RN Case Manager
4 weeks ago
Effingham Health System is seeking a skilled RN Case Manager to join our team. As a RN Case Manager, you will be responsible for managing a designated patient caseload and planning effectively to meet patient needs, manage the length of stay, and promote efficient utilization of resources.
The ideal candidate will have a solid knowledge base, critical thinking skills, and ability to apply evidence-based guidelines. Excellent interpersonal skills, self-motivation, and strong organizational skills are essential for success in this role.
Key Responsibilities- Admission review and continued stay reviews of patients using evidence-based clinical guidelines
- Contacting insurance companies to provide clinicals to support admissions/continued hospital stays
- Referring cases to the Physician Advisor for further review and collecting QA and Avoidable Days data as directed
- Functioning as an integral member of a collaborative and interdisciplinary team to re-assess and adjust the plan for care progression and transition according to the patient's clinical condition
- Providing federal notices to Medicare beneficiaries per federal guidelines and hospital policy
- Supporting Nursing Services and other clinical and non-clinical ancillary services in assuring the continuum of care for patients and in maintaining the quality of service delivery
- Serving as a patient advocate in appropriate utilization of benefits and community resources
- Completing and documenting timely clinical reviews based on assessment of medical necessity and documented clinical findings in accordance with hospital policy and payer findings
- Demonstrating understanding of medical necessity and intensity of service and incorporating payer requirements into development of safe, effective, and timely discharge plan
- Incorporating risk of re-admission and socio-economic factors in the creation of a safe and individualized transition plan
- Engaging patient and family support network in developing the transition plan
- Collaborating with interdisciplinary team throughout the patient's stay to re-assess and adjust the plan for care progression and transition according to the patient's clinical condition
- Maintaining communication with Transitional Care Director to review and discuss patient care, progress, and identified outcomes
- Participating and facilitating patient care conferences and family meetings
- Facilitating peer-to-peer discussions between attending physicians, case managers, physician advisors in cases requiring evaluation and justification of medical necessity for admission by payer
- Assuring prompt reporting of medical/legal issues to Risk Management, supervisor, and appropriate Administrative parties
- Developing and maintaining a good working rapport with other departments within the facility and outside community health & welfare and social agencies to assure that social service programs can be properly utilized to meet the needs of the patient
- Within Scope of Nursing practice, the Case Manager continuously assesses self-knowledge and competencies to assure job performance
- Ensuring adherence to proper infection control, OSHA, and safety standards
We offer a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and compassionate RN with a passion for case management, we encourage you to apply for this exciting opportunity.
-
Clinical Case Manager RN
4 weeks ago
Springfield, Illinois, United States CVS Health Full timeJob SummaryCVS Health is seeking a skilled RN Case Manager to join our team. As a Case Manager RN, you will play a critical role in facilitating the delivery of appropriate benefits and healthcare information to our members, while promoting wellness activities and developing health strategies to ensure timely return to work.Key ResponsibilitiesAct as a...
-
Case Manager RN
4 weeks ago
Springfield, Illinois, United States CVS Health Full timeJob Summary:The Case Manager RN position at CVS Health is a 100% remote opportunity that allows employees to live in any state, with most having an Illinois RN license. This role is part of Aetna's Commercial Care Management division.Key Responsibilities:Telephonically and/or face-to-face assess, plan, implement, and coordinate all case management activities...
-
Case Manager RN- Field
4 weeks ago
Springfield, Illinois, United States CVS Health Full timeTransforming Patient Care with Compassion and ExcellenceCVS Health is seeking a dedicated and compassionate Case Manager RN to join our team. As a key member of our Aetna team, you will play a vital role in delivering exceptional patient care to our dual eligible populations.Program OverviewOur Case Manager RN will work closely with members, providers, and...
-
Case Manager RN- Field
1 month ago
Springfield, Illinois, United States CVS Health Full timeTransforming Patient CareCVS Health is seeking a dedicated and compassionate Case Manager RN to join our team. As a key member of our Aetna team, you will play a vital role in elevating patient care to new heights.Program OverviewOur Case Manager RN will work closely with members, providers, and community organizations to address the full continuum of health...
-
Travel Nurse RN Case Manager
1 month ago
Springfield, Illinois, United States Medical Solutions Full timeJob Title: Travel Nurse RNMedical Solutions is seeking a skilled travel nurse RN to join our team as a Case Manager, Utilization Review. This exciting opportunity is available in Springfield, Missouri, and offers a unique blend of clinical expertise and business acumen.Job Summary:We are looking for a talented RN with a strong background in case management...
-
Home Health RN Case Manager
1 month ago
Springfield, Illinois, United States CodeForce Full timeJob Summary:RN Case Manager for Home Health and Hospice Care is responsible for managing a case load of facility patients. The ideal candidate will have experience in home health and hospice care, with a strong focus on patient-centered care and collaboration with healthcare teams.Key Responsibilities: Assess, plan, implement, coordinate, and evaluate care...
-
Case Manager RN- Field Position
4 weeks ago
Springfield, Illinois, United States CVS Health Full timeJob Summary:CVS Health is seeking a skilled Case Manager RN to join our Community Care team. As a Case Manager RN, you will play a critical role in delivering high-quality patient care and promoting wellness activities.Key Responsibilities:Facilitate the delivery of appropriate benefits and/or healthcare information to determine eligibility for benefits...
