability to prioritize. Demonstrate proficiency in computer skills such as Windows computer function, computer navigation, and ability to use computerized patient care systems. Competence in navigating the internet/intranet and use of browser software such as Microsoft Explorer and applications such as  Excel, Word, and PowerPoint Excellent interpersonal, verbal and written communication skills.      Ability to articulate clinical and non-clinical information to individuals of all levels of understanding. Ability to be flexible and work according to availability of office personnel, patient and resources required to coordinate care of patient.   Thu, 30 Jul 2026 00:56:10 -0400 https://careers.cmsa.org/jobs/rss/22451210/case-management-rn-float-pool https://careers.cmsa.org/jobs/rss/22451210/case-management-rn-float-pool Orlando, Florida, Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 601 E Rollins St City: Orlando State: Florida Postal Code: 32803 Job Description: Creates plan for care across the continuum, integrating patient/family preferences and values. Monitors patient care through assessments, evaluations and/or patient records. Advocates for resources and removal of barriers. Maintains ongoing dialog with supervisor and other health providers to ensure effective implementation of health plan. Acts as a resource for adequate medical record documentation, appropriateness of services as they relate to diagnoses, and treatment options for post-discharge care.' Knowledge, Skills, and Abilities: • N/A Education: • Associate's of Nursing [Required] • Bachelor's of Nursing [Preferred] Field of Study: • N/A Work Experience: • Must have 2 years of adult care management experience in a healthcare setting Additional Information: • Schedule can include weekend days Licenses and Certifications: • Registered Nurse (RN) [Required] • Basic Life Support - CPR Cert (BLS) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/2vvwrzem Pay Range: $32.76 - $57.47 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Thu, 30 Jul 2026 01:14:54 -0400