Your perfect Nurse Case Manager job is here! Find that Nurse Case Manager job in Birmingham with the Livecareer Job Search Engine

Field Nurse Case Manager III

Job Description: **JOB SUMMARY:** The Medical Case Manager provides medical and vocational

Posted on October 18, 2017

Job Description **JOB SUMMARY:** The Medical Case Manager provides medical and vocational assistance and coordination services to assist injured workers in reaching maximum medical improvement and return to work. The Medical Case Manager facilitates communication between all parties including the injured worker, the adjuster, the employer, treating physician(s) and ancillary providers to assist the injured worker in obtaining prompt and appropriate medical treatment. The Medical Case Manager assesses rehabilitation needs and makes appropriate recommendations. The ultimate goal is for the injured worker to recover and return to work as soon as is medically appropriate. The Medical Case Manager facilitates any temporary or permanent job modifications necessary to allow the injured worker to return to work within the applicable physical restrictions assigned by the doctor. The exact role the Medical Case Manager plays will vary with the injury management model used by each customer. The responsibilities on each case may vary. **ESSENTIAL JOB RESPONSIBILITIES:** * Maintains regular contact with all parties involved to facilitate communication and to provide medical and vocational management and coordination services * Arranges for prompt and appropriate medical treatment of an injured worker by qualified providers (choice of providers as per regulations); Schedules appointments to avoid delays in treatment by primary care physicians, specialists or ancillary services * Assists the treating physician in developing a written treatment plan for the injured worker, including the identity and scope of treatment by any other providers to which referrals have been made. Work with the medical providers to track progress and to modify the treatment plan as necessary until maximum medical improvement is achieved * Obtains medical reports and required work status forms. Ensures all parties receive appropriate reports * Facilitate authorization/certification of procedures, diagnostic testing, physical therapy/occupational therapy and durable medical equipment as per regulations to ensure appropriate treatment is not delayed * Cooperates with the treating physician to obtain a full or conditional release to return to work before injury becomes a lost time claim; Work with the treating physician to update any conditions as medical treatment progresses * Assesses the injured worker and his/her support system and family; Makes appropriate referrals throughout the continuum of care including educational, financial, and psychological or other human services as indicated * Coordinates with the employer to develop a modified duty job for the injured worker who cannot immediately return to his/her full pre-injury employment; The job must be consistent with any physical restrictions assigned by the treating doctor; Educates the employer on the tangible and intangible benefits of accommodating the injured worker to keep him in the work force * Where a return to work with the same employer is not possible, provide vocational services to the injured worker to identify vocational goals and develop an early return to work plan * Maintains constant contact with the adjuster assigned to the file through telephone calls, EMAIL and written reports. For each customer be aware of the limits of decision-making authority delegated by the adjuster to the case manager and respect these limits. Satisfy the documentation and reporting requirements of each customer * Makes appropriate use of Wellcomp physicians for adjuster support, peer-to-peer consultation and as professional resource; Make appropriate use of Wellcomp clinical and information systems staff to deliver exceptional service to direct & indirect customers * Organizes and review medical records to identify specific medical issues; Provides information and recommendations to appropriate parties * Acts as an advocate for the injured worker with all parties while maintaining the injured worker’s privacy and safety; Adheres to Wellcomp's confidentiality policies and procedures. Follows ethical, legal, and regulatory standards * Participates in the collection of outcome information and Wellcomp’s Quality Improvement process to determine the impact of case management activities on timely injury recovery, medical treatment, return to work, claim costs, and both injured worker and client satisfaction. The result achieves desirable outcomes for all * Maintains continuing education requirements per state license requirements. Maintains an updated and working knowledge of workers’ compensation and federal laws that impact the delivery of health care and return to work * Become proficient in the software used in the department * Contribute to the success of the company and its posture toward customer service by a positive and professional attitude and by understanding and responding to the needs of our direct and indirect customers; Follows ethical, legal, and regulatory standards * Performs other duties as assigned **SUPERVISORY RESPONSIBILITIES:** * The Medical Case Manager reports to the Team Manager, Case Management and has no direct reports. Required Skills **KNOWLEDGE: SKILLS/ABILITIES** * The ability to work effectively with minimal direct supervision * The ability to plan and use time effectively * The ability to work as a member of the Wellcomp team * Must be computer literate * Keyboard typing and dialing of telephone require hand dexterity and the repetitive use of finger movement * Due to the nature of the position, sitting in a sustained position for prolonged periods may be necessary * Vision must be adequate to view the computer screen * This may include occasional air travel and overnight stays * Must have the ability and willingness to travel for task and/or field case management visits if within assigned geographic areas * Must possess a valid driver’s license; Must provide proof of insurance Required Experience **EDUCATION:** * MA/ BS / BA in Nursing or Associates Degree in Nursing from accredited school with Equivalent Work Experience and a CCM, CIRS, CRRN, COHN or other related designation or; * BA/BS or MA in related field with a CCM, CDMS, or CRC or other related designation or; * Current Nursing license and/or certification * CCM required based on state guidelines. **EXPERIENCE:** * Three or more year’s workers compensation case management experience or related field *Tracking Code:* BIRMINGHAM08291701 *Job Location:* Birmingham, Alabama, United States *Position Type:* Full-Time/Regular

