https://careers.cmsa.org Latest CMSA Career Center Jobs Mon, 14 Sep 2026 11:08:49 Z https://careers.cmsa.org/jobs/rss/22579559/patient-care-manager-endoscopy https://careers.cmsa.org/jobs/rss/22579559/patient-care-manager-endoscopy Bethlehem, Pennsylvania, The Patient Care Manager is responsible for the quality, safety and efficiency of patient care providers in the assigned department(s). This includes functional responsibility for the day-to-day operation of all components of the department(s) and integration into the hospital’s network, personnel, and planning, budgeting, marketing, clinical review and committee structure. Assumes leadership role planning for the department(s) including but not limited to personnel, performance improvement, patient safety, regulatory compliance, programs/services, and physical plant issues. JOB DUTIES AND RESPONSIBILITIES: Assumes 24-hour  responsibility/accountability  for planning, organizing, and supervising care necessary to assure patient safety and meet the needs of patients served by assigned department(s). Performs direct administrative functions for assigned department(s). Develops, implements and evaluates short and long range of performance improvement and operational goals and objectives for the department(s). Implements policies, procedures, rules, regulations, and recommended practices and ensures that clinical practice standards are met. Analyzes and responds accordingly to unit specific performance, outcome, and financial data. Develops capital and operational budgets in collaboration with Finance, hospital and Service line leadership. Selects, motivates and retains staff; initiates formal recognition plan. Responsible for developing and evaluating staffing based on patient care needs while maintaining costs within budget. Maintains departmental records for administrative and regulatory purposes. Facilitates unit-based councils, participates in network councils, leads projects for performance improvement and organizes monthly staff meetings and committee meetings. Enhances job knowledge by remaining current in trends in the health care industry and specialty areas. Works closely with appropriate medical staff leadership and members in the development and attainment of departmental goals. Promotes an environment that fosters inquiry and creative thought, nursing education , development and application of evidence-based practice initiatives  and maintenance of staffing competencies. Reviews performance of staff, assures staff competency and initiates remedial actions, when appropriate.   PHYSICAL AND SENSORY REQUIREMENTS: Sit up to 2 hours per day; 1 hour at a time. Stand for up to 10 hours time; 3 hours at a time. Walk 6 hours per day; 10 minutes at a time. Consistently lift and carry objects up to 10 lbs. Frequently push objects up to 10 lbs. Occasionally lift and carry objects up to 50 lbs. Frequently stoop and bend. Occasionally squat. Frequently reach above shoulder level objects. object through touch. Frequently finger and handle objects. Occasionally firmly grasp, twist and turn and turns objects with hands and fingers. Must be able to hear as it relates to normal conversation. Must be able to see as it relates to general, near, far, color, and visual monotony. EDUCATION: Graduate of an accredited professional nursing program.  Registered Nurse with current license to practice in the state of Pennsylvania or seeking licensure through endorsement. Bachelor of Nursing preferred. Enrollment in Bachelor of Nursing program required upon hire or at time of promotion. Bachelor of Nursing required within 5 years of hire or promotion. Master's degree preferred TRAINING AND EXPERIENCE: Minimum of three (3) years clinical experience with demonstrated leadership abilities required. Sound clinical knowledge in area to be managed. Strong interpersonal skills. Demonstrates ability in Human Resources and Financial Resource Management. Current BLS certification. Basic computer skills.   Please complete your application using your full legal name and current home address.  Be sure to include employment history for the past seven (7) years, including your present employer.  Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable.  It is highly recommended that you create a profile at the conclusion of submitting your first application.  Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer. St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.   Mon, 14 Sep 2026 08:34:04 -0400 https://careers.cmsa.org/jobs/rss/22578673/registered-nurse-rn-case-manager-ft-days https://careers.cmsa.org/jobs/rss/22578673/registered-nurse-rn-case-manager-ft-days Braselton, Georgia, Job Category: Nursing - Registered Nurse Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. About the Role: Job Summary Responsible for providing comprehensive assessment, planning, implementation and overall evaluation of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure patient management that efficiently and effectively aligns with patient needs using resources to meet quality, clinical and cost effective outcomes. Coordinates a team approach designed to facilitate the achievement of expected patient outcomes with appropriate transitions to the next level of care; Responsible for length of stay management, regulatory compliance, and attending/participating with interdisciplinary team rounds on assigned unit; Collaborates with community providers to facilitate and coordinate the plan of care for post-hospitalization needs of the patient. This position will come in contact with patients in the neonate, infant, child, adolescent, adult, and geriatric age groups; Employees will perform clinical duties in accordance with population specific guidelines and adhere to National Patient Safety Guidelines. Provides cross coverage for all RNCM as required across all settings in the care continuum, including weekend rotation (as needed). Minimum Job Qualifications Licensure or other certifications: Licensed to practice as an RN in Georgia. Educational Requirements: Associate degree. Graduate of an accredited school of nursing. Minimum Experience: Three ( 3) to five (5) years of experience in direct patient care and/or case management. Financial and discharge planning experience. Other: Preferred Job Qualifications Preferred Licensure or other certifications: CCM (Case Management Certification) or ACM (American Case Management Certification) preferred. Preferred Educational Requirements: Bachelors Degree Preferred Experience: Other: Job Specific and Unique Knowledge, Skills and Abilities Demonstrates aptitude in critical care, cardiac, medical, and/or surgical nursing Working knowledge of State and Federal regulations required Must demonstrate excellent observation skills, analytical thinking, problem solving abilities, and be self directed Excellent oral and written communication skills Demonstrates interpersonal skills including professionalism, a team player, pleasing personality and positive approach to the position Demonstrates the ability to think outside of the box and consistently create new, and effective solutions to today's problems and opportunities Essential Tasks and Responsibilities Monitor all patients on assigned units to ensure appropriate use of resources and interventions while managing patient's length of stay based on working DRG/admitting diagnosis. Communicates with Physician, patient/family, and other disciplines the expected length of stay, along with patient progress towards discharge. Provides coordination and facilitation oversight of patient care to assure required interventions occur in proper sequence and processes occur in a timely manner without delays. Identifies and acts upon potential delays in services; escalates unresolved delays to management for appropriate intervention. Assess, coordinate and facilitate patient's discharge plan to assure post-acute needs are arranged and secured prior to discharge; Communicate discharge plan with Physician, patient/family, and other members of the healthcare team as appropriate; Reassess discharge plan routinely throughout patient's stay to ensure timely, safe discharge and appropriate transition to the next level of care. Provides patient/family with information regarding their plan of care, discharge and any financial responsibility of inpatient or post-hospitalization services. Maintain knowledge of reimbursement methodologies and general coverage guidelines for all levels of inpatient and outpatient care. Communicate with Physician, patient/family or other team members as needed to ensure services will be covered. Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients are in the right status and level of care. Facilitate changes by communicating with Physician, mid-level or nursing staff as needed. Serve as liaison to patients family, Physicians, nursing staff and all other disciplines to achieve optimal outcomes in the development of patient's discharge plan. Serve as a leader on assigned unit in the areas of discharge planning, social service issues, community resources/referrals and financial information related to patient care and outcomes. Empowered to think outside of the box to consistently create new, and effective solutions to complex problems or opportunities. Actively supports a customer service oriented environment to continually enhance customer service; Communicates directly with Physicians, nursing staff, patient/family and other disciplines to ensure collaborative practice. Provide appropriate hand-off communication as patients transition from one unit to another to ensure and achieve optimal outcomes. Maintains positive attitude, and communicates appropriately with patients/families, Physician, management and other staff; responds positively to change and offers suggestions to effectively incorporate change as needed in daily workflow. Maintain detailed knowledge of community resources, governmental regulations, third party payers (PPO/HMO's) to facilitate appropriate outcomes. Adheres to all regulatory and DNV requirements; Knowledgeable of third party/governmental payer regulatory requirements and adheres to appropriate processes. Completes paperwork as required. Consistently demonstrates a 'sense of urgency' in his/her work, while mindful of the pillars and financial stewardship opportunities. Works all scheduled shifts, including weekend rotation, and remote coverage. Physical Demands Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time Weight Carried: Up to 20 lbs, Occasionally 0-30% of time Vision: Moderate, Occasionally 0-30% of time Kneeling/Stooping/Bending: Occasionally 0-30% Standing/Walking: Occasionally 0-30% Pushing/Pulling: Occasionally 0-30% Intensity of Work: Frequently 31-65% Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status. Mon, 14 Sep 2026 00:40:40 -0400 https://careers.cmsa.org/jobs/rss/22579030/case-manager-prn https://careers.cmsa.org/jobs/rss/22579030/case-manager-prn 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)   Occ Summary 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 for 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. Perform other related duties incidental to the work described herein. 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. BSN required and must have current or compact RN licensure in state of NC. or MSW(if no BSN or compact RN licensure in 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. Mon, 14 Sep 2026 00:56:29 -0400 https://careers.cmsa.org/jobs/rss/22578737/senior-director-health-plan-utilization-management-denver-health-medical-plan-x28-must-live-in-colorado-weekly-on-site-requirement-x29 https://careers.cmsa.org/jobs/rss/22578737/senior-director-health-plan-utilization-management-denver-health-medical-plan-x28-must-live-in-colorado-weekly-on-site-requirement-x29 Denver, Colorado, We are recruiting for a mission-driven Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement) to join our team! We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in-it’s something we live every day, for life’s journey. Our Values Respect | Belonging | Accountability | Transparency Department Managed Care Administration * Must Live in Colorado * This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week. Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational leadership for all utilization management functions across the organization. This area has unique regulatory and contractual compliance requirements for each line of business. This role is responsible for ensuring clinically appropriate, cost-effective, and regulatory-compliant medical necessity determinations while supporting high-quality member outcomes and provider collaboration. The Senior Director partners closely with Operations, Network Management, Quality, Compliance, and Finance to align utilization management strategy with organizational goals. In this capacity, the Senior Director oversees multiple teams performing this work. The Director reports to the DHMP Chief Medical Officer and collaborates closely with them to develop, update and implement the DHMP Utilization Management vision and strategy. Essential Functions : Assures that all staff are appropriately trained on all relevant software programs and applications necessary to perform their job functions. (10%) Participates in presentation of reports to the Operations Team, DHMP Board of Directors, and other bodies, as required. (10%) Attends and participates in Quality Management Committee, DHMP Operations Team meetings, Utilization Management Committee, enterprise Care Coordination meetings and other related meetings and activities as required. (10%) Serves as an issue-related or escalation liaison between Utilization Management and other departments and/or agencies both within DH, contractors and/or plan members. (10%) Oversees the maintenance, development, implementation, and continuous improvement of UM policies and procedures and management of information systems to accomplish UM goals for all contracted populations. (10%) Develops, analyzes, and presents reports on productivity, quality and outcomes. (10%) Ensures DHMP can provide documentation of compliance with contractual and regulatory requirements prior to audit by the State, CMS, DOI, etc. (10%) Develops, implements, and evaluates formal educational activities and follows up on issues identified through educational activities. Brings new knowledge to staff meetings. (10%) Works closely with DHMP Compliance Officer to ensure all DHMP lines of business operational performance meets or exceeds regulatory requirements including, but not limited to, policies and procedures reporting. Acts as a voting member of the DHMP Compliance Committee. (10%) Ensures routine and ad hoc reporting available which may include utilization data by setting (inpatient, outpatient, and Pharmacy), or other special projects supporting the overall goals of DHMP. (10%) Education : Master's degree required Graduation from an accredited educational program for Nursing or Physician’s Assistants required Work Experience : Seven years of experience in administration in managed care, health plan administration or healthcare provider organizations required AND Minimum of five years of supervisory and management experience required AND 1-3 years Health Plan or healthcare experience with various lines of business including Medicare, Medicaid, CHP, Exchange and/or Commercial Plans required AND 1-3 years Experience in managing vendors required required Licenses : Knowledge, Skills and Abilities : Knowledge of regulatory and accreditation standards for health plan or healthcare operations required. Strong program development, analysis, and evaluation skills required. Demonstrated excellence in managing people and processes. Strong leadership skills with ability to engage multidisciplinary clinical and non-clinical teams to solve complex problems. Strong knowledge and experience in utilization principles, concepts, and strategies preferred. Ability to develop and maintain effective relationships with internal and external stakeholders. * Must Live in Colorado * This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week. Shift Days (United States of America) Work Type Regular Salary $143,800.00 - $237,300.00 / yr Benefits At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future - with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development - while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you’re joining a mission-driven organization that invests in you. Here is a small list of our benefit programs: Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays 100% paid parental leave up to 6 weeks Immediate eligibility for retirement plans with employer contribution up to 9.5% Generous medical, dental, vision plans in addition to employer paid disability and life insurance. Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center Free RTD EcoPass (public transportation) Childcare discount programs & exclusive perks on large brands, travel, and more Tuition reimbursement & assistance Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways Professional clinical advancement program & shared governance Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer About Denver Health Denver Health is an integrated, high-quality academic healthcare system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation. As Colorado’s primary, and essential, safety-net healthcare system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year. Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer. Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled. Mon, 14 Sep 2026 00:44:27 -0400 https://careers.cmsa.org/jobs/rss/22578672/registered-nurse-rn-case-manager-ft-days https://careers.cmsa.org/jobs/rss/22578672/registered-nurse-rn-case-manager-ft-days Gainesville, Georgia, Job Category: Nursing - Registered Nurse Work Shift/Schedule: 8 Hr Morning - Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. About the Role: Job Summary Responsible for providing comprehensive assessment, planning, implementation and overall evaluation of individual patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure patient management that efficiently and effectively aligns with patient needs using resources to meet quality, clinical and cost effective outcomes. Coordinates a team approach designed to facilitate the achievement of expected patient outcomes with appropriate transitions to the next level of care; Responsible for length of stay management, regulatory compliance, and attending/participating with interdisciplinary team rounds on assigned unit; Collaborates with community providers to facilitate and coordinate the plan of care for post-hospitalization needs of the patient. This position will come in contact with patients in the neonate, infant, child, adolescent, adult, and geriatric age groups; Employees will perform clinical duties in accordance with population specific guidelines and adhere to National Patient Safety Guidelines. Provides cross coverage for all RNCM as required across all settings in the care continuum, including weekend rotation (as needed). Minimum Job Qualifications Licensure or other certifications: Licensed to practice as an RN in Georgia. Educational Requirements: Associate degree. Graduate of an accredited school of nursing. Minimum Experience: Three ( 3) to five (5) years of experience in direct patient care and/or case management. Financial and discharge planning experience. Other: Preferred Job Qualifications Preferred Licensure or other certifications: CCM (Case Management Certification) or ACM (American Case Management Certification) preferred. Preferred Educational Requirements: Bachelors Degree Preferred Experience: Other: Job Specific and Unique Knowledge, Skills and Abilities Demonstrates aptitude in critical care, cardiac, medical, and/or surgical nursing Working knowledge of State and Federal regulations required Must demonstrate excellent observation skills, analytical thinking, problem solving abilities, and be self directed Excellent oral and written communication skills Demonstrates interpersonal skills including professionalism, a team player, pleasing personality and positive approach to the position Demonstrates the ability to think outside of the box and consistently create new, and effective solutions to today's problems and opportunities Essential Tasks and Responsibilities Monitor all patients on assigned units to ensure appropriate use of resources and interventions while managing patient's length of stay based on working DRG/admitting diagnosis. Communicates with Physician, patient/family, and other disciplines the expected length of stay, along with patient progress towards discharge. Provides coordination and facilitation oversight of patient care to assure required interventions occur in proper sequence and processes occur in a timely manner without delays. Identifies and acts upon potential delays in services; escalates unresolved delays to management for appropriate intervention. Assess, coordinate and facilitate patient's discharge plan to assure post-acute needs are arranged and secured prior to discharge; Communicate discharge plan with Physician, patient/family, and other members of the healthcare team as appropriate; Reassess discharge plan routinely throughout patient's stay to ensure timely, safe discharge and appropriate transition to the next level of care. Provides patient/family with information regarding their plan of care, discharge and any financial responsibility of inpatient or post-hospitalization services. Maintain knowledge of reimbursement methodologies and general coverage guidelines for all levels of inpatient and outpatient care. Communicate with Physician, patient/family or other team members as needed to ensure services will be covered. Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients are in the right status and level of care. Facilitate changes by communicating with Physician, mid-level or nursing staff as needed. Serve as liaison to patients family, Physicians, nursing staff and all other disciplines to achieve optimal outcomes in the development of patient's discharge plan. Serve as a leader on assigned unit in the areas of discharge planning, social service issues, community resources/referrals and financial information related to patient care and outcomes. Empowered to think outside of the box to consistently create new, and effective solutions to complex problems or opportunities. Actively supports a customer service oriented environment to continually enhance customer service; Communicates directly with Physicians, nursing staff, patient/family and other disciplines to ensure collaborative practice. Provide appropriate hand-off communication as patients transition from one unit to another to ensure and achieve optimal outcomes. Maintains positive attitude, and communicates appropriately with patients/families, Physician, management and other staff; responds positively to change and offers suggestions to effectively incorporate change as needed in daily workflow. Maintain detailed knowledge of community resources, governmental regulations, third party payers (PPO/HMO's) to facilitate appropriate outcomes. Adheres to all regulatory and DNV requirements; Knowledgeable of third party/governmental payer regulatory requirements and adheres to appropriate processes. Completes paperwork as required. Consistently demonstrates a 'sense of urgency' in his/her work, while mindful of the pillars and financial stewardship opportunities. Works all scheduled shifts, including weekend rotation, and remote coverage. Physical Demands Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time Weight Carried: Up to 20 lbs, Occasionally 0-30% of time Vision: Moderate, Occasionally 0-30% of time Kneeling/Stooping/Bending: Occasionally 0-30% Standing/Walking: Occasionally 0-30% Pushing/Pulling: Occasionally 0-30% Intensity of Work: Frequently 31-65% Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status. Mon, 14 Sep 2026 00:40:40 -0400 https://careers.cmsa.org/jobs/rss/22578847/registered-nurse-x28-rn-x29-case-manager https://careers.cmsa.org/jobs/rss/22578847/registered-nurse-x28-rn-x29-case-manager Fairfax, Virginia, Registered Nurse (RN) Case Manager Alexandria, VA, United States Job Identification: 689589 Posting Date: 09/12/2026, 12:50 PM Job Schedule: Locations: Inova Mount Vernon Hospital Job Description: Inova Mt. Vernon Hospital is looking for a dedicated Experienced Registered Nurse Case Manager 1 to join the Case Management Team. This role will be Full-Time; Monday - Friday, rotating weekends. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. Work/Life Balance: offering paid time off, paid parental leave. The RN Case Manager 1 provides discharge planning and continuity of care for assigned patients in acute and post-acute settings. Provides coordination of services and acts as key liaison between patients, families and interdisciplinary healthcare members. Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely regulatory compliance and facilitation of precertification and payer authorization processes when indicated. Actively participates in clinical performance improvement activities. Registered Nurse (RN) Case Manager 1 Job Responsibilities: Collects delay and other data for specific performance and/or outcome indicators. Assists in the collection and reporting of resource and financial indicators including acute and post-acute case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals. Collects, analyzes and addresses variances from plans of care and care paths with physicians and/or other members of the healthcare team. Uses concurrent variance data to drive practice changes and positively impact outcomes. Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g. discharge planning, chronic disease planning). Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently. Ensures safe care to patients by 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/continuing education and skills competency. Supports department based goals which contribute to the success of the organization. Provides discharge planning and continuity of care for assigned patients in the acute and post-acute setting. Initiates and facilitates referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated. Collaborates with the interdisciplinary healthcare team, patients and families in the assessment and coordination of discharge planning needs, delivery of post-discharge planning needs, delivery of post-discharge services and transition of patients from hospitals to the discharge setting as well as ongoing care in the community. Documents relevant discharge planning information in medical records according to department standards and/or care management plans. Collaborates/communicates with internal and external case managers. Understands pre-acute and post-acute resources. Provides coordination of services and acts as a key Liaison between patients, families and the interdisciplinary healthcare team members. Work closely with members of patients' healthcare teams to manage and coordinate all areas of patients' care. Works holistically to ensure that healthcare plans and discharge plans meet the physical, social and emotional needs of patients. Provides educational resources and/or referrals to patients and patients' families to address identified needs such as social or financial. Acts as an advocate for patients to resolve barriers to care progression. Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Discusses payer criteria and issues on a case by case basis with clinical staff and follows-up to resolve problems with payers as needed. Applies approved clinical criteria to monitor appropriateness of admissions, continued stays or post-acute setting appropriateness and documents findings based on department standards. Identifies at risk populations by using approved screening tools and following established reporting procedures. Monitors LOS and ancillary resource use, depending on inpatient stay or outpatient program criteria, on an ongoing basis and takes actions to achieve continuous improvement efficiencies in both areas. Refers cases and issues appropriately to resolve barriers to care progression. Participates in the assessment of patients' clinical and psychosocial needs through review of patient information, personal contact with patients/families and interdisciplinary healthcare team members. Communicates routinely with patients, families, interdisciplinary healthcare team members and other appropriate parties with regard to the status of patients' care plans and progress toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict resolution when necessary. Works with the multidisciplinary team to address/resolve system problems impeding diagnostic or treatment progress. Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge. Ensures that all elements critical to patients' care plans have been communicated to the patients/families and members of the healthcare team. Minimum Qualifications: Certification: Basic Life Support (American Heart Association) Licensure: Licensed or eligible for licensure in the Commonwealth of Virginia as a Registered Nurse or an active multi-state Registered Nurse license Experience: 1 year of case management and/or clinical care experience Education: Bachelor's Degree Nursing or Associate's Degree. If RN has an Associate's Degree, within 2 years of date of hire, they must meet with their nurse leader and conduct the following: 1.) Identify which accredited school they plan to attend 2.) Provide a written plan with anticipated BSN completion date 3.) Submit a review of transcripts from the school indicating the required pre-requisites and timeline for taking the courses 4.) Complete BSN within 5 years of start date. Preferred Qualifications: One (1) year of previous inpatient case management and discharge planning experience is highly preferred. About Us: We are Inova, Northern Virginia's leading nonprofit healthcare provider. Every day, our 26,000+ team members provide world-class healthcare to the communities we serve. Our people are the reason we're a national leader in healthcare safety, quality and patient experience. And from best-in-class facilities to professional development opportunities, we support them at every step. At Inova, we're constantly striving to be ever better - to shape a more compassionate future for healthcare. Inova Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy-related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law. To apply, visit https://apptrkr.com/9825741 ""> https://elar.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/689589/?mode=location Copyright 2025 Jobelephant.com Inc. All rights reserved. Posted by the FREE value-added recruitment advertising agency je-b5bca49bce624099832c82ba1cbe1b33 Mon, 14 Sep 2026 00:48:32 -0400 https://careers.cmsa.org/jobs/rss/22578223/inpatient-registered-nurse-case-manager-care-coordination-full-time https://careers.cmsa.org/jobs/rss/22578223/inpatient-registered-nurse-case-manager-care-coordination-full-time Great Falls, Montana, Benefis is one of Montana's largest and premier health systems, and we are committed to providing excellent care for all, healing body, mind, and spirit. At Benefis, we work hard to support our employees in every aspect of their careers by offering outstanding benefits and compensation, state-of-the-art facilities, and multiple growth opportunities. The only thing missing is you! Flexible Scheduling! Option to work through the weekend or weekdays. Sample Workdays: Monday - Friday or Thursday - Sunday or Saturday - Tuesday, etc. Weekend shift differential! Responsible for the coordination and implementation of case management activities. Encompasses all care needs of patient during the time frame the patient requires care within the hospital setting. Remains point of contact for patient/family/legal representative until patient transitions to another service line OP case manager or patient navigator. Works with all members of the healthcare and multidisciplinary team to assure a collaborative approach is maintained in care and treatment of the patient. Reviews care and treatment for appropriateness against screening and reimbursement criteria for appropriate referral management. Plans and coordinates all necessary care services and needs for the patient. Provides patient/family/legal representative with community and/or care need resources. Organizes and leads necessary care conferences or multidisciplinary care team discussions. Sends any ordered or necessary referrals to the appropriate service line Patient Navigators, OP Case Manager, or community resource contact for review of appropriateness of services or resources requested. Attends daily care rounds if applicable, communicates any changes in the patient's clinical condition that may impact their transitional care plan to the multi-disciplinary care team and remains point of contact for the patient/family/legal representative during hospitalization. Communicates and collaborates with multidisciplinary care team members, Patient Navigators, OP Case Manager, patients/families/legal representatives. Continual monitoring and assessment of patients care plan goals and needs and modifies referrals and resource requests as necessary. Provides indirect and/or direct patient care as they identify, assess, plan, and evaluate the needs of patients for discharge and transitions of care. Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations. Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict. Will perform all job duties or job tasks as assigned. Will follow and adhere to all requirements, regulations and procedures of any licensing board or agency. Must comply with all Benefis Health System's organization policies and procedures. Education/License/Experience Requirements: Graduate of an accredited school of nursing, BSN Preferred Current state registered nurse license required. Current BLS certification. Must have thorough knowledge of clinical nursing skills. Exemption Wage Non-Exempt Starting Wage $35.19/hourly Actual offered wage is based on applicable experience Mon, 14 Sep 2026 00:31:03 -0400 https://careers.cmsa.org/jobs/rss/22577754/registered-nurse-care-manager https://careers.cmsa.org/jobs/rss/22577754/registered-nurse-care-manager 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: Up to $10,000 Sign-On Bonus * For Eligible Candidates Up to $10,000 Relocation Bonus * For Eligible Candidates Shift: 10 hours shift 8:30a-7:00pm or 9:00am-7:30pm Weekends and Holidays are required* 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. 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] Pay Range: $32.48 - $56.84 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22576743/care-manager-x2f-discharge-planner https://careers.cmsa.org/jobs/rss/22576743/care-manager-x2f-discharge-planner Cape May Court House, New Jersey, About us Cooper University Health Care is an integrated healthcare delivery system serving residents and visitors throughout Cape May County. The system includes Cooper University Hospital Cape Regional; three urgent care facilities; nearly 30 primary care and specialty care offices in multiple locations throughout Cape May County; The Cancer Center at Cooper University Hospital Cape Regional; the Claire C. Brodesser Surgery Center; AMI at Cooper, Miracles Fitness and numerous freestanding outpatient facilities providing wound care, lab, and physical therapy services. We have a commitment to our employees by providing competitive rates and compensation programs.  Cooper offers full and part time employees a comprehensive employee benefits program, including health, dental, vision, life, disability, retirement, on-site Early Education Center (employee discount), attractive working conditions, and the chance to build and explore a career opportunity by offering professional development. Short Description Conduct comprehensive assessments to identify patient discharge and transition-of-care needs. Develop and coordinate individualized discharge plans in collaboration with the interdisciplinary care team. Facilitate patient transitions to appropriate post-acute care settings and community resources. Coordinate referrals to home care, rehabilitation, skilled nursing, and other support services. Collaborate with physicians, nurses, and ancillary staff to support timely and safe discharges. Obtain and manage payer authorizations and address insurance-related barriers to discharge. Educate patients and families regarding available resources, services, and discharge plans. Monitor and resolve barriers to discharge while ensuring compliance with regulatory and organizational requirements. Experience Required Previous acute care experience preferred. Education Requirements Bachelor Degree -Social Work/Registered Nurse required.  License/Certification Requirements RN licensure in the State of New Jersey. Mon, 14 Sep 2026 00:51:43 -0400 https://careers.cmsa.org/jobs/rss/22577167/case-manager-part-time-days-8a-4p-atlantic-private-care https://careers.cmsa.org/jobs/rss/22577167/case-manager-part-time-days-8a-4p-atlantic-private-care Basking Ridge, New Jersey, Job Description Provide patient care and clinical support to field team as needed. Conduct prospect client evaluations, medical condition screening, service recovery and community representation with provider partners. Develop and coordinate education programming for CHHA, LPN and RN field staff. Supervise clinical field staff and provide case management to clients. Principal Accountabilities: Include, but are not limited to: * Provide clinical support services to APC S clients and case managers * Comply with policies and procedures necessary to maintain the standards required by accrediting bodies and/or licensing agencies. * Complete incident forms, follow up and document on staff/ client complaints and concerns * Provide input into the development of in-service program and conduct education sessions * Assist with private duty nursing (PDN) cases, as necessary. * Assist Scheduling Coordinators and HR Manager, with coordinating supervisions and client monitoring visits. * Ensure case manager visits are completed and all necessary documentation Include, but are not limited to: * Provide Clinical support services to APCS clients and case managers * Comply with policies and procedures necessary to maintain the standards required by accrediting bodies and/or licensing agencies. * Complete incident forms, follow up and document on staff/ client complaints and concerns * Provide input into the development of in-service program and conduct education sessions * Assist with private duty nursing (PDN) cases, as necessary. * Assist Scheduling Coordinators and HR Manager, with coordinating supervisions and client monitoring visits. * Ensure case manager visits are completed and all necessary documentation * Screen prospective Skilled Nursing clients * Conduct Chart audits as assigned and participate in PI committee * Serve as mentor for new APC S team members and monitor performance. * Participate in investigations and service recovery. * Secure MD orders, create, care plans, medication profiles, assessments, reassessments, admission paperwork, discharge paperwork. * Participate in case conferences, and departmental / staff meetings. * Provide Weekend and evening RN call coverage as needed * Screen prospective Skilled Nursing clients * Conduct Chart audits as assigned and participate in PI committee * Serve as mentor for new APC S team members and monitor performance. * Participate in investigations and service recovery. * Secure MD orders, create, care plans, medication profiles, assessments, reassessments, admission paperwork, discharge paperwork. * Participate in case conferences, and departmental / staff meetings. * Provide Weekend and evening RN call coverage as needed Qualifications Required: Education: Associate's degree in nursing. Bachelor's degree preferred Experience: At least 2 years' experience in a home health care setting or revenant clinical setting Experience working with home health care standards and quality assurance / risk management. One year acute care nursing Certificates: CPR Licenses: Current license as a Registered Nurse the state of New Jersey or RN compact license Meets the requirements of continuing education annually for license recertification Meets or exceeds the requirements of the competency exams. Possesses certification and/or proof of a passing grade on a written exam. Preferred: 2-3 years of previous Clinical Specialist experience preferred. About Us AHS Investment Corporation (AHSIC) is the wholly owned for-profit subsidiary of Atlantic Health. Our Business Units AtHome Medical - a Durable Medical Equipment Company, combining professional services and high-quality medical products. Atlantic Private Care Services - a private duty Nursing and Home Health Aide service provider, servicing the NJ counties of Morris, Essex, Union and Sussex. Real Estate Division - Commercial Property and Residential Housing ownership and management services for AHSIC and Atlantic Health. MSO - Management Services to a variety of healthcare enterprises, such as Atlantic Mobile Health/ Atlantic Ambulance, Primary Care Partners, Atlantic Health Partners, AHS ACO LLC, and others. Eagle Ambulance - a private ambulance company. Joint Ventures - Investment interests with various healthcare organizations. AHa! Innovation Center - an incubator designed to promote and commercialize innovation in the health care arena. Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted: Team Member Benefits Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members) Life & AD&D Insurance. Short-Term and Long-Term Disability (with options to supplement) 403(b) Retirement Plan: Employer match, additional non-elective contribution PTO & Paid Sick Leave Tuition Assistance, Advancement & Academic Advising Parental, Adoption, Surrogacy Leave Backup and On-Site Childcare Well-Being Rewards Employee Assistance Program (EAP) Fertility Benefits, Healthy Pregnancy Program Flexible Spending & Commuter Accounts Pet, Home & Auto, Identity Theft and Legal Insurance ____________________________________________ Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer. EEO STATEMENT Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status. Job Info Minimum Salary (Hourly Rate): 50.150000 Maximum Salary (Hourly Rate): 88.280000 Assignment Category: Part time - Benefits Hours per Week: 22.5 Primary Shift: Day Salary Admin Plan: RNS Mon, 14 Sep 2026 00:59:17 -0400 https://careers.cmsa.org/jobs/rss/22577741/registered-nurse-rn-care-management-surgical-transplant https://careers.cmsa.org/jobs/rss/22577741/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. Schedule: Full-Time Shift: Days 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] 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: $33.08 - $58.04 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22577260/care-manager-ii-case-management https://careers.cmsa.org/jobs/rss/22577260/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 Mon, 14 Sep 2026 01:01:22 -0400 https://careers.cmsa.org/jobs/rss/22575459/care-manager-rn https://careers.cmsa.org/jobs/rss/22575459/care-manager-rn Mckinney, Texas, About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Location: McKinney, TX Setting: Case Management Schedule: Full Time -Monday-Friday  Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job Summary You'll oversee patient care, using guidelines to establish benefits and resolve service necessity issues. Various roles will be adopted to encourage optimal outcomes. Manage care efficiently to reduce unnecessary usage. Essential Functions of the Role Producing, implementing, documenting, and updating care plans in collaboration with the entire healthcare team Formulating patient care management plans and setting treatment and self-management goals. Evaluating the healthcare, educational, and psychosocial requirements of the patient and their family. Helping patients stay healthy by educating, visiting, and communicating via phone; also, supporting adherence to care plans. Studying, establishing, and recommending resources to fulfill medical and non-medical needs of patients and families. Collaborating with all programs to ensure proper coordination of services. Proactively identifying issues and suggesting solutions for care coordination to ensure it's in the best setting. Communicating and linking with hospital, long-term care, and home health representatives. Key Success Factors Completion of an associate degree in nursing. Completion of a specialty certification is highly recommended. Familiarity with care coordination, managing resources and handling patient needs effectively. Proficiency in assessing patient health and creating effective management plans accordingly. Outstanding verbal and written communication skills. Ability to diligently monitor, evaluate and document patient progress in line with a care plan. Capability to aid patient access to community resources. Willingness to collaborate with both in-house and external medical professionals, partner agencies and organizations. Ability to handle rapidly changing situations and potential crises with understanding and composure. Commitment to ensuring confidentiality of patient details in line with all relevant policies and regulations. Belonging Statement We believe that all people should feel welcomed, valued and supported. Qualifications Associate's degree (2) two years of hands-on experience in the relevant field. An (RN) Registered Nurse license is required. Mon, 14 Sep 2026 01:07:58 -0400 https://careers.cmsa.org/jobs/rss/22574673/population-health-care-manager-team-lead-medicaid https://careers.cmsa.org/jobs/rss/22574673/population-health-care-manager-team-lead-medicaid 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.   Population Health Care Management Team Lead   The Care Management Team Lead is a role developed to work in coordination with the PHMO leadership in an assigned program to ensure that the work of care management staff is accomplished effectively.  Responsible for supervision of assigned team that includes productivity, performance and quality of assigned team. In collaboration with the managers, identifies plans and executes activities to promote effective quality care management and to ensure compliance according to policies and procedures. Additionally, may be assigned a small percentage of a caseload/portfolio to ensure the ability to engage customers within an identified population.  Model for staff best-in-class care management by using practical experience engaging the identified customers. General Description of the Job Class The Team Lead may be responsible for additional responsibilities above their respective general job class that they are leading. The Team Lead is responsible for clinical/functional expertise for specific customer populations (QA/QI, Engagement/Referral Process, Clinical conditions, Education/Training, and Care Management) with a design to meet specific contractual and program related requirements. The role functions as an integral part of an interdisciplinary team, ensuring excellence with transitions of care to achieve optimal clinical outcomes through a seamless model of access and care. Duties and Responsibilities of this Level Coordinate and facilitate timely implementation of appropriate interventions for identified customer populations following established policies and procedures. Or making necessary recommendations when gaps to policies and procedures are identified. Monitor, support, and engage both staff and additional management in related systemic opportunities, strengths, and benchmarks that will enhance negotiations with payers, improve care management, and/or address gaps in care. Using accessible data from multiple sources to ensure appropriate outreach, education, and necessary interventions are identified. Participation in the hiring/firing process of staff across care management. Engage with direct reports on a monthly basis via monthly individual supervision and larger team meetings to provide timely departmental updates, training, and coaching. Provide information on staff productivity on a monthly basis, at minimum. Shadow each direct report at least once per evaluation period unless concerns are identified and more is required. Conduct one-on-one training and group training with team members for identified areas of need related to workflow, documentation, and/or patient care. Manage time and attendance for staff members in API system. Complete routine audits (in data management system, MaestroCare/Virtual Health, and recorded calls) for quality, clinical care, understanding of education provided, accuracy of process, and overall experience of any PHMO customers. Provide timely and accurate oversight of process and feedback loops. Participates in identified PHMO/DukeWELL meetings, and role enhancing trainings that are health system/state/regional/nationally appropriate, etc. Develop and maintain positive relationships with customers internal and external to Duke Health System.   Maintain small caseload/patient-level responsibilities, following identified workflow and meeting required timeframes for completion of documentation, assessment, medication reconciliation and care planning. Required Qualifications at this Level Education Requirements Bachelor's degree in a clinical field such as Nursing, Counseling, Social Work, Therapy, Allied Health, or community health related fields.             Experience: 3 years of clinical experience required. Extensive management experience Care/Case management experience within different settings i.e. Home Health, Community, Gen. Med Strategic Planning experience           Degree and Certification (one of the following) Must have a current license in at least one of these areas: current or compact RN licensure in the state of North Carolina   Current licensure as a licensed clinical social worker by the NC Social Work Certification and Licensure Board, current licensure as a Licensed Professional Counselor by the state of NC  Current licensure as a Licensed Addiction Specialist by the state of North Carolina. Requires ACM or CCM certification within 3 years of hire date or by December 31, 2020 .             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. Mon, 14 Sep 2026 00:56:29 -0400 https://careers.cmsa.org/jobs/rss/22574771/registered-nurse-case-manager-vuh https://careers.cmsa.org/jobs/rss/22574771/registered-nurse-case-manager-vuh 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: TMO/UM Team D 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. . 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: 5 years Education: Bachelor's 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. Mon, 14 Sep 2026 00:58:17 -0400 https://careers.cmsa.org/jobs/rss/22575582/utilization-management-rn https://careers.cmsa.org/jobs/rss/22575582/utilization-management-rn Altamonte Springs, 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: 900 HOPE WAY City: ALTAMONTE SPRINGS State: Florida Postal Code: 32714 Job Description: Monitor admissions and perform initial and continued stay medical necessity reviews. Maintain thorough knowledge of payer guidelines and regulatory requirements and manages concurrent and pre-bill denials to prevent loss of reimbursement. Collaborate and communicate with the multidisciplinary care team regarding patient status and concurrent denials. Build relationships to promote interdisciplinary collaboration. Ensure requested clinical information is communicated, monitors daily discharge reports, and follows up with insurance carriers to obtain complete authorization. Other duties as assigned. Knowledge, Skills, and Abilities: Must be able to demonstrate knowledge and skills necessary to provide appropriate status recommendations. Demonstrates knowledge of the principles of growth, development, and disease states as it relates to the different life cycles. Ability to understand differences between notification, reference, and authorization numbers. Maintains up-to-date concurrent authorizations for in-house patients, utilizing daily commercial authorization reports. Accesses and reviews payer portals for authorization numbers in collaboration with department assistants; ensures proper update of authorization fields within EMR accordingly, delegating appropriate tasks to support staff. Familiarizes self with authorization requirements for assigned payers, based on payer matrix. Assists in assuring proper patient status authorization, by reviewing patient admission status within the electronic health record and matching with the correct authorization. Expedites communication with insurance contacts to assure timely authorization is received to avoid unnecessary denials. Demonstrates working knowledge and understanding of state and federal guidelines pertinent to care management, as well as current procedural terminology (CPT) codes and inpatient-only procedures. Ability to provide appropriate status recommendations based on medical necessity indicators, findings, and documentation. Navigates and utilizes other related software and databases to perform required actions that encompass Utilization Management. Demonstrates strong analytical, problem-solving skills, and the ability to analyze complex data. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as a resource to less experienced staff. Excellent interpersonal communication and negotiation skill. Strong analytical, data management, and computer skills. Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components. Thorough knowledge of medical admission screening requirements to assist in determining appropriateness of admission, treatment requested, for a variety of conditions, per evidence-based guidelines. Knowledge of hospital reimbursement models and trends and their impact. Previous experience with and working knowledge of medical necessity screening tool. Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Schedule: Schedule consists of rotating 8–10-hour shifts, Monday through Friday, with one Saturday approximately every six weeks and one major holiday per year, subject to business needs. Work Experience: 3+ years clinical nursing [Required] 5+ years clinical nursing in an acute care setting [Preferred] Experience working in electronic health records [Preferred] Utilization Management or Case Management [Preferred] Licenses and Certifications: Registered Nurse (RN) [Required Basic Life Support (BLS) [Preferred] Accredited Case Manager (ACM) [Preferred]   OR  Certified Case Manager (CCM) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay Range: $68,806.40 - $120,723.20 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22575620/care-manager-rn-full-time https://careers.cmsa.org/jobs/rss/22575620/care-manager-rn-full-time 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: Full 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: $35.39 - $65.82 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22575590/registered-nurse-rn-inpatient-care-manager https://careers.cmsa.org/jobs/rss/22575590/registered-nurse-rn-inpatient-care-manager Kissimmee, 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: 2450 N ORANGE BLOSSOM TRL City: KISSIMMEE State: Florida Postal Code: 34744 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: $33.08 - $58.04 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22575521/care-manager-rn-weekends-sat-sun https://careers.cmsa.org/jobs/rss/22575521/care-manager-rn-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: Schedule: Every Saturday and Sunday, working 10-hour shifts each day (20 hours per week). Shift times may vary. 