Case Manager
4 weeks ago
• Assesses, plans, monitors, and coordinates plan of care from pre-admission to community re-entry through the implementation of case management standards and processes.
• Assesses the individual’s personal and medical history, current status, diagnosis, prognosis, and the proposed treatment plan.
• Promotes and utilizes the appropriate level of care for the patient and refers to other facilities as needed.
• Adheres to contract agreements and specific criteria.
• Serves as a liaison with payor source points of contact to verify and guarantee coverage and identify items required to process the claim for service.
• Assists patient and or caregiver in developing realistic goals to direct the treatment regimen.
• Proactively communicates with payor source to explore coverage solutions (flex benefits, out of contract, etc.). Planning, Implementation & Facilitation
• Promotes optimal outcomes for the patient within the boundaries of the diagnosis.
• Coordinates and facilitates interdisciplinary team (IDT) meetings and plan of treatment.
• Meets with patient, family, and IDT to facilitate “continuity of care”.
• Implements utilization review process and continuously evaluates the appropriate level of care with the interdisciplinary team and payor, and patient/caregiver(s). Proactively obtains authorization for any extension of service of LOS.
• Coordinates the discharge plan with the IDT and providers.
• Monitors expense versus revenue for caseload on a daily basis. Advocacy
• Proactively collaborates with the health care team, payors, community agencies, providers and legal representatives to ensure continuity throughout the continuum.
• Serves as a liaison with the treatment team and the primary care physician, referring physician, medical director, patient/caregiver(s), and other parties as appropriate.
• Promotes effective communications among treatment team members, patient/caregiver(s), primary care physician, referring physician, medical director, and payor.
• Participates in care conferences, family conferences, etc. when indicated.
• Educates and supports the individual/family to be empowered and self-reliant in being advocates for themselves.
• Uses the mechanism of early referral to promote and provide optimum care and cost containment.
• Represents the individual’s best interests through assisting in finding necessary funding, offering treatment alternatives, and coordinating treatment. Monitoring & Evaluation
• Continuously reviews and evaluates the patient’s progress, as reflected by the goals defined in the treatment plan.
• Uses appropriate auditing processes and tools to ensure department and treatment efficiency.
• Participates in performance improvement evaluation processes with particular emphasis on results-oriented treatment. Professional Growth
• Maintains professional growth in case management by: attending continuing education opportunities; reviewing pertinent professional literature; maintaining knowledge of current community resources; and reviewing and being familiar with the managed care marketplace to determine managed care growth potential, opportunities, penetration, service trends, relationships, networks, etc. QUALIFICATIONS Education and Training: RN licensure in state where the hospital resides required. Current BLS certification required. Experience: Three to five years of inpatient experience, preferably in an acute, IRF or LTACH setting. PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status. Application window is anticipated to close a minimum of 7 days after posting %4508685% %%mednurse%%
-
Case Management Nurse
3 weeks ago
Greeley, CO, United States BrightStar Care of Northern Colorado Full timeCompany DescriptionBrightStar Care of Northern Colorado is a professional care team dedicated to delivering expert, compassionate, and personal care. Led by Registered Nurses, our team provides the right level of care for individuals' personal and medical needs, from bathing and dressing to Alzheimer's care and high-tech nursing. We strive to ensure the...
-
Case Manager
4 weeks ago
Greeley, United States PAM Health Full timeCase Manager PRN - RNHourly Rate - $48Our Benefits-at-a-Glance: Please visit The Case Manager is responsible for the interdisciplinary coordination of care for a designated patient population. The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate...
-
RN Case Manager
1 week ago
Longmont, CO, United States Bristol Hospice Full timeRN Case Manager Do you have a heart for hospice? Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We believe all patients and families entrusted in our care deserve the highest level of compassion, respect, and quality of care. As the...
-
RN Case Manager
1 week ago
Littleton, CO, United States Bristol Hospice Full timeRN Case Manager Do you have a heart for hospice? Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We believe all patients and families entrusted in our care deserve the highest level of compassion, respect, and quality of care. As the...
-
Case Manager
1 week ago
Greeley, United States Sunrise Community Health Full timeApplication Deadline: Accepted on an ongoing basis. Sunrise Community Health Summary Founded in 1973, Sunrise Community Health is dedicated to delivering high quality, affordable healthcare to Weld, Larimer, and surrounding counties in northern Colorado. With exceptional providers and convenient locations, we support each patient’s journey to wellness...