Nurse Case Manager

Cigna Birmingham ,AL

Case Manager in applicable state\. Minimum two years clinical practice experience in a providers’

Posted on October 18, 2017

**Description:** **Summary:** Coordinates and manages relationships with single office practices to multiple provider practices in HealthSpring’s P4Q or P4Q2programs\. Consistently monitors participating provider performance on the identified P4Q and/or HEDIS STAR measures and regularly communicates status of those measures to the appropriate HealthSpring team members\. Establishes and maintains regularly scheduled contact with designated P4Q or P4Q2Program Point\-of\-Contact in each participating office and conducts on\-site visits in those offices\. Coordinates and ensures that all communication is maximized effectively between the practice, health plan, and any disease management vendors Coordinate and manage member care in participating provider practices: Under general supervision, responsible for identifying medium/ high risk members by utilizing predictive modeling reports for the assigned physician and/or practice\. Identify gaps in care and document compliance\. Assists in coordinating the delivery of cost\-effective, quality\-based health care services for health plan members by incorporating physician/staff and other health plan services to address individual needs of the member, and awareness of community resources\. Initiate contact with member/family, physician, and health care providers/suppliers to discuss the alternative treatment plan\. Greet members at on\-site visits and assess members that need an ECC visit to assure coordination\. Daily monitors, and evaluates inpatient admissions and discharge census and follows through for post discharge appointments and needs\. Evaluates cases for quality of care\. Partner with in\-office Point\-of\-Contact$s$ to ensure member compliance and practice success:Coordinate real\-time performance measure management\. Ensure that participating practices are driving improvement on P4Q Program performance measures\. Review data for those members that are frequent users of healthcare resources to ensure they are receiving the proper care\. Suggest physician referrals to case management or behavioral health\. Communicate real\-time updates to identified team members\. Develop and maintain a process to ensure that all members in participating practices receive the screenings and services needed within the given timeframe\. Maintain detailed understanding of all P4Q Program $HEDIS STAR$ performance measures\. **Qualifications:** Minimum Requirements:Unrestricted Licensed Vocational Nurse $LVN$ or Licensed Practical Nurse $LPN$ in the applicable state\. At least one year related experience in a healthcare environment\. Excellent written and oral communication skills; excellent problem solving skills; highly organized and proactive; ability to handle multiple tasks and set priorities; detailed oriented; works independently with minimum of supervision\. Ability to travel to and work at participating practices\. Preferred Requirements:Current licensure as a Registered Nurse $RN$, or Certified Case Manager in applicable state\. Minimum two years clinical practice experience in a providers’ office, hospital setting\. USCandidates Only: Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status\. If you require a special accommodation, please visit our Careers website or contact us atSeeYourself@cigna\.com\. **Primary Location:** Birmingham\-Alabama **Work Locations:** 2 Chase Corporate Drive STE 300 Birmingham 35244 **Job:** Med Mgt\-\-Case Management **Schedule:** Regular **Shift:** Standard **Employee Status:** Individual Contributor **Job Type:** Full\-time **Job Level:** Day Job **Travel:** Yes, 100 % of the Time **Job Posting:** Sep 14, 2017, 11:55:58 AM

Onsite Nurse Case Manager (Rn)

Genex Services Birmingham ,AL

Overview We are currently seeking an Onsite Nurse Case Manager (RN) for our customer in Birmingham,