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: $35.39 - $65.82 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22575595/registered-nurse-rn-inpatient-care-manager https://careers.cmsa.org/jobs/rss/22575595/registered-nurse-rn-inpatient-care-manager Kissimmee, 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: 2450 N ORANGE BLOSSOM TRL City: KISSIMMEE State: Florida Postal Code: 34744 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: $33.08 - $58.04 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22573641/community-care-social-worker-case-manager-hcbs-billings-full-time https://careers.cmsa.org/jobs/rss/22573641/community-care-social-worker-case-manager-hcbs-billings-full-time Billings, Montana, Benefis is one of Montana's largest and premier health systems, and we are committed to providing excellent care for all, healing body, mind, and spirit. At Benefis, we work hard to support our employees in every aspect of their careers by offering outstanding benefits and compensation, state-of-the-art facilities, and multiple growth opportunities. The only thing missing is you! Home and Community-Based case management services are centered care services delivered in the home and community. Program services fall into the categories of health services and human services. Primarily responsible for the human service aspect of case management to meet the psychosocial needs of members. Member of the multi-disciplinary Care Management Team that provides individualized member-driven planning, coordination, assessment, and monitoring of services to help enrolled Montana Big Sky Waiver Medicaid beneficiaries who are elderly or physically disabled residing in their own homes or communities rather than institutionalized care settings. Provides psychosocial assessments, mental health, navigating housing, financial stability, and community resources that focus on the human service psychosocial needs, community resources, and long-term care placements as part of the Care Management team. The goal is to improve quality of life, provide emotional support, and coordinate psychosocial services. Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations. Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict. Will perform all job duties or job tasks as assigned. Will follow and adhere to all requirements, regulations and procedures of any licensing board or agency. Must comply with all Benefis Health System's organization policies and procedures. Education/License/Experience Requirements: Bachelor's degree in social work or psychology, sociology, or other field related to social work Three (3) years of social work experience in a health care setting preferred Knowledge of case management methods, practice, and procedure. Knowledge of the application of diagnostic and crisis intervention skills. Knowledge of issues and needs of long-term care consumers. Prior knowledge of managing a budget. Knowledge of human behavior, disabilities, and the aging process. Exemption Wage Non-Exempt Starting Wage $22.13/hourly Actual offered wage is based on applicable experience Mon, 14 Sep 2026 00:31:03 -0400 https://careers.cmsa.org/jobs/rss/22575589/registered-nurse-rn-inpatient-care-manager https://careers.cmsa.org/jobs/rss/22575589/registered-nurse-rn-inpatient-care-manager Kissimmee, 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: 2450 N ORANGE BLOSSOM TRL City: KISSIMMEE State: Florida Postal Code: 34744 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: $33.08 - $58.04 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22574652/case-manager-float https://careers.cmsa.org/jobs/rss/22574652/case-manager-float 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 Regional Hospital Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services. 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)   External candidates eligible for $7,500.00 Commitment Bonus and relocation package of up to $8000.00 if moving more than 50 miles to join Duke   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. Mon, 14 Sep 2026 00:56:29 -0400 https://careers.cmsa.org/jobs/rss/22574540/utilization-management-nurse-auditor https://careers.cmsa.org/jobs/rss/22574540/utilization-management-nurse-auditor Los Angeles, California, Description Patient Business Services Provide clinical review, audit, analytical, and qualityimprovement support for utilization management, medical necessitydeterminations, and denial prevention and response efforts across the healthsystem. As the Utilization Management Nurse Auditor, you will conductconcurrent and retrospective case reviews, support denial appeals, analyzeutilization and denial trends, and collaborate with Care Coordination, ClinicalDocumentation Integrity, Revenue Cycle, and Physician Advisor teams. This rolehelps strengthen level-of-care determinations, clinical documentation, payercompliance, and operational and financial performance. In this role, you will: • Review concurrent and retrospective clinical denials to assess admissionstatus, level of care, length of stay, medical necessity, and other factorscontributing to denials. • Prepare clinical summaries and supporting documentation for first- andsecond-level appeals, support payer, RAC, and Medi-Cal audit responses, andcollaborate with Revenue Cycle and Physician Advisor teams to strengthen appealstrategies. • Analyze denial and audit findings to identify trends, root causes,documentation gaps, avoidable delays, and opportunities to improve utilizationmanagement performance. • Evaluate cases using established utilization review criteria, includingInterQual, MCG, organizational guidelines, and payer requirements, and escalatecomplex or questionable cases as appropriate. • Partner with Physician Advisors, Care Coordination teams, and clinical staffto improve documentation supporting medical necessity, status designation, andaccurate level-of-care determinations. • Prepare reports, dashboards, presentations, case summaries, trend analyses,and recommendations for leadership and Utilization Management Committee review. • Support performance improvement initiatives focused on length of stay,avoidable days, denial rates, status accuracy, utilization outcomes, and dataintegrity. • Serve as a clinical resource while collaborating with clinical andoperational leaders across the health system to support utilization management,clinical quality, patient safety, care progression, discharge planning, andcontinuous improvement efforts. Salary Range: $98,200 to $214,600 annually Qualifications Required • Bachelor’s degree in Nursing or a related healthcare field, or an equivalentcombination of healthcare education and experience. • Five or more years of professional healthcare experience in a clinical,quality improvement, utilization management, or related setting. • Three or more years of experience in utilization management, case management,and/or clinical auditing. • Active, unrestricted Registered Nurse license in California. • Thorough knowledge of utilization management criteria, including InterQualand MCG guidelines. • Thorough knowledge of payer requirements, medical necessity determinations,and denial management processes. • Advanced knowledge of quality improvement standards, clinical chart review,abstraction methodologies, and regulatory requirements. • Ability to use data collection, aggregation, validation, analysis, andreporting techniques to support utilization management and quality improvementactivities. • Strong analytical and critical thinking skills with the ability to interpretcomplex clinical, operational, and financial information. • Strong written and verbal communication skills for preparing reports,summaries, recommendations, and appeal documentation. • Ability to collaborate effectively with physicians, clinical staff,operational leaders, and external regulatory representatives. • Proficiency with electronic health records and healthcare data managementapplications, including familiarity with systems such as Epic. • Project management and organizational skills with the ability to managemultiple priorities and deadlines. Preferred • Master’s degree in Healthcare Administration, Public Health, BusinessAdministration, or a related field. • Certification in Case Management (CCM), Certified Professional UtilizationReview (CPUR), Certified Professional Coder (CPC), or a related specialty. • AAPC certification, such as Certified Professional Coder, CertifiedProfessional Biller, or Revenue Cycle Management Specialist Mon, 14 Sep 2026 00:53:01 -0400 https://careers.cmsa.org/jobs/rss/22572468/registered-nurse-care-manager-home-health https://careers.cmsa.org/jobs/rss/22572468/registered-nurse-care-manager-home-health Merriam, 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. 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: 23351 Prairie Star Pkwy City: Lenexa State: Kansas Postal Code: 66227 Job Description: All the benefits and perks you need for you and your family: Up to a $10,000 Sign on Bonus Available for eligible applicants Mileage reimbursement provided: $0.76 per mile Flexible scheduling with Full Time, Part Time and PRN available Company provided phone and laptop/iPad Shift: Monday-Friday 8am-4:30pm /On-Call Weekend Commitment Monthly/ Quarterly Location: Kansas Counties – Leavenworth, Johnson, Wyandotte,  Franklin, Douglas and Miami Counties Missouri Counties coverage of Platte, Clay, Jackson and Cass Counties. 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: $34.75 - $64.64 Applications are accepted on an on-going basis This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22571872/social-worker-bsw-ii-hp-utilization-management https://careers.cmsa.org/jobs/rss/22571872/social-worker-bsw-ii-hp-utilization-management Irving, Texas, Description Summary: Interviews patients and relatives to obtain social history relevant to medical problems and planning. Assists patients with environmental difficulties that interfere with obtaining maximum benefits from medical care. Serves as liaison between medical and nursing staffs, patients, relatives and appropriate outside agencies. Interprets and assists in resolving social problems that relate to medical condition and/or hospitalization. Responsibilities: The Social Worker is responsible for meeting patient need for the continuum of care by the discharge planning process. Directs access to appropriate community and adjunct resources that foster quality of life. Interviews patients and their family members/support systems to obtain an age-specific psychosocial assessment. Assist patients and families in adjustments to illness and disabilities and resolving personal financial and environmental difficulties which interfere with the care management process. Provides crisis intervention, individual and family therapy where skilled social work judgment is required. Provide discharge arrangements beginning upon patient?s admission. Attends and actively participates in interdisciplinary patient care rounds and works with the health care team to collaboratively formulate appropriate and realistic discharge plans. Assesses the psychosocial needs of family members / support systems that may interfere with optimizing the patient?s care management. Demonstrates awareness of the importance of addressing patient?s quality of life by maintaining current and up to date information of community resources and refers patients to those community resources which will enhance patient?s life. Provides resource/referral for counseling services and other recognized psychosocial therapies, child abuse referrals, adult protective service referrals, guardianship petitions and psychiatric petitions. Initiates referrals and appears in court as subpoenaed. Demonstrates competence to perform assigned patient care responsibilities in a manner that meets the age-specific and developmental needs of the patients served by the department. Provides referral to Spiritual Care and assist in crisis intervention to patients and their family members involved in emergency trauma, deaths, loss of home, family violence, etc. Assess high-risk patients who exhibit behaviors that are maladaptive to the adjustment of the illness and /or disability. Requirements: Bachelor's Degree LBSW in state of employment Work Schedule: 5 Days - 8 Hours Work Type: Full Time Mon, 14 Sep 2026 01:01:22 -0400 https://careers.cmsa.org/jobs/rss/22572358/care-manager-registered-nurse-home-health https://careers.cmsa.org/jobs/rss/22572358/care-manager-registered-nurse-home-health Altamonte Springs, 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 ALTAMONTE DR City: ALTAMONTE SPRINGS State: Florida Postal Code: 32701 Job Description: What Sets AdventHealth Home Health apart from the rest? Mileage reimbursement provided: $0.76 per mile Flexible scheduling with Full Time, Part Time and PRN available Company provided phone and laptop/iPad Locations available all across Florida! Apply today to learn more about the opportunities nearest you! 