-
Case Manager
1 day ago
Greeley, United States Sunrise Community Health Full timeApplication Deadline: Accepted on an ongoing basis. Sunrise Community Health Summary Founded in 1973, Sunrise Community Health is dedicated to delivering high quality, affordable healthcare to Weld, Larimer, and surrounding counties in northern Colorado. With exceptional providers and convenient locations, we support each patient’s journey to wellness...
-
Telephonic Nurse Case Manager II
1 week ago
Denver, CO, United States Elevance Health Full timeTelephonic Nurse Case Manager II Description "Telephonic" Nurse Case Manager II Location: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location. Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST. This position requires an on-line pre-employment skills assessment....
-
Nurse Medical Case Manager
3 weeks ago
Centennial, CO, United States The Travelers Companies Full timeNurse Medical Case Manager - Clinic Taking care of our customers, our communities and each other. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. The annual base salary...
-
RN Case Manager
20 hours ago
Englewood, CO, United States Swedish Medical Center Full timeDescription Hourly Wage Estimate: $39.68 - $56.74 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees...
-
RN Case Manager
18 hours ago
Englewood, CO, United States Swedish Medical Center Full timeDescription Hourly Wage Estimate: $39.68 - $56.74 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees...
-
RN Case Manager
1 week ago
Littleton, CO, United States Bristol Hospice Full timeRN Case ManagerDo you have a heart for hospice? Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We believe all patients and families entrusted in our care deserve the highest level of compassion, respect, and quality of care. As the Registered...
-
RN Case Manager
1 week ago
Longmont, CO, United States Bristol Hospice Full timeRN Case ManagerDo you have a heart for hospice? Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We believe all patients and families entrusted in our care deserve the highest level of compassion, respect, and quality of care. As the Registered...
-
RN Case Manager
23 hours ago
Littleton, CO, United States Bristol Hospice Full timeRN Case ManagerDo you have a heart for hospice? Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We believe all patients and families entrusted in our care deserve the highest level of compassion, respect, and quality of care. As the Registered...
-
RN Case Manager
23 hours ago
Longmont, CO, United States Bristol Hospice Full timeRN Case ManagerDo you have a heart for hospice? Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities. We believe all patients and families entrusted in our care deserve the highest level of compassion, respect, and quality of care. As the Registered...
-
Telephonic Nurse Case Manager II
1 week ago
Denver, CO, United States Elevance Health Full timeLocation: This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location. Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST. The "Telephonic" Nurse Case Manager II is responsible for performing care management within the scope of licensure for members with complex and chronic...
-
Case Management Registered Nurse
2 weeks ago
Lakewood, CO, United States Supplemental Health Care Full timeJob Description: Supplemental Health Care is seeking Case Management RNs in Lakewood, Colorado for a 12-week assignment at a partnering hospital. Named Best in Staffing based on real feedback from our working nurses and healthcare professionals, Supplemental Health Care is proud to be a partner to every nurse and healthcare professional we work with. Case...
-
RN Case Manager PRN
20 hours ago
Englewood, CO, United States Swedish Medical Center Full timeDescription Hourly Wage Estimate: $39.03 - $58.52 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees...
-
RN Case Manager PRN
18 hours ago
Englewood, CO, United States Swedish Medical Center Full timeDescription Hourly Wage Estimate: $39.03 - $58.52 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees...
-
Registered Nurse
1 week ago
Pueblo, CO, United States Interim HealthCare Full timeHome Health Registered Nurse (RN) Case Manager in Pueblo, CO Status: Full Time Visit Rates: $45 - $125 per visit Experience a work culture where nurses are valued, management backs you and you’re empowered to be a patient’s advocate. At Interim HealthCare®, these are just a few of the rewards you’ll enjoy as a Home Health RN Case Manager. What...
-
Registered Nurse
1 week ago
Pueblo, CO, United States Interim HealthCare Full timeHome Health Registered Nurse (RN) Case Manager in Pueblo, CO Status: Full Time Visit Rates: $45 - $125 per visit Experience a work culture where nurses are valued, management backs you and you’re empowered to be a patient’s advocate. At Interim HealthCare®, these are just a few of the rewards you’ll enjoy as a Home Health RN Case Manager. What...
