16 case mgmt specialist jobs found

Req #: 184489 Summary Summary Continuously evaluates the quality, care, treatment and outcomes of complex patient populations. Collaborates with the patient/family and caregivers to facilitate necessary resources and options for post-discharge services to support a safe discharge. Provides consultation with physicians and other members of the interdisciplinary healthcare team to facilitate patient progression to discharge. Ensures clinical documentation supports medical necessity criteria and meets regulatory requirements. Communicates the clinical status of patients related to medical necessity criteria to the physician advisor (internal or external) and/or the Inpatient Care Transitions leadership team as needed. Monitors length of stay and documents avoidable days for delay of discharge. Reviews payer source for potential negative financial liabilities to the patient. Education Bachelor of Science...

Req #: 182814 Summary Summary Continuously evaluates the quality, care, treatment and outcomes of complex patient populations. Collaborates with the patient/family and caregivers to facilitate necessary resources and options for post-discharge services to support a safe discharge. Provides consultation with physicians and other members of the interdisciplinary healthcare team to facilitate patient progression to discharge. Ensures clinical documentation supports medical necessity criteria and meets regulatory requirements. Communicates the clinical status of patients related to medical necessity criteria to the physician advisor (internal or external) and/or the Inpatient Care Transitions leadership team as needed. Monitors length of stay and documents avoidable days for delay of discharge. Reviews payer source for potential negative financial liabilities to the patient. Education Bachelor of Science...

Req #: 181446 Summary Summary Continuously evaluates the quality, care, treatment and outcomes of complex patient populations. Collaborates with the patient/family and caregivers to facilitate necessary resources and options for post-discharge services to support a safe discharge. Provides consultation with physicians and other members of the interdisciplinary healthcare team to facilitate patient progression to discharge. Ensures clinical documentation supports medical necessity criteria and meets regulatory requirements. Communicates the clinical status of patients related to medical necessity criteria to the physician advisor (internal or external) and/or the Inpatient Care Transitions leadership team as needed. Monitors length of stay and documents avoidable days for delay of discharge. Reviews payer source for potential negative financial liabilities to the patient. Education Bachelor of Science in...

Req #: 183450 Summary Bachelor of Science in Nursing (BSN) required. Must be an RN with current licensure. Preferred recent experience in acute care setting. Preferred experience in Case Management activities. Preferred experience or knowledge of InterQual criteria. Demonstrates knowledge of DRGs managed care initiatives payment methods and statistical analysis. Demonstrates understanding of managed care concepts. Must have good verbal and written communication skills. Must have excellent people skills and the ability to problem solve efficiently and effectively. Must be available to work flexible hours assuming on-call duties on weekends and other times when deemed necessary. Must be available to respond within a reasonable length of time.

Req #: 181447 Summary Summary Continuously evaluates the quality, care, treatment and outcomes of complex patient populations. Collaborates with the patient/family and caregivers to facilitate necessary resources and options for post-discharge services to support a safe discharge. Provides consultation with physicians and other members of the interdisciplinary healthcare team to facilitate patient progression to discharge. Ensures clinical documentation supports medical necessity criteria and meets regulatory requirements. Communicates the clinical status of patients related to medical necessity criteria to the physician advisor (internal or external) and/or the Inpatient Care Transitions leadership team as needed. Monitors length of stay and documents avoidable days for delay of discharge. Reviews payer source for potential negative financial liabilities to the patient. Education Bachelor of Science in...

Job Description Description Why You’ll Love This Role Work-life balance you’ve been looking for: Monday–Friday, 8:30 AM–5:00 PM No nights and no on-call Be part of a supportive team: Join the Disposition Resource Team in our Care Management Department . Make a real impact: Help complex patients receive the care, resources, and support they need to thrive. Primary goal: Improve patient outcomes and satisfaction by promoting high-quality, coordinated care. What You’ll Do As a Care Manager RN, you’ll: Provide ongoing support and clinical expertise through comprehensive assessment, planning, implementation, and evaluation of care for patients with complex needs. Foster collaboration with multidisciplinary teams and community resources to ensure continuity of care, and supporting cost-effective discharge planning. Serve as a key resource in case management, utilization review, and...