Posted on October 18, 2017

Overview We are currently seeking an Onsite Nurse Case Manager (RN) for our customer in Birmingham, Alabama. Responsible for assessment, planning, coordination, implementation and evaluation of injured/disabled individuals involved in the medical case management process. Working as an intermediary between carriers, attorneys, medical care providers, employers and employees, you will closely monitor the progress of the injured worker and report results back to the employer and insurance carrier. This will ensure appropriate and cost-effective healthcare services leading to a medically rehabilitated individual who is ready to return to an optimal level of work and functioning. Responsibilities Main responsibilities will include but are not limited to: + Using clinical/nursing skills to help coordinate the individual’s treatment program while maximizing cost containment. + Serving as an intermediary to interpret and educate the individual on his/her disability, and the treatment plan established by the case manager, physicians, and therapists. Explaining physician’s and therapists’ instructions, and answering any other questions the claimant may have in an effort to facilitate his/her return to work. + Working with the physicians and therapists to set up medical assessments to develop an overall treatment plan that ensures cost containment while meeting state and other regulator’s guidelines. + Researching alternative treatment programs such as pain clinics, home health care, and work hardening. Coordinating all aspects of the individual’s enrollment into the programs, and then monitors his/her progress, in an effort to maximize cost containment and minimize time away from work. + Working with employers on modifications to job duties based on medical limitations and the employees functional assessment. Helping employer rewrite a job description, when necessary and possible, in an effort to return the client to the workplace. + May provide testimony on litigated cases. + Coordinates injured workers’ appointments and arranges for transportation as needed. + Documenting and reporting all case activity is critical for accurate case management and billing procedures. + Maintaining all case documents in files ensuring a comprehensive and detailed source of information for all parties involved in the case. + Preparing detailed evaluation reports, as per account guidelines, and case recording documenting for each phase of activity as it is completed. + Maintains phone contact with all parties involved to monitor, update, and advance case activity to ensure the progress of the case. + Completing insurance carrier reports on a monthly (or as required) basis, as well as other necessary paperwork for the insurance company, state, or other regulatory bodies. + Maintaining professionalism at all times despite the stressful demands of the position. Capable of maintaining close relationships among all parties involved both in person and over the phone. Must be readily available for and responsive to all parties concerned. + Acquiring and maintaining knowledge of developments in the medical case management field. Keeping abreast of local workers’ compensation laws and regulations, as well as other issues related to the case management/managed care industry. This is also critically important in keeping licenses and certifications valid. + Participating in professional associations keeps the case manager informed of events in their field while establishing referral contacts. + May assist in training/orientation of new staff as requested. + Other duties may be assigned. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Diploma, Associate or bachelors degree in nursing or bachelors degree (or higher) in a health or human services related field required. Masters level and/or advanced study in a health-related field desired. + Minimum of two (2) years full time equivalent of direct clinical care to consumers required. Workers’ compensation-related experience preferred. Prior case management experience preferred. + A current, unrestricted license or certification to practice a health or human services discipline in a state or territory of the United States that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline; or + In the case of an individual in a state that does not require licensure or certification, the individual must have a baccalaureate or graduate degree in social work, or another health or human services field that promotes the physical, psychosocial, and/or vocational well-being of the persons being served, that requires: + A degree from an institution that is fully accredited by a nationally recognized educational accreditation organization; + The individual must have completed a supervised field experience, in case management, health, or behavioral health as part of the degree requirements; and + URAC-recognized certification in case management within four (4) years of hire as a case manager + Pursue URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN) upon eligibility. Other state licenses/certifications as required by law. + Valid driver’s license required. + Experience in rehabilitation services industry, vocational/occupational/industrial nursing preferred. + Background in state workers’ compensation law and practices desirable. + Excellent interpersonal skills, phone manners, and organizational skills. + Ability to set priorities and work independently. + Computer literacy required. Job LocationsUS-AL-Birmingham Job ID2017-1712 CategoryField Case Management

Nurse Case Manager RN Or LVN - Birmingham

Kelly Services Birmingham ,AL

for a Nurse Case Manager to come work with our client located near Birmingham, AL. If you’re ready