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] Work Experience: 1+ relevant clinical nursing experience [Required] Recent, relevant experience in a Medicare-certified home health agency as a case-manager [Preferred] 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: $34.32 - $63.84 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22571759/inpatient-care-manager-rn-per-diem-days-7a-3p-atlantic-health-newton-medical-center https://careers.cmsa.org/jobs/rss/22571759/inpatient-care-manager-rn-per-diem-days-7a-3p-atlantic-health-newton-medical-center Newton, New Jersey, Job Description Responsible for providing care and services of selected member populations across the continuum of illness. Ensures effective utilization and monitors health care resources. Manages the interdisciplinary team to achieve optimal clinical and resource outcomes. Works with the Supervisor/Manager of Case Management to assess, plan, implement, coordinate, monitor and evaluate services and outcomes to maximize the health of the patient. Principal Accountabilities: 1. Manages, coordinates, and facilitates the care delivered to patients through patient/family assessment and multidisciplinary collaboration. 2. Ensures daily chart review, utilization reviews, coordination of discharge planning activities and comprehensive clinical documentation in the electronic medical record. 3. Provides interdisciplinary patient care rounds, and identifies and works to resolve quality of care issues, barriers to the progression of care and discharge delays. 4. Formulates, coordinates and implements discharge plans and an efficient plan of care to ensure safe, timely and effective discharge plan. 5. Works with the interdisciplinary healthcare team to manage and assist the patient care plan. 6. Performs variance tracking, outcome analysis and identifies problems to assess the effectiveness of the clinical pathways. 7. Servers as a representative of the department and for the hospital community outreach. 8. Performs other related duties as assigned. Qualifications Required: 1. Bachelor's degree in Nursing or related field. 2. Valid New Jersey Nursing License Required. Preferred: 1. BSN preferred. 2. Minimum of 3 years of Acute Care experience is strongly preferred. About Us At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include: Atlantic Health Morristown Medical Center, Morristown, NJ Atlantic Health Overlook Medical Center, Summit, NJ Atlantic Health Newton Medical Center, Newton, NJ Atlantic Health Chilton Medical Center, Pompton Plains, NJ Atlantic Health Hackettstown Medical Center, Hackettstown, NJ Atlantic Health Goryeb Children's Hospital, Morristown, NJ Atlantic Health CentraState Healthcare System, Freehold, NJ Atlantic Medical Group Atlantic Visiting Nurse Atlantic Mobile Health Atlantic Rehabilitation We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades: Chosen for 17 years by Fortune as one of the magazine's "100 Best Companies to Work For." Atlantic Health Morristown and Atlantic Health Overlook Named by Newsweek as two of the "World's Best Hospitals" in 2026. Atlantic Health Morristown and Atlantic Health Overlook ranked within the top three hospitals in New Jersey by U.S. News & World Report's 2025-2026 Best Hospital rankings. Atlantic Health scored four "A" grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm. Atlantic Health Morristown and Atlantic Health Overlook are New Jersey's only hospitals to be named among America's 50 Best hospitals by Healthgrades in 2026. Named by Becker's Healthcare as one of the "165 Top Places to Work in Healthcare - 2026. Atlantic Health Morristown, Atlantic Health Overlook, Atlantic Health Chilton and Atlantic Health Newton all Forbes Top Hospitals for 2026. Named by Newsweek as one of America's Greatest Workplaces for Inclusion & Diversity 2025. Atlantic Health rated LEVEL 9 - 2025 CHIME Digital Health Most Wired. Since 1932, Newton Medical Center has been providing care to the people of Sussex and warren counties in New Jersey, Pike County in Pennsylvania and southern Orange County in New York. We are home to the Center for Breast Health, the only one of its kind in Sussex County, addressing all of a woman's breast health needs with state-of-the-art technology, resources, education, support and follow-up care. Newton Medical Center recently achieved the American Nurses Credentialing Center's Pathway to Excellence designation and is one of a select few health care facilities in New Jersey accredited by the Intersocietal Accreditation Commission (IAC) in all three echocardiography procedures: adult transthoracic, adult transesophogeal and adult stress. Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted: Team Member Benefits Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members) Life & AD&D Insurance. Short-Term and Long-Term Disability (with options to supplement) 403(b) Retirement Plan: Employer match, additional non-elective contribution PTO & Paid Sick Leave Tuition Assistance, Advancement & Academic Advising Parental, Adoption, Surrogacy Leave Backup and On-Site Childcare Well-Being Rewards Employee Assistance Program (EAP) Fertility Benefits, Healthy Pregnancy Program Flexible Spending & Commuter Accounts Pet, Home & Auto, Identity Theft and Legal Insurance ____________________________________________ Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer. EEO STATEMENT Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status. Job Info Minimum Salary (Hourly Rate): 55.620000 Maximum Salary (Hourly Rate): 55.620000 Assignment Category: Per Diem Hours per Week: 0.01 Primary Shift: Day Salary Admin Plan: RNS Mon, 14 Sep 2026 00:59:17 -0400 https://careers.cmsa.org/jobs/rss/22572083/clinical-case-manager-rn https://careers.cmsa.org/jobs/rss/22572083/clinical-case-manager-rn Albuquerque, New Mexico, Overview Join our team as a weekend shift, full-time, Case Management Acute Care Clinical Case Manager Registered Nurse in Albuquerque, NM.   You may be eligible for a sign on bonus for up to $10,000. You may also be eligible for relocation assistance. (if applicable)   WEEKEND SHIFT - FULL TIME   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: Lovelace Women?s Hospital is a 53-bed advanced neonatal intensive care unit, family care unit, an award-winning breast care center, and the first robotic surgery program in the state recognized as a Center of Excellence in Robotic Surgery by Surgical Review Corporation. Responsibilities The Clinical Case Manager assesses the social, psychosocial, cultural, environmental and financial situations concerning the patient and family. He/she is a patient/family advocate, promoting rights and dignity and striving to involve the patient/family in aspects of care as appropriate. The Clinical Case Manager also facilitates the acute, rehabilitative, and long-term discharge processes to provide for an optimal age-specific continuum of care for the populations listed below. Qualifications Job Requirements:   Minimum: BS or BA in Social Work or an associate's degree in nursing or Diploma of Nursing. Social Worker: Medical Social Worker, Licensed Clinical Social Worker preferred.  Must have a current license as a Social Worker from the New Mexico Board of Social Work Examiners, and basic life support certification.  Registered Nurse: Valid NM Nursing license or NM compact license (within 90 days of hire) and BLS certification must be obtained within 14 days of hire or transfer into the role and prior to providing direct patient care HIRING DEPARTMENT MAY ALSO REQUIRE ACLS and or PALS. Preferred Job Requirements:  Master?s degree in social work or bachelor?s degree in nursing Two years of medical social worker or RN Case Manager experience CCM or ACM  Mon, 14 Sep 2026 01:03:23 -0400 https://careers.cmsa.org/jobs/rss/22572032/case-manager-rn https://careers.cmsa.org/jobs/rss/22572032/case-manager-rn Pocatello, Idaho, Overview Join our team as a rotating shift, PRN, Case Management Acute Care Registered Nurse (RN) in Pocatello, ID.    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:   Portneuf Medical Center is a nationally recognized healthcare leader with 205 beds, serving as the region's tertiary care and Level II Trauma Center, housing the Portneuf Heart and Vascular Institute, Portneuf Cancer Center, Portneuf Medical Group, and Portneuf Air Rescue. 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.     Essential Functions   Act as a patient and caregiver advocate.  Work with the entire healthcare team to improve the quality of patient care, patient safety and customer service.   Act as a good steward of the patient?s healthcare resources and the resources of the hospital.   Screening and assess patients for needs using a standard tool.   Create a discharge plan of care based on identified needs.   Coordinate care to ensure consults, tests, and procedures are performed in a manner appropriate and consistent with patient choice and resources.   Communicate in both written (in the medical record) and oral fashion all contributions to the progression of care in a way that is easily understood by the patient, the caregiver, the healthcare team, and the payer.   Use compliant and ethical behaviors to ensure that federal, state, hospital, and patient self-determinations are met.   Assist the patient to transition to the next level of care in a timely manner with recognition given to readmission risks and appropriate post-discharge interventions are established.   Ensure that community resources are readily known, and patients are provided with a choice of post-acute providers.   Balance the responsibility of patient advocacy with stewardship of hospital resources.   Use the hospital defined method to ensure the patient is in the appropriate status and level of care throughout the continuum of care.   Follow the hospital utilization management process in respect to payer requirements for timely notification and communication of pertinent clinical data to support the admission, as well as continued stay and post-discharge needs of a patient.   Identify and track avoidable days/delays and use the information as an opportunity for improvement.   Work proactively to prevent medical necessity denials, assist in the appeal process if a denial is received and escalate the process as needed.   Keep current and abreast of regulatory requirements effecting role and responsibilities.  Excellent interpersonal and communication skills to build and foster collaborative partnerships using a team approach to span traditional boundaries within the health care setting.    Must be highly motivated with a positive attitude and high degree of flexibility in a rapidly changing environment.  Demonstrated ability to deliver accurate results on time and efficiently with a customer-focuses approach.   Demonstrated ability to change priorities quickly, work independently and multi-task without hesitancy.   Excellent written and verbal communication, complex problem solving and team leadership skills.  Qualifications Job Requirements:  Current RN license  BLS certification must be obtained within 14 days of hire or transfer into the role and prior to providing direct patient care. Preferred Job Requirements: 2+ years' acute hospital based nursing experience. Experience in acute care hospital case management. Certification in case management (ACM or CCM). Mon, 14 Sep 2026 01:03:23 -0400 https://careers.cmsa.org/jobs/rss/22572470/registered-nurse-care-manager-home-health https://careers.cmsa.org/jobs/rss/22572470/registered-nurse-care-manager-home-health 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. 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: 23351 Prairie Star Pkwy City: Lenexa State: Kansas Postal Code: 66227 Job Description: All the benefits and perks you need for you and your family: Up to a $10,000 Sign on Bonus Available for eligible applicants Mileage reimbursement provided: $0.76 per mile Flexible scheduling with Full Time, Part Time and PRN available Company provided phone and laptop/iPad Shift: Monday-Friday 8am-4:30pm /On-Call Weekend Commitment Monthly/ Quarterly Location: Kansas Counties – Leavenworth, Johnson, Wyandotte,  Franklin, Douglas and Miami Counties Missouri Counties coverage of Platte, Clay, Jackson and Cass Counties. 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: $34.75 - $64.64 Applications are accepted on an on-going basis This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22571663/rn-case-manager-ft-days-monroe-carell-jr-children-s-hospital-at-vanderbilt https://careers.cmsa.org/jobs/rss/22571663/rn-case-manager-ft-days-monroe-carell-jr-children-s-hospital-at-vanderbilt Nashville, Tennessee, Discover Vanderbilt Health : With eight hospitals and over 180 clinics, we are the region's largest comprehensive academic health system. Vanderbilt Health has a long tradition of providing world-class care to the people of the Mid-South, living out our mission of moving medicine forward through preeminent programs in patient care, education and research. Here you'll find a spirit of collaboration and a supportive community where your expertise is valued, your knowledge expanded and your uniqueness celebrated. We are committed to fostering an environment where talented, compassionate people are united in bringing the most advanced care to our neighbors throughout the region. Organization: MCJCHV Case Mgmt 20 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. Mon, 14 Sep 2026 00:58:17 -0400 https://careers.cmsa.org/jobs/rss/22571492/cased-manager-neuro https://careers.cmsa.org/jobs/rss/22571492/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. Mon, 14 Sep 2026 00:56:29 -0400 https://careers.cmsa.org/jobs/rss/22572052/clinical-case-manager-rn https://careers.cmsa.org/jobs/rss/22572052/clinical-case-manager-rn Albuquerque, New Mexico, Overview Join our team as a day shift, full-time, Case Management Acute Care Clinical Case Manager Registered Nurse in Albuquerque, NM.   