RN Case Manager Hybrid I/II
2 weeks ago
Minimum Education
Bachelor's Degree (Required)
Master's Degree (Preferred)
Minimum Work Experience
5 years experience with at least three in a pediatric setting (Required)
Required Licenses and Certifications
Registered Nurse in District of Columbia (Required)
Current certification in Case Management or Utilization Management (Preferred)
Functional Accountabilities
Professional Practice/Research
Participate in Shared Leadership.
Contribute to the MAGNET Journey of Children’s National.
Ensure nursing practice is based on evidence of best practice.
Accountable to participate in the Nursing Division’s Performance Improvement process (division or unit level).
Participate in community activities.
Patient Resource Services
Communicate denials, high risk, or changes in level of care using accepted processes to limit financial risk to CNMC and patients’ families.
Navigate internal and external systems to accurately identify or secure payers and link patients to needed services.
Discharge Transitional Plan of Care
Define discharge and transitional care criteria with the healthcare team to facilitate efficient care transitions.
Conduct an initial assessment of patient and family to identify potential discharge barriers and needs in accordance with departmental and regulatory requirements.
Develop and implement a plan of care and make referrals based on a needs assessment and available resources in conjunction with care team members.
Transition care to external providers and services to achieve quality outcomes for patient and family .
Provide clinical reviews to third party payers using nationally recognized criteria and validate authorization or denial of services and
document appropriately in ST AR.
Documentation
Document according to departmental policy.
Performance Improvement
Identify , implement, and evaluate processes to improve customer service, reimbursement and/or hospital performance.
Participate in the identification of PI issues and take steps to improve unit or CRM processes.
Promote the development of CRM department and other members of the healthcare team.
Organizational Accountabilities
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
Anticipate and responds to customer needs; follows up until needs are met
Teamwork/Communication
Demonstrate collaborative and respectful behavior
Partner with all team members to achieve goals
Receptive to others’ ideas and opinions
Performance Improvement/Problem-solving
Contribute to a positive work environment
Demonstrate flexibility and willingness to change
Identify opportunities to improve clinical and administrative processes
Make appropriate decisions, using sound judgment
Cost Management/Financial Responsibility
Use resources efficiently
Search for less costly ways of doing things
Safety
Speak up when team members appear to exhibit unsafe behavior or performance
Continuously validate and verify information needed for decision making or documentation
Stop in the face of uncertainty and takes time to resolve the situation
Demonstrate accurate, clear and timely verbal and written communication
Actively promote safety for patients, families, visitors and co-workers
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
-
Case Manager II
1 month ago
Washington, United States Mb Staffing Services LLC Full timeJob DescriptionJob DescriptionMb Staffing Services LLC has the perfect opportunity for a Case Manager (II) to support our DC Based client. This client's mission is to fulfill the company mission, provide care and support for people in their homes and communities. Our interactions with the people we serve and each other are guided by our commitment to our...
-
Specialist, Hybrid Events
2 weeks ago
Washington, United States White & Case Full timeFirm Summary White & Case is an elite global law firm serving leading companies, financial institutions and governments worldwide. Our long history as an international firm means we are perfectly placed to help our clients resolve their most complex legal challenges wherever they may be. With lawyers operating from more than 40 locations, working in...
-
Specialist, Hybrid Events
1 week ago
Washington, United States White & Case Full timeFirm Summary White & Case is an elite global law firm serving leading companies, financial institutions and governments worldwide. Our long history as an international firm means we are perfectly placed to help our clients resolve their most complex legal challenges wherever they may be. With lawyers operating from more than 40 locations, working in...
-
Paralegal II
4 days ago
Washington, United States Williams & Connolly LLP Full timeWilliams & Connolly LLP, recognized as one of the world's premier litigation firms, is currently seeking candidates for the position of Paralegal II to serve as an important member of the legal team. This is a mid-level position within a tiered department. Our depth of experienced, upper-level paralegals and case managers, as well as our unique single office...
-
Substance Abuse Peer Support
4 weeks ago
Washington, United States Creative Pathways, Inc. Full timeSUD Peer Support Specialist / Case Manager will be responsible for providing substance abuse treatment services in an outpatient setting. Responsible for counseling people suffering from alcohol or other drug addiction. Will be responsible for teaching drug addicts the skills and mechanics to cope with addiction and providing treatment to people with mental,...
-
Case Manager
5 days ago
Washington, United States District of Columbia Bar Full timeThe Legal Assistant/Case Manager is responsible for conducting preliminary reviews of ethical complaints against attorneys licensed to practice in the District of Columbia. The Legal Assistant/Case Manager reports to the Sr. Assistant Disciplinary Counsel-Intake. ESSENTIAL DUTIES & RESPONSIBILITIES • Conducts preliminary investigations of ethical...
-
Site Program Coordinator I
1 month ago
Washington, United States Unity Health Care. Full time**JOB TITLE**:Site Program Coordinator-My Health GPS (I, II) **FLSA**:Non-Exempt **REPORTS TO**:Health Center Director **INTRODUCTION** Under the supervision of the Health Center Director, the Site Program Coordinator provides care coordination and patient navigation activities for patients enrolled in the My Health GPS program which seeks to improve...