Job Description Description Have you ever considered a role in Care Management? UNC Health in Hillsborough is the place for you! What is the schedule? 40 hrs/week (Five 8-hour shifts) Weekend rotation Holiday rotation No Nights No on-call Free Parking! Who are we looking for? Experienced RNs and RN Care Managers who: Have at Least 2 years of RN inpatient in an Acute Care setting (Preference given to candidates with Care Manager experience) Have the interest and drive to direct safe discharge process. Enjoy advocating for and leading patient care progression Want to become part of a supportive team in a positive environment. Want to expand your knowledge and experience in a Care Manager career at UNC Health in Hillsborough If this opportunity interests you…apply now! Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and...

26000003 Registered Nurse (RN) II - Cardiac Intensive Care Unit (CICU) - ( 26000003 ) Description Full-Time | Rotating Shifts | $25,000 Sign-On Bonus Children’s National Hospital is the region’s leading provider of critical care for seriously ill and injured infants and children. We offer the only Level IV Pediatric Intensive Care Unit and specialized Cardiac ICU (CICU) in the greater Washington, DC area. In our state-of-the-art CICU, our team of pediatric heart specialists is dedicated to saving and improving the lives of our most vulnerable patients. The Cardiac ICU provides subspecialty care for critically ill patients with congenital, acquired cardiovascular or related diseases. The 26-bed unit integrates the latest technology in a family friendly environment. The multidisciplinary team is dedicated to improving outcomes for children through innovation and research. The CICU staff includes an integrated cardiac team with all...

26000091 Clinical Instructor (RN) - Heart and Kidney Unit - ( 26000091 ) Description Only in pediatrics can you save a lifetime.® 3E-Heart and Kidney Unit (HKU): is a 20-bed unit which focuses on family-centered care for children with cardiac and renal diseases. On the HKU, patients range in age from neonates through adults. Patients may be receiving care for: Heart surgery Diagnostic or interventional cardiac catheterizations Dialysis Acute or chronic renal failure Nephrotic or nephritic disorders Organ transplantation All patient beds have cardiac and respiratory monitoring. The HKU primarily admits patients from the Cardiac Intensive Care Unit, Ambulatory Clinic, PACU and EMTC. The unit also admits 23-hour patients with cardiac and renal disease. To learn more about the Heart and Kidney Unit, please check out this video....

250002KV Registered Nurse (RN) II Fellowship - Cardiac Intensive Care Unit (CICU) -June 2026 Cohort - ( 250002KV ) Description Children’s National Hospital is the region’s leading provider of critical care for seriously ill and injured infants and children. We offer the only Level IV Pediatric Intensive Care Unit and specialized Cardiac ICU (CICU) in the greater Washington, DC area. In our state-of-the-art CICU, our team of pediatric heart specialists is dedicated to saving and improving the lives of our most vulnerable patients. The Cardiac ICU is a 26-bed unit. This unit provides comprehensive cardiac care to pediatric patients. The CICU Patient Care Management Team coordinates interdisciplinary patient assessment and patient care and provided by cardiac surgeons, cardiologists, and pediatric intensivists and nursing in conjunction with multiple specialty services within the Medical Center. Patients are admitted to the CICU from the ED,...

250002VC Faculty Advanced Practice Provider, Rehabilitation Medicine - ( 250002VC ) Description The Advanced Practice Provider is an Advanced Practice Registered Nurse (nurse practitioners, clinical nurse specialists, nurse anesthetists) or Physician Assistant who practices within their scope of practice as appropriate in their jurisdictional area and in accordance with their organizational Medical Staff Bylaws. The provider is responsible for the management of care to patients including diagnostic and therapeutic interventions, and the assessment, implementation, and evaluation of an appropriate plan of care. Provides leadership and consultation with their respective clinical area through participation in division/department initiatives and mentorship of others. Participates in division/departmental and organization wide initiatives to represent advanced practice and leverage the role of the advanced practice provider As a faculty member, you are expected...

