RN Medical Case Manager
About the Opportunity
Workers Compensation, Disability or Occupational Health experience accepted
• Case manager will assess medical and vocational status of injured worker, identifying barriers to case resolution.
• Case manager will make recommendations for consumer to overcome obstacles that prevent the consumer from returning to as close to pre-injury level of health and function as possible.
• Case manager will work collaboratively with all ...
Specific Responsibilities of the Job:
· Provides clinical practitioner duties in the clinic including, obtaining histories, performing examinations, diagnoses, ordering tests, treating and referring patients as necessary to ensure optimal patient healthcare management consistent with the mission of patient centered care.
· Identifies and analyzes the design of patient flow and workflow for clinical services provided to patients. Assures the implementation of appropriate changes to ...
The Care Manager uses nursing process and critical thinking to perform observation and inpatient utilization case reviews for patients located in network and out of network facilities, ensuring cost effective and efficient utilization of health services for USFHP membership. All admissions shall be reviewed by the Care Manager utilizing appropriate InterQual screening criteria to ensure that all USFHP members receive medically necessary hospital services at an appropriate level of care. The ...
The Case Manager identifies, evaluates, and provides management of services for patients with complex, catastrophic, long term illness or injury, targeted diseases, as well as those patients receiving out of network services. To promote quality, cost-effective outcomes throughout the care continuum, the Case Manager will utilize ongoing nursing process and critical thinking skills to administer all facets of the case management process including assessment, planning, development of nursing diagnoses ...
This position requires the ability to work independently researching and compiling medical information. Also requires knowledge of benefit terminology, claims processing, CPT and ICD coding. Responsible for analyzing researching, and managing reconsiderations, appeals and provider inquiries related to appeals and reconsiderations. Responsible for verbal and written communication internally and externally, completeness and accuracy of files and system entries, timeliness of processing and meeting ...
Salary mid salary 80K and up
Bonus Eligible - Yes
Overtime Eligible - Yes
Management Experience Required - Yes
Minimum Education - Associate's Degree
Requirements : *1-3 years Circulating General, Ortho and Neuro cases *Minimum 1-3 years RN Clinical experience required along with management of Surgery Staff *ADN ; BSN will be required within 3 years of employment start date *Manage and supervise other Surgery nurses *MUST HAVE Leadership / Charge / Manager / Supervisor ...
Case Management Opportunity with a national acute care provider!
Position includes case management and utilization management
Provide concise management of patients hospitalization from pre-admission through discharge in the areas of patient care, fiscal management, and Payor/referral satisfaction
Conduct Discharge Planning Evaluations, performing discharge planning to ensure patients and their families receive maximum benefits, and awareness of community and government agencies.
MUST BE RN or ...
A growing medical organization is looking for Nurse Practitioners or Physician Assistants (experienced NP/PAs or new grads with previous RN experience) to complete in-home patient assessments in Texas, Virginia, Ohio, or Indiana. The location is based on a radius near where you currently reside as there will be travel required to the homes. Each visit includes a limited physical exam, a prescription review, and a discussion about health history. Upon completion of the health ...
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We are looking for RN's for various positions throughout the country including:
Director of Patient Care
Director of Nursing
Field Nurses/Case Managers
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