Posted on October 18, 2017

**Nurse Case Manager - RN or LVN - Birmingham** Kelly Services has an exciting opportunity for a Nurse Case Manager to come work with our client located near Birmingham, AL. If you’re ready to help individuals maintain a healthy life, then what are you waiting for?! Apply today! **ROLES AND RESPONSIBILITIES:** + Responsible for collaborating with healthcare providers and members to optimize member benefits and to promote effective use of resources. + Assesses the medical necessity of inpatient admissions, outpatient services, surgical and diagnostic procedures, and out of network services. + May also manage appeals for services denied. + May conduct pre-certification, concurrent and retrospective reviews to ensure compliance with medical policy, member eligibility, benefits, and contracts. **REQUIRED QUALIFICATIONS:** + Active and unrestricted RN or LVN license in state of Alabama + Working knowledge of the insurance industry and the overall claims process a plus. + Case Management or Utilization Review experience for at least 1 year + Managed Care experience is a plus HOW TO APPLY: This position is recruited for by a remote Kelly office, not your local Kelly branch. To apply for this opportunity please utilize the “Apply Now/Submit Resume” button. Every day, Kelly Healthcare Resources (KHR) specializes in providing highly skilled nursing and allied health professionals within hospitals and other health care facilities, as well as positions in sectors such as insurance, pharmaceutical, health management and education. In addition to working with the world’s most recognized and trusted name in staffing, Kelly employees can expect: •Competitive pay •Access to a comprehensive employee benefits package including health, prescription, vision, dental, and life and short-term disability insurance •Paid service bonus and holidays •Portable 401(k) plans •Recognition and incentive programs •Access to continuing education via the Kelly Learning Center Related Search Terms: Registered nurse, RN, nurse liaison, case manager, nurse case manager, case manager RN, registered nurse manager, case management RN, nurse care manager, case coordinator, care coordinator, LPN, License Practical Nurse, case coordinator **Why Kelly** **®** **?** With Kelly, you’ll have direct connections to leading healthcare companies—providing you with the chance to positively impact quality and delivery of patient care. In a field where innovation and change happen constantly, our connections and opportunities will help you take your career exactly where you want to. We work with 95 of the Fortune 100™ companies, and more than 1,200 healthcare hiring managers turn to us each year to access the best talent: people like you. Let us help advance your healthcare career today. **AboutKelly Services** **®** As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people around the world and have a role in connecting thousands more with work through our global network of talent suppliers and partners. Revenue in 2016 was $5.3 billion. Visit kellyservices.com and connect with us on Facebook , LinkedIn and Twitter . Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females, Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is committed to employing a diverse workforce. Equal Employment Opportunity is The Law. at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm

Registered Nurse Case Manager

Care First Hospice, LLC Birmingham ,AL

Fulltime RN Case Manager - Hospice Division Jefferson county RN Case Manager Hospice - Fulltime St.

Posted on October 7, 2017

Fulltime RN Case Manager - Hospice Division Jefferson county RN Case Manager Hospice - Fulltime St. Vincent's Home Health & Hospice, an Ascension at Home Company, is growing and has an immediate RN / Registered Nurse opportunity. Primary functions are to plan, develop, implement, evaluate, organize and direct home care services with the interdisciplinary team including physician, patient/family, and referring agency; and administer skilled nursing care for clients of all ages in their place of residence and assume the responsibility for the total provision of care. Join a team that's making a difference; We offer: Competitive Salary/Benefits Inspiring Work Spiritually centered Sign-on Bonus Find your next career opportunity at www.ahah.net Essential Duties and Responsibilities: Assesses home health patients to identify the physical, psychosocial, and environmental needs as evidenced by documentation, clinical record, case conference, team report, and evaluations Case manages and provides clinical oversight and direction to the interdisciplinary team, physician, and family Implements/develops/documents the plan of care and revises as necessary Provides care utilizing infection control measures that protect both the staff and the patient (OSHA) Supervises and provides directions to the HHA/LVN to ensure quality and continuity of services provided Assures continuity of quality patient care delivered with appropriate documentation Monitors assigned cases to ensure compliance with requirements of third party payors Performs on-call responsibilities and provides on-call service to patients/families, as assigned Provides effective communication to patient/family, team members, physicians, and other health care professionals Adheres to all company policies and procedures. Adherence to and compliance with information systems security is everyone's responsibility. It is the responsibility of every computer user to: Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems. Minimum Qualifications: Education/Licensing/Certification: Graduate of an accredited college/university, Associate, Diploma, or Baccalaureate School of nursing Current, unencumberedState License as a registered Nurse Current Driver's License Current CPR, negative TB screen and Hepatitis consent/declination Experience: Two years of experience as a registered nurse in a clinical care setting, home health preferred. Knowledge and Skills: Nursing skills as defined as generally accepted standards of practice. Good interpersonal skills. Associated topics: asn, cardiothoracic, care, ccu, maternal, neonatal, nurse clinical, nurse rn, psychatric, registed