You may be eligible for a sign on bonus for up to $10,000. You may also be eligible for relocation assistance. (if applicable)   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: Lovelace Westside Hospital provides care to Albuquerque?s Westside and Rio Rancho, including a 24-hour emergency department and a wide range of inpatient and outpatient surgical capabilities such as Ear Nose and Throat (ENT), bariatric and orthopedic service lines. Responsibilities The Clinical Case Manager assesses the social, psychosocial, cultural, environmental and financial situations concerning the patient and family. He/she is a patient/family advocate, promoting rights and dignity and striving to involve the patient/family in aspects of care as appropriate. The Clinical Case Manager also facilitates the acute, rehabilitative, and long-term discharge processes to provide for an optimal age-specific continuum of care for the populations listed below. Qualifications Job Requirements: BS or BA in Social Work or Associate's Degree in Nursing or Diploma in Nursing. Social Worker: Medical Social Worker, Licensed Clinical Social Worker preferred.  Must have current license as Social Worker from New Mexico Board of Social Work Examiners, and basic life support certification.  Registered Nurse: Valid NM Nursing license or NM compact license (within 90 days of hire) BLS certification must be obtained within 14 days of hire or transfer into the role and prior to providing direct patient care. HIRING DEPARTMENT MAY ALSO REQUIRE ACLS and or PALS. Preferred Job Requirements:  Master?s Degree in Social Work or Bachelor?s Degree in Nursing Two years of medical social worker or RN Case Manager experience CCM or ACM preferred Mon, 14 Sep 2026 01:03:23 -0400 https://careers.cmsa.org/jobs/rss/22572417/rn-care-management-nights https://careers.cmsa.org/jobs/rss/22572417/rn-care-management-nights Wesley Chapel, 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: 2600 BRUCE B DOWNS BLVD City: WESLEY CHAPEL State: Florida Postal Code: 33544 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] Work Experience: 2+ medical/hospital nursing experience [Required] Prior Care Management/Utilization Management experience [Preferred] Required Certs: 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: $33.08 - $58.04 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22572469/registered-nurse-care-manager-home-health https://careers.cmsa.org/jobs/rss/22572469/registered-nurse-care-manager-home-health Lees Summit, Missouri, 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: 23351 Prairie Star Pkwy City: Lenexa State: Kansas Postal Code: 66227 Job Description: All the benefits and perks you need for you and your family: Up to a $10,000 Sign on Bonus Available for eligible applicants Mileage reimbursement provided: $0.76 per mile Flexible scheduling with Full Time, Part Time and PRN available Company provided phone and laptop/iPad Shift: Monday-Friday 8am-4:30pm /On-Call Weekend Commitment Monthly/ Quarterly Location: Kansas Counties – Leavenworth, Johnson, Wyandotte,  Franklin, Douglas and Miami Counties Missouri Counties coverage of Platte, Clay, Jackson and Cass Counties. 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: $34.75 - $64.64 Applications are accepted on an on-going basis This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22571905/care-manager-ii-case-management https://careers.cmsa.org/jobs/rss/22571905/care-manager-ii-case-management Santa Fe, New Mexico, Description 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 Mon, 14 Sep 2026 01:01:22 -0400 https://careers.cmsa.org/jobs/rss/22571311/rn-case-manager-float https://careers.cmsa.org/jobs/rss/22571311/rn-case-manager-float 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 General Medicine, ED, pediatrics, and surgery/transplant experience is preferred. Mon, 14 Sep 2026 00:53:01 -0400 https://careers.cmsa.org/jobs/rss/22570153/social-worker-case-management-nights https://careers.cmsa.org/jobs/rss/22570153/social-worker-case-management-nights Yuma, Arizona, Job Number: 13891, Job Title: Social Worker | Case Management | Nights |, Salary: Yuma, AZ, 85364 Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Nights Pay Rate Type: Hourly Location: Yuma Medical Center Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $27.89 Mid = $34.86 Max = $41.83 Summary: The Social Worker is a key member of the interdisciplinary care team responsible for addressing the psychosocial, emotional, behavioral, environmental, financial, and community resource needs of patients and families across the continuum of care. The Social Worker conducts comprehensive psychosocial assessments, provides crisis intervention, facilitates complex discharge planning, advocates for vulnerable populations, and connects patients with community resources to support safe transitions and optimal outcomes. Working collaboratively with physicians, nursing, case management, behavioral health, palliative care, and community agencies, the Social Worker helps patients and families navigate complex healthcare needs while promoting patient-centered care, quality outcomes, and continuity of services. Responsibilities: Psychosocial Assessment and Intervention: Conducts screening and assessments of patient's psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, assists in the identification and management and took out treatment again of victims of abuse, neglect, domestic violence, rape, etc. and those requiring crisis intervention. Abuse, Neglect, and Vulnerable Population Advocacy: Intervenes in cases involving child abuse/neglect, domestic violence, elderly abuse, institutional abuse, and sexual assault. Follows hospital policy in child abuse/neglect, domestic violence, guardianship (temporary/permanent), foster care, adoption, mental health placement, adult/elderly abuse, child protection, and sexual assault. Patient and Family Support: Communicates with patients and families regarding emotional, social, and financial impact of illness and/or disability; assess and mobilizes family/community resources to meet identified needs and proactively identifies the needs for and conducts family meetings that result in comfort, decisions and implementation of treatment plan (i.e., establishing social service goals for alleviating problems, providing supportive/ Counseling taken out, assisting the patient and family in problem solving, and making community referrals). Educates patient/family and physician regarding post-acute options, adaptation to patients' diagnosis, illness, treatment, and /or life situation Care Coordination and Discharge Planning: Participates in discharge planning activities for complex patients, in order to ensure a timely discharge and provide appropriate linkage with post discharge care providers and documents assessment, plan, interactions, and interventions according to departmental, hospital and/or health system guidelines and standards. Assist Registered Nurse Case Managers with discharge planning actives as requested. Coordinates with Registered Nurse Case Manager when significant or intensive community resources is necessary to achieve desired treatment outcomes. Takes, reviews, evaluates and prioritizes written and oral referrals. Serves as a liaison with community agencies and resources, member of the multi-disciplinary health care team, and the lead in obtaining charity and financial resources, legal guardianship, adoptions, psychiatric referrals, competency taken out, palliative care issues, and other needs. Documentation and Professional Practice: Maintains accurate, timely, and comprehensive documentation of assessments, interventions, referrals, and patient outcomes. Ensures compliance with departmental, organizational, regulatory, accreditation, and professional practice standards. Maintains patient confidentiality in accordance with HIPAA and organizational policies. Participates in quality improvement initiatives, departmental meetings, and professional development activities. Performs other duties as assigned. Education: Essential: * MASTER'S DEGREE Other information: Minimum Education Required: Master's degree in Social Work Other Information: Preferred 3 years' experience Join us at Yuma Regional Medical Center dba Onvida Health A career at Onvida Health is more than just a job. It's a place to have a long and rewarding career, making a difference in the lives of those in our shared community. When you join our team, you become an integral part of a thriving community committed to improving the health and well-being of everyone in southwestern Arizona. At Onvida Health, we believe in progress with purpose. Our commitment to innovation is matched by our dedication to kindness and integrity. We take our values seriously because we know they lead to better outcomes for our patients and a better experience for all of us. We're looking for people who approach each day with a sense of possibility, a drive to make things better, and a commitment to kindness. If that sounds like you, you're our kind of people. If you're looking for a career where innovation meets compassion, where you can grow and contribute to building a healthier tomorrow, Onvida Health is the place for you. Life in Yuma, Arizona Yuma, recognized by Guinness World Records as the Sunniest City on Earth, offers more than just sunshine. It's a place where the great outdoors meets a welcoming, tight-knit community. Hike scenic trails, explore the Colorado River, or immerse yourself in local cultural festivals - all while embracing the beauty of this desert oasis. With easy access to larger cities and popular destinations, Yuma makes it easy to balance a fulfilling career with time for personal adventures and relaxation. https://www.visityuma.com/ https://www.yumachamber.org/ Physical Requirements and working conditions for this position will be provided to you up on interview. Mon, 14 Sep 2026 00:26:22 -0400 https://careers.cmsa.org/jobs/rss/22571809/care-manager-ii-emergency-department https://careers.cmsa.org/jobs/rss/22571809/care-manager-ii-emergency-department Lake Charles, Louisiana, Description 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: 5 Days - 8 Hours Work Type: Full Time Mon, 14 Sep 2026 01:01:22 -0400 https://careers.cmsa.org/jobs/rss/22572522/registered-nurse-rn-care-manager-hospice https://careers.cmsa.org/jobs/rss/22572522/registered-nurse-rn-care-manager-hospice Altamonte Springs, 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 ALTAMONTE DR City: ALTAMONTE SPRINGS State: Florida Postal Code: 32701 Job Description: ​Sign On Bonus For eligible applicants, up to $10,000 Schedule: Full Time Days Shift: Days Mon-Fri, 8am-5pm, plus up to 2-3 days of call per month (includes some weekends). Location 1 : East Orlando, Oviedo and surrounding (Blue Team) Location 2: Longwood, Altamonte Springs, Maitland and surrounding (Red, Copper Team) Location 3: Apoka, Zellwood and surrounding (Red Team) Location 4: Ocoee, Winter Garden, Pine Hills, Windermere, Celebration and surrounding (Teal Team) Location 5: Central Orlando (32752, 32811, 32810, 32739) and surrounding (Blue and Pink Team) Location 6: Orlando Airport Area (32822, 32825, 32829, 32812) and surrounding (Pink Team) Location 7: Sanford, Lake Mary and Surrounding (Yellow Team) Completes all required documentation in the electronic medical records system.  Provides comfort and support to family members and caregivers. Participates in on-call rotations for emergency clinical needs after hours. Provides hospice nursing services to patients at home or in nursing facilities. Initiates and coordinates the Plan of Care for an assigned caseload of patients. Monitors patient conditions and conducts regular assessments. Administers medications and treatments as prescribed. Educates patients, families, and caregivers on end-stage disease processes, safety issues, and symptom management. Collaborates with physicians and interdisciplinary team members to develop and adjust care plans. Orders necessary resources, including medications, supplies, and medical equipment.  Communicates with physicians regarding symptomatic changes and medication adjustments. Other duties as assigned. Knowledge, Skills, and Abilities: Demonstrates ability to communicate by reading, writing, and typing legibly, speaking, and comprehending English effectively to carry out job requirements. Knowledge of electronic medical record. Knowledge of nursing skills in the performance of duties in compliance with legal and ethical parameters established based on the level of education and certification attained by the employee. Knowledge of basic to intermediate application of Microsoft Office Suite including Word, Excel, PowerPoint, Outlook, as well as internet software. Ability to read and interpret documents such as physician orders, plan of care documents, policies, procedures, and other instructions furnished in written, oral, diagram, or schedule form. Ability to follow standard precaution guidelines for infection control, including when providing patient care. Ability to complete necessary orientation and training. Application of InterQual® Criteria set. Assessment competency and knowledge application for all ages served within specific care environments. Ability to work independently. Innovative and creative in identifying discharge options for medically complex patients. Leadership skills. Process and Outcome data analysis skills. Critical thinking and problem-solving skills. Ability to manage multiple tasks and prioritize levels of importance. Customer service skills. Ability to work and communicate with people of all social, economic, and cultural backgrounds; flexible, open-minded, and adaptable to change. Effective organizational skills. Computer proficiency with Outlook e-mail and electronic medical records. Flexible in a complex and changing healthcare environment. Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Field of Study: N/A Work Experience: 3+ years experience as a Registered Nurse [Preferred] Home health and/or acute care nursing experience [Preferred] Additional Information: N/A Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support - CPR Cert (BLS) [Required] Driver's License (DL) [Required] Auto Insurance (AL) [Required] Certified Hospice and Palliative Nurse (CHPN) [Preferred] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements - https://tinyurl.com/msy4mja2 Pay Range: $71,385.60 - $132,787.20 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22571305/transitional-case-manager-weekday-prn https://careers.cmsa.org/jobs/rss/22571305/transitional-case-manager-weekday-prn Camden, New Jersey, About us At   Cooper University Health Care , our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs.  Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description Provides psychosocial assessments, crisis intervention, resources referrals, to facilitate discharge plans, and/or adjustment to illness, and complex discharge planning for patients and their families.   Formulates the discharge plan with patient, families and the care team based upon a needs assessment. Coordinates appropriate referrals to home care agencies, skilled nursing and rehabilitation centers, and community based programs.   Coordinates care authorization process with insurers. Coordinates specific details of patient’s hospitalization with Utilization Management department to ensure appropriate admission status. Experience Required 3 - 5 years health care experience preferred Education Requirements Requires a master's degree in social work  ( MSW) or a licensed RN, BSN preferred License/Certification Requirements Current NJ SW License, LCSW Preferred. or Current NJ RN License   ACM (American Case Management Association) preferred CCMC (Commission for Case Manager Certification) preferred Special Requirements License (or Certification):NJ-LCSW Preferred; License (or Certification):NJ-LSW Preferred; License (or Certification):NJ-RN Preferred; Education:MSW Preferred Mon, 14 Sep 2026 00:51:43 -0400 https://careers.cmsa.org/jobs/rss/22572404/rn-care-manager-acute-care https://careers.cmsa.org/jobs/rss/22572404/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: Monday - Friday with rotational weekends Shift(s) available: 8AM - 4:30PM (Five days per week, 8 hours per day) and 10AM - 8:30PM (Four days per week, 10 hours per day) 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 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: $71,385.60 - $132,787.20 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. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22572066/social-worker-case-manager https://careers.cmsa.org/jobs/rss/22572066/social-worker-case-manager Pocatello, Idaho, Overview Join our team as a variable shift, PRN, Case Management Social Worker in Pocatello, ID.    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:   Portneuf Medical Center is a nationally recognized healthcare leader with 205 beds, serving as the region's tertiary care and Level II Trauma Center, housing the Portneuf Heart and Vascular Institute, Portneuf Cancer Center, Portneuf Medical Group, and Portneuf Air Rescue. Responsibilities The Case Manager Social Worker is responsible for assessing and coordinating patient care across the continuum, utilizing accepted community and professional guidelines to manage social, psychosocial, cultural, environmental, and financial needs for the patient and the patient?s caregiver. Reporting to the Director of Case Management, the Case Manager Social Worker supports patients and family members to develop coping strategies, development of discharge plans, assists with bereavement counseling as well as working with state and local law enforcement entities to ensure venerable patients are protected.   Act as a patient and caregiver advocate. Work with the entire healthcare team to improve the quality of patient care, patient safety and customer service. Create a discharge plan of care based on identified needs. Coordinate care to ensure consults, tests, and procedures are performed in a manner appropriate and consistent with patient choice and resources. Communicate all contributions to the progression of care in a way that is easily understood by the patient, the caregiver, the healthcare team, and the payer. Use compliant and ethical behaviors to ensure that federal, state, hospital, and patient self-determinations are met. Assist the patient to transition to the next level of care in a timely manner with recognition given to readmission risks and appropriate post-discharge interventions are established. Ensure that community resources are readily known, and patients are provided with a choice of post-acute providers.   Intervene in situations concerning child and adult abuse/neglect, domestic violence, guardianship, foster care, adoption, mental health placements, and advanced directives. Provide support to patients and families with palliative care and hospice services regarding end-of-life decisions. Identify and track avoidable days/delays and use the information as an opportunity for improvement. Qualifications Job Requirements:  Bachelor?s Degree in Social Work. Must be licensed BSW or LMSW within 6 months of hire or transfer into position. Preferred Job Requirements: Two or more years of social work experience. Experience in acute care hospital case management. Certification in case management (ACM or CCM). Mon, 14 Sep 2026 01:03:23 -0400 https://careers.cmsa.org/jobs/rss/22566873/case-manager-complex-guardianship https://careers.cmsa.org/jobs/rss/22566873/case-manager-complex-guardianship 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 Regional Hospital Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services. 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. Mon, 14 Sep 2026 00:56:29 -0400 https://careers.cmsa.org/jobs/rss/22567852/registered-nurse-care-manager-home-health https://careers.cmsa.org/jobs/rss/22567852/registered-nurse-care-manager-home-health 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: 104 HOSPITAL CT City: CALHOUN State: Georgia Postal Code: 30701 Job Description: All the benefits and perks you need for you and your family: Mileage reimbursement provided: $0.76 per mile Flexible scheduling with Full Time, Part Time and PRN available Company provided phone and laptop/iPad Hours: M-F 8am - 5pm; Weekend on-call rotation Locations: Bartow, Floyd, Gordon Counties 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: $32.80 - $61.02 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22568083/case-management-rn-part-time-weekends https://careers.cmsa.org/jobs/rss/22568083/case-management-rn-part-time-weekends Denver, 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-Weekend (United States of America) Address: 2525 S DOWNING ST City: DENVER State: Colorado Postal Code: 80210 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: • N/A Additional Information: • N/A 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: $35.39 - $65.82 This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. Mon, 14 Sep 2026 01:10:43 -0400 https://careers.cmsa.org/jobs/rss/22565684/community-care-nurse-case-manager-hcbs-butte-full-time https://careers.cmsa.org/jobs/rss/22565684/community-care-nurse-case-manager-hcbs-butte-full-time Butte, Montana, Benefis is one of Montana's largest and premier health systems, and we are committed to providing excellent care for all, healing body, mind, and spirit. At Benefis, we work hard to support our employees in every aspect of their careers by offering outstanding benefits and compensation, state-of-the-art facilities, and multiple growth opportunities. The only thing missing is you! Home and Community-Based case management services are centered care services delivered in the home and community. Program services fall into the categories of health services and human services. Primarily responsible for the health service aspect of case management to meet the medical needs of members. Member of the multi-disciplinary Care Management Team that provides individualized member-driven planning, coordination, assessment, and monitoring of services to help enrolled Montana Big Sky Waiver Medicaid beneficiaries who are elderly or physically disabled residing in their own homes or communities rather than institutionalized care settings. Provides clinical assessment, medication review, management of chronic illnesses, and coordination of skilled services that focus on the health service clinical needs, medical stability, and skilled services of the member. The goal is to prevent hospitalization and ensure medical stability at home. Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations. Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict. Will perform all job duties or job tasks as assigned. Will follow and adhere to all requirements, regulations and procedures of any licensing board or agency. Must comply with all Benefis Health System's organization policies and procedures. Education/License/Experience Requirements: Graduate of an accredited school of nursing, bachelor in nursing preferred or LPN, if state approved. Current state licensure as a Registered Nurse or LPN if state approved. Certification in Case Management preferred. Experience as a Nurse (RN/LPN) commensurate with minimum of three (3) years of professional nursing experience Knowledge of case management methods, practice, and procedure. Knowledge of the application of diagnostic and crisis intervention skills. Knowledge of issues and needs of long-term care consumers. Prior knowledge of managing a budget. Prior experience with Medicare and Medicaid reimbursement. Knowledge of human behavior, disabilities, and the aging process. Exemption Wage Non-Exempt Starting Wage $27.86/hourly Actual offered wage is based on applicable experience Mon, 14 Sep 2026 00:31:03 -0400 https://careers.cmsa.org/jobs/rss/22566858/case-manager-prn https://careers.cmsa.org/jobs/rss/22566858/case-manager-prn 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 Regional Hospital Pursue your passion for caring with Duke Regional Hospital in Durham, North Carolina. With 388 beds it is the second largest of Duke Health's four hospitals and offers a comprehensive range ofmedical, surgical, and diagnostic services, including orthopedics, weight-loss surgery, women's services, and heart and vascular services. 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. Mon, 14 Sep 2026 00:56:29 -0400 https://careers.cmsa.org/jobs/rss/22565690/inpatient-registered-nurse-case-manager-care-coordination-full-time https://careers.cmsa.org/jobs/rss/22565690/inpatient-registered-nurse-case-manager-care-coordination-full-time Great Falls, Montana, Benefis is one of Montana's largest and premier health systems, and we are committed to providing excellent care for all, healing body, mind, and spirit. At Benefis, we work hard to support our employees in every aspect of their careers by offering outstanding benefits and compensation, state-of-the-art facilities, and multiple growth opportunities. The only thing missing is you! Responsible for the coordination and implementation of case management activities. Encompasses all care needs of patient during the time frame the patient requires care within the hospital setting. Remains point of contact for patient/family/legal representative until patient transitions to another service line OP case manager or patient navigator. Works with all members of the healthcare and multidisciplinary team to assure a collaborative approach is maintained in care and treatment of the patient. Reviews care and treatment for appropriateness against screening and reimbursement criteria for appropriate referral management. Plans and coordinates all necessary care services and needs for the patient. Provides patient/family/legal representative with community and/or care need resources. Organizes and leads necessary care conferences or multidisciplinary care team discussions. Sends any ordered or necessary referrals to the appropriate service line Patient Navigators, OP Case Manager, or community resource contact for review of appropriateness of services or resources requested. Attends daily care rounds if applicable, communicates any changes in the patient's clinical condition that may impact their transitional care plan to the multi-disciplinary care team and remains point of contact for the patient/family/legal representative during hospitalization. Communicates and collaborates with multidisciplinary care team members, Patient Navigators, OP Case Manager, patients/families/legal representatives. Continual monitoring and assessment of patients care plan goals and needs and modifies referrals and resource requests as necessary. Provides indirect and/or direct patient care as they identify, assess, plan, and evaluate the needs of patients for discharge and transitions of care. Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations. Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict. Will perform all job duties or job tasks as assigned. Will follow and adhere to all requirements, regulations and procedures of any licensing board or agency. Must comply with all Benefis Health System's organization policies and procedures. Education/License/Experience Requirements: Graduate of an accredited school of nursing, BSN Preferred Current state registered nurse license required. Current BLS certification. Must have thorough knowledge of clinical nursing skills. Mon, 14 Sep 2026 00:31:03 -0400