-
Case Manager
5 days ago
Washington, United States The Excalibur Group Full timeThe Excalibur Group is currently seeking Case Managers to join our dynamic team in Washington, D.C. Do you want to perform meaningful work? Are you passionate about other’s success? Join our team as we help DC residents secure meaningful employment and financial freedom! REQUIREMENTS Bachelor’s degree in social work, social services, counseling, business...
-
Case Manager
3 days ago
Washington, United States The Excalibur Group Full timeJob DescriptionJob DescriptionThe Excalibur Group is currently seeking Case Managers to join our dynamic team in Washington, D.C. Do you want to perform meaningful work? Are you passionate about other’s success? Join our team as we help DC residents secure meaningful employment and financial freedom! REQUIREMENTSBachelor’s degree in social work, social...
-
RN Case Manager
1 day ago
Washington, Washington, D.C., United States MEDSTAR HEALTH Full timeThe Case Manager is responsible for facilitating the patient's hospitalization from admission through discharge. The Case Manager coordinates with physicians, nurses and social workers and other disciplines within the care team, including outside agencies, to expedite the appropriateness, effectiveness and timeliness of care. Applies clinical expertise and...
-
Case Manager
2 days ago
Washington, United States Morgan & Morgan, P.A. Full timeAt Morgan & Morgan, the work we do matters. For millions of Americans, we're their last line of defense against insurance companies, large corporations or defective goods. From attorneys to client support staff, creative marketing to operations teams, every member of our firm has a key role to play in the winning fight for consumer rights. Our over 3,000...
-
RN, Case Manager-Capital Caring Health
2 weeks ago
Washington, United States Chapters Health System Full timeRN, Case Manager-Capital Caring HealthIt's inspiring to work with a company where people truly BELIEVE in what they're doing! When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our...
-
RN, Case Manager-Capital Caring Health
2 weeks ago
Washington, United States Chapters Health System Full timeRN, Case Manager-Capital Caring HealthIt's inspiring to work with a company where people truly BELIEVE in what they're doing! When you become part of the Chapters Health Team, you'll realize it's more than a job. It's a mission. We're committed to providing outstanding patient care and a high level of customer service in our communities every day. Our...
-
Foia Program Manager
24 minutes ago
Washington, United States Arcetyp LLC Full timeArcetyp LLC is a growing small business that provides a broad range of consulting services to US Federal Government, US Military, and Commercial clients. Services include Management & IT Consulting, Program & Project Management, and Professional & Admin Services. We are recruiting to fill a position to lead business development activities for a small...
-
RN Case Manager
1 day ago
Washington, Washington, D.C., United States MEDSTAR HEALTH Full timeThe Case Manager is responsible for facilitating the patient's hospitalization from admission through discharge. The Case Manager coordinates with physicians, nurses and social workers and other disciplines within the care team, including outside agencies, to expedite the appropriateness, effectiveness and timeliness of care. Applies clinical expertise and...
-
Substance abuse Peer Support
4 weeks ago
Washington, United States Creative Pathways, Inc. Full timeJob DescriptionJob DescriptionSalary: $20-$30 Per Billable HourSUD Peer Support Specialist / Case Manager will be responsible for providing substance abuse treatment services in an outpatient setting. Responsible for counseling people suffering from alcohol or other drug addiction. Will be responsible for teaching drug addicts the skills and mechanics to...
-
Fraud Associate Level Ii
1 week ago
Washington, United States XTREME SOLUTIONS INC Full timeJob Summary: With oversight from the Client Fraud Program Manager (FPM), the Fraud Associate Level II performs data analysis in support of the Fraud Program Office and other duties as assigned. The Fraud Associate Level II performs all duties assigned to a Fraud Associate Level I. **Roles and Responsibilities**: - Enter and maintain data in an in-house...
-
RN Case Manager
10 hours ago
Washington, United States HH MedStar Health Inc Full timeRN Case Manager (Discharge Planner) General Summary of Position The Case Manager is responsible for facilitating the patient's hospitalization from admission through discharge. The Case Manager coordinates with physicians, nurses and social workers and other disciplines within the care team, including outside agencies, to expedite the appropriateness,...
-
RN Case Manager
3 days ago
Washington, United States HH MedStar Health Inc Full timeRN Case Manager (Discharge Planner)General Summary of Position The Case Manager is responsible for facilitating the patient's hospitalization from admission through discharge. The Case Manager coordinates with physicians, nurses and social workers and other disciplines within the care team, including outside agencies, to expedite the appropriateness,...
-
Case Manager RN
2 weeks ago
Washington, United States CHRISTUS Health Full timeDescription Five years recent relevant clinical experience in an acute care facility required. Strong Interpersonal skills and ability to work with patients, families, providers, peers, and other departments required. Ability to use word processing and computer spreadsheets and other computer-based programs required to do the job. Excellent communication and...