-
Travel Nurse RN Position
4 weeks ago
Springfield, Illinois, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN PositionJob Summary:TotalMed Case Management Staffing is seeking a travel nurse RN for a home health assignment in a dynamic healthcare environment. As a travel nurse, you will have the opportunity to work with a variety of patients and develop your skills in a fast-paced setting.Responsibilities:- Provide high-quality patient care...
-
Nurse Case Manager
3 weeks ago
Springfield, Illinois, United States Inova Health System Full timeInova Health System is seeking a skilled Registered Nurse to fill a Case Management position.Job DescriptionThe RN Case Manager will provide discharge planning and continuity of care for assigned patients in acute and post-acute settings.Key ResponsibilitiesCollects and analyzes data to identify areas for improvement and drives practice changes to positively...
-
RN Case Manager
1 month ago
Springfield, Illinois, United States CoxHealth Full timeUnlock Your Potential in a Best-in-Class Work EnvironmentCoxHealth is proud to be recognized as one of the 5x Modern Healthcare Best Places to work and America's Greatest Workplaces 2023 – Newsweek. We're committed to providing a work environment that supports your growth and well-being.Enjoy a robust benefits package, including up to $10,000 Sign-On...
-
Nurse Case Manager
1 month ago
Springfield, Illinois, United States DaVita Full timeJob Title: Peritoneal Dialysis Registered NurseWe are seeking a highly motivated and organized Peritoneal Dialysis Registered Nurse to join our team. As a Peritoneal Dialysis Registered Nurse, you will be responsible for providing comprehensive patient care in an independent setting. You will work closely with patients and their care partners to educate them...
-
Case Manager RN- Field
1 month ago
Springfield, Illinois, United States CVS Health Full timeJob SummaryCVS Health is seeking a highly skilled Case Manager RN to join our Community Care team. As a key member of our team, you will be responsible for facilitating the delivery of appropriate benefits and healthcare information to our members, while promoting wellness activities and developing strategies to ensure timely return to work.Key...
-
Travel Nurse RN Position
4 weeks ago
Springfield, Illinois, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN PositionJob Summary:TotalMed Case Management Staffing is seeking a travel nurse RN for a home health position. This is a great opportunity for a registered nurse to work in a dynamic environment and make a difference in the lives of patients.Job Requirements:- Specialty: Home Health- Discipline: RN- Start Date: ASAP- Duration: 8...
-
Registered Nurse Case Manager
4 weeks ago
Springfield, Illinois, United States Healthcare Staffing Plus Full timeJob Title: Registered Nurse Case Manager - Local ContractJob SummaryWe are seeking a highly skilled Registered Nurse Case Manager to join our team at Healthcare Staffing Plus. As a key member of our interdisciplinary team, you will be responsible for directing and coordinating the care of patients from admission through transfer or discharge to achieve...
-
Field Case Manager RN
4 weeks ago
Springfield, Illinois, United States CVS Health Full timeJob SummaryCVS Health is seeking a highly skilled Field Case Manager RN to join our team in the Chicago Metro Area. As a Field Case Manager RN, you will play a critical role in coordinating care for our members, ensuring they receive the best possible outcomes.Key ResponsibilitiesCollaborate with healthcare providers, members, and families to develop and...
-
RN, Hospital Case Manager, Part Time
1 month ago
Springfield, Illinois, United States Baystate Health Full timeHospital Case Manager Job DescriptionThe Hospital Case Manager is a registered nurse responsible for coordinating clinical care, quality, and financial outcomes of a designated population of patients.Key Responsibilities:Facilitate patient care plans as outlined in the plan of careLead daily patient care huddles with nursing to direct timely progress along...
-
Travel Nurse RN Case Manager
1 month ago
Springfield, Illinois, United States Vibra Travels Full timeTravel Nurse RN Case Management Job in Springfield, MOVibra Travels is seeking a travel nurse RN Case Management for a travel nursing job in Springfield, Missouri.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeksHours: 40 hours per weekShift: 8 hours, daysEmployment Type: TravelVIBRA TRAVELS is looking for a CORPORATE TRAVEL REGISTERED...
-
Case Manager
4 weeks ago
Springfield, Illinois, United States Children's Study Home Full timeComprehensive Foster Care Program**Job Summary**Helix Human Services is seeking a skilled Case Manager to provide intensive case management to children and youth referred by the Department of Children and Families (DCF) to the Comprehensive Foster Care program (CFC).**Key Responsibilities:**• Provide case management supports to children and adolescent...
-
Travel Nurse RN Position in Home Health
4 weeks ago
Springfield, Illinois, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse for a home health position.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNEmployment Type: TravelWe are seeking a Registered Nurse for a travel assignment in a home health setting.TotalMed Case Management Staffing Job ID #About TotalMed Case Management StaffingWe are a team who...
-
Travel Nurse RN Position in Home Health
3 weeks ago
Springfield, Illinois, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN for a home health position in Springfield, Missouri.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNAssignment Length: 8 weeksTotal Hours Per Week: 40Shift Breakdown: 5x8 hoursThe pay package is based on 8 hour shifts and 40 hours per week, with a tax-free stipend amount to be...