Onsite Nurse Case Manager (Rn)

Genex Services, LLC Birmingham ,AL

OverviewWe are currently seeking an Onsite Nurse Case Manager (RN) for our customer

Posted on October 10, 2017

OverviewWe are currently seeking an Onsite Nurse Case Manager (RN) for our customer in Birmingham, Alabama. Responsible for assessment, planning, coordination, implementation and evaluation of injured/disabled individuals involved in the medical case management process. Working as an intermediary between carriers, attorneys, medical care providers, employers and employees, you will closely monitor the progress of the injured worker and report results back to the employer and insurance carrier. This will ensure appropriate and cost-effective healthcare services leading to a medically rehabilitated individual who is ready to return to an optimal level of work and functioning.ResponsibilitiesMain responsibilities will include but are not limited to: <ul><li>Using clinical/nursing skills to help coordinate the individual s treatment program while maximizing cost containment. </li><li>Serving as an intermediary to interpret and educate the individual on his/her disability, and the treatment plan established by the case manager, physicians, and therapists. Explaining physician s and therapists instructions, and answering any other questions the claimant may have in an effort to facilitate his/her return to work.</li><li>Working with the physicians and therapists to set up medical assessments to develop an overall treatment plan that ensures cost containment while meeting state and other regulator s guidelines.</li><li>Researching alternative treatment programs such as pain clinics, home health care, and work hardening. Coordinating all aspects of the individual s enrollment into the programs, and then monitors his/her progress, in an effort to maximize cost containment and minimize time away from work.</li><li>Working with employers on modifications to job duties based on medical limitations and the employees functional assessment. Helping employer rewrite a job description, when necessary and possible, in an effort to return the client to the workplace.</li><li>May provide testimony on litigated cases.</li><li>Coordinates injured workers appointments and arranges for transportation as needed.</li><li>Documenting and reporting all case activity is critical for accurate case management and billing procedures. </li><li>Maintaining all case documents in files ensuring a comprehensive and detailed source of information for all parties involved in the case.</li><li>Preparing detailed evaluation reports, as per account guidelines, and case recording documenting for each phase of activity as it is completed. </li><li>Maintains phone contact with all parties involved to monitor, update, and advance case activity to ensure the progress of the case.</li><li>Completing insurance carrier reports on a monthly (or as required) basis, as well as other necessary paperwork for the insurance company, state, or other regulatory bodies.</li><li>Maintaining professionalism at all times despite the stressful demands of the position. Capable of maintaining close relationships among all parties involved both in person and over the phone. Must be readily available for and responsive to all parties concerned.</li><li>Acquiring and maintaining knowledge of developments in the medical case management field. Keeping abreast of local workers compensation laws and regulations, as well as other issues related to the case management/managed care industry. This is also critically important in keeping licenses and certifications valid.</li><li>Participating in professional associations keeps the case manager informed of events in their field while establishing referral contacts.</li><li>May assist in training/orientation of new staff as requested.</li><li>Other duties may be assigned.</li></ul> CB2 To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.<ul><li>Diploma, Associate or bachelors degree in nursing or bachelors degree (or higher) in a health or human services related field required. Masters level and/or advanced study in a health-related field desired.</li><li>Minimum of two (2) years full time equivalent of direct clinical care to consumers required. Workers compensation-related experience preferred. Prior case management experience preferred.</li><li>A current, unrestricted license or certification to practice a health or human services discipline in a state or territory of the United States that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline; or</li><li> In the case of an individual in a state that does not require licensure or certification, the individual must have a baccalaureate or graduate degree in social work, or another health or human services field that promotes the physical, psychosocial, and/or vocational well-being of the persons being served, that requires: </li><ul><li> A degree from an institution that is fully accredited by a nationally recognized educational accreditation organization; </li><li> The individual must have completed a supervised field experience, in case management, health, or behavioral health as part of the degree requirements; and </li><li> URAC-recognized certification in case management within four (4) years of hire as a case manager</li></ul><li>Pursue URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN) upon eligibility. Other state licenses/certifications as required by law. </li><li>Valid driver s license required. </li><li>Experience in rehabilitation services industry, vocational/occupational/industrial nursing preferred. </li><li>Background in state workers compensation law and practices desirable. </li><li>Excellent interpersonal skills, phone manners, and organizational skills. </li><li>Ability to set priorities and work independently. </li><li>Computer literacy required.</li></ul> Associated topics: care, domiciliary, hospice, mhb, nurse, psychatric, registered nurse, staff nurse, surgical, unit