250002UN Professional Practice Specialist (RN) - Dialysis - ( 250002UN ) Description The Professional Practice Specialist (PPS) supports both the acute and chronic dialysis programs at Children’s National Hospital. This role serves as a clinical expert, providing leadership in practice development, education, quality improvement, and regulatory compliance. The PPS collaborates with nursing, medical, and administrative teams to ensure safe, evidence-based dialysis care and optimal patient outcomes. Responsibilities include staff education and competency validation, policy development, quality and safety initiatives, and clinical consultation across inpatient and outpatient dialysis services. Position Summary All nursing practice is based on the legal scope of practice, national and specialty nursing standards, CNMC Policies and Procedures, and in accordance with all applicable laws and regulations. The Professional Model of Care requires registered...

250002HI **PRN ECMO Specialist-RN - ( 250002HI ) Description ECMO Specialist is a registered Nurse who will function as an identified resource to staff in a service area to provide comprehensive patient care to a variety of patients. The RN will incorporate all members of the healthcare team to plan and deliver patient care. Will provide patient assessments and recommendations for continuity of care and will successfully deal with the most complex clinical problems as they relate to ECMO. Will demonstrate expanded knowledge base through participation in program projects and activities. May be transferred into regular staffing as required, for urgent/emergent situations. Qualifications Minimum Education Bachelor's Degree Graduate from an approved school of nursing Must be licensed to practice in the District of Columbia. (Required) BSN (Preferred) Minimum Work Experience 2 years Related clinical experience in a comparable setting....

250002TT Registered Nurse II PRN Inpatient Psych Unit - ( 250002TT ) Description Child Psychiatric Unit is a 12-bed unit. It is a short-term child oriented program designed to provide crisis intervention and stabilization to children 3-13 years of age. The average length of stay is three to seven days. Each patient receives an initial psychiatric evaluation upon admission. While on the unit treatment may include additional psychological and medical evaluations as needed. The treatment team can consist of the following: Attending Psychiatrist, Individual Therapist (Residents/Fellows), Medical Students, Psychology Interns, Family Therapist (LSW), Expressive Art Therapist, Educational Assistant, Registered Nurses, and Child Psychiatric Specialists. Adolescent Psychiatric Unit (APU) is a 14-bed short-term treatment unit that provides an extensive bio-psychosocial and treatment services to the adolescent population between 14-17...

2500031Q Nurse Navigator - Cardiology - ( 2500031Q ) Description The Nurse Navigator partners collaboratively with various interdisciplinary specialty team members and coordinates a patient care and communication plan for patients with assigned patient population to ensure continuity of care with compassion, commitment, and connection. Under the supervision of the healthcare providers, they provide patient education related to illness and planned treatment. Ensures continuity of care is maintained and staff, patient, parent safety is a priority. Ensures continuity of care is maintained and service excellence is a priority. The work schedule is Monday through Friday, 8am - 4:30pm. Qualifications Minimum Education BSN (Required) Master's Degree (Preferred) Minimum Work Experience 4 years Nursing experience (Required) 1 year Demonstrated experience in a charge nurse role in a comparable setting. (Required) 1 year Recent pediatric...

Job Description Description UNC Health Southeastern in Lumberton, NC seeks a Thoracic/Vascular Advanced Practice Provider to join our community-based practice of Cardiologist, Interventional Cardiologist, Cardiology Fellows, a Vascular Surgeon, a Thoracic Surgeon, and APPs. RECOGNIZED FOR HIGH QUALITY UNC 2025: American College of Cardiology NCDR Chest Pain ̶ MI Registry Platinum Performance Achievement Award 2024-2025 US News & World Report's Best Hospitals Report: Best Regional Hospitals for Equitable Access List; Best Hospitals in North Carolina for the Coastal Plain Region List; and High Performing in Seven Adult Procedures and Conditions including Heart Attack, Heart Failure, Diabetes, Kidney Failure, Stroke, COPD, and Pneumonia OPPORTUNITY HIGHLIGHTS Practice Hours: Monday-Friday 8:30 am – 5:00pm Schedule is split with days in the clinic and in the...