RN Nurse Case Mgr I/Ii/Sr "Remote" 135166Vmj

Anthem Birmingham ,AL

to do innovative work that means more to you and those we serve. * * * Nurse Case Manager I/II/Sr * * Location:

Posted on October 18, 2017

Your Talent. Our Vision. At Empire Blue Cross Blue Shield, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve. * * * Nurse Case Manager I/II/Sr * * Location: REMOTE * * * *The schedule for this position is M-F 8:30am to 5:00pm or 9:00am to 5:30pm EST* Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. Primary duties may include, but are not limited to: * Ensures member access to services appropriate to their health needs * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment * Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements * Coordinates internal and external resources to meet identified needs * Monitors and evaluates effectiveness of the care management plan and modifies as necessary * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans * Negotiates rates of reimbursement, as applicable * Assists in problem solving with providers, claims or service issues * Requires a BA/BS in a health related field * 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background * Current, unrestricted RN license from the State you reside in required * Current, unrestricted RN license from the State of New York required * Multi-state licensure is required if this individual is providing services in multiple states * Certification as a Case Manager is preferred Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers.*/EOE. M/F/Disability/Veteran./* **Job** *Medical* Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity. **Title:** *RN Nurse Case Mgr I/II/Sr "REMOTE" 135166VMJ* **Location:** *Alabama-Birmingham* **Requisition ID:** *135166*

Nurse Case Manager RN Or LVN - Birmingham

Kelly Healthcare Resources Birmingham ,AL

has an exciting opportunity for a Nurse Case Manager to come work with our client located near Birmingham, AL.

Posted on October 10, 2017

Nurse Case Manager - RN or LVN - Birmingham Kelly Services has an exciting opportunity for a Nurse Case Manager to come work with our client located near Birmingham, AL. If you re ready to help individuals maintain a healthy life, then what are you waiting for?! Apply today! ROLES AND RESPONSIBILITIES: <ul> <li>Responsible for collaborating with healthcare providers and members to optimize member benefits and to promote effective use of resources.</li> <li>Assesses the medical necessity of inpatient admissions, outpatient services, surgical and diagnostic procedures, and out of network services.</li> <li>May also manage appeals for services denied. </li> <li>May conduct pre-certification, concurrent and retrospective reviews to ensure compliance with medical policy, member eligibility, benefits, and contracts.</li> </ul> REQUIRED QUALIFICATIONS: <ul> <li>Active and unrestricted RN or LVN license in state of Alabama</li> <li>Working knowledge of the insurance industry and the overall claims process a plus.</li> <li>Case Management or Utilization Review experience for at least 1 year</li> <li>Managed Care experience is a plus</li> </ul> HOW TO APPLY: This position is recruited for by a remote Kelly office, not your local Kelly branch. To apply for this opportunity please utilize the Apply Now/Submit Resume button. Every day, Kelly Healthcare Resources (KHR) specializes in providing highly skilled nursing and allied health professionals within hospitals and other health care facilities, as well as positions in sectors such as insurance, pharmaceutical, health management and education. In addition to working with the world s most recognized and trusted name in staffing, Kelly employees can expect: Competitive pay Access to a comprehensive employee benefits package including health, prescription, vision, dental, and life and short-term disability insurance Paid service bonus and holidays Portable 401(k) plans Recognition and incentive programs Access to continuing education via the Kelly Learning Center Related Search Terms: Registered nurse, RN, nurse liaison, case manager, nurse case manager, case manager RN, registered nurse manager, case management RN, nurse care manager, case coordinator, care coordinator, LPN, License Practical Nurse, case coordinator <div>Why Kelly ?</div> With Kelly, you ll have direct connections to leading healthcare companies providing you with the chance to positively impact quality and delivery of patient care. In a field where innovation and change happen constantly, our connections and opportunities will help you take your career exactly where you want to. We work with 95 of the Fortune 100 companies, and more than 1,200 healthcare hiring managers turn to us each year to access the best talent: people like you.Let us help advance your healthcare career today. <div>AboutKelly Services </div> As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people around the world and have a role in connecting thousands more with work through our global network of talent suppliers and partners. Revenue in 2016 was $5.3 billion. Visit <a ExLinkAttribute=\"\" class=\"exLink\" href=\"\" rel=\"nofollow\">kellyservices.com</a> and connect with us on <a ExLinkAttribute=\"\" class=\"exLink\" href=\"\" rel=\"nofollow\">Facebook</a>, <a ExLinkAttribute=\"\" class=\"exLink\" href=\"\" rel=\"nofollow\">LinkedIn</a> and <a ExLinkAttribute=\"\" class=\"exLink\" href=\"\" rel=\"nofollow\">Twitter</a>.Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females, Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is committed to employing a diverse workforce. <a ExLinkAttribute=\"\" class=\"exLink\" href=\"\" rel=\"nofollow\">Equal Employment Opportunity is The Law.</a> Associated topics: licensed vocational, lvn, mtp, nurse ii, nurse iii, nurse lpn, pediatrics, practical, practical nurse lpn, vocational nurse

Registered Nurse Case Manager

Ascension Health At Home Birmingham ,AL

RN Case Manager Hospice - Fulltime Jefferson

Posted on October 9, 2017

RN Case Manager Hospice - Fulltime Jefferson county St. Vincent's Home Health & Hospice, an Ascension at Home Company, is growing and has an immediate RN / Registered Nurse opportunity. Primary functions are to plan, develop, implement, evaluate, organize and direct home care services with the interdisciplinary team including physician, patient/family, and referring agency; and administer skilled nursing care for clients of all ages in their place of residence and assume the responsibility for the total provision of care. Join a team that's making a difference; We offer:<ul><li>Competitive Salary/Benefits</li><li>Inspiring Work</li><li>Spiritually centered</li><li>Sign-on Bonus</li></ul> Find your next career opportunity at <a ExLinkAttribute=\"\" class=\"exLink\" href=\"\" rel=\"nofollow\">www.ahah.net</a> Essential Duties and Responsibilities:<ul><li>Assesses home health patients to identify the physical, psychosocial, and environmental needs as evidenced by documentation, clinical record, case conference, team report, and evaluations</li><li>Case manages and provides clinical oversight and direction to the interdisciplinary team, physician, and family</li><li>Implements/develops/documents the plan of care and revises as necessary</li><li>Provides care utilizing infection control measures that protect both the staff and the patient (OSHA)</li><li>Supervises and provides directions to the HHA/LVN to ensure quality and continuity of services provided</li><li>Assures continuity of quality patient care delivered with appropriate documentation</li><li>Monitors assigned cases to ensure compliance with requirements of third party payors</li><li>Performs on-call responsibilities and provides on-call service to patients/families, as assigned</li><li>Provides effective communication to patient/family, team members, physicians, and other health care professionals</li><li>Adheres to all company policies and procedures.</li><li>Adherence to and compliance with information systems security is everyone's responsibility. It is the responsibility of every computer user to: Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems.</li></ul> Minimum Qualifications: Education/Licensing/Certification:<ul><li>Graduate of an accredited college/university, Associate, Diploma, or Baccalaureate School of nursing</li><li>Current, unencumbered State License as a registered Nurse</li><li>Current Driver's License</li><li>Current CPR, negative TB screen and Hepatitis consent/declination</li></ul> Experience:<ul><li>Two years of experience as a registered nurse in a clinical care setting, home health preferred.</li></ul> Knowledge and Skills:<ul><li>Nursing skills as defined as generally accepted standards of practice.</li><li>Good interpersonal skills</li></ul> Associated topics: bsn, care unit, ccu, coronary, hospice, infusion, intensive care unit, recovery, staff nurse, surgical

RN - Field Based Case Manager - Per Diem - Birmingham, AL

Unitedhealth Group Birmingham ,AL

live healthier lives while doing your life's best work.(sm) The Nurse Case Manager position

Posted on October 18, 2017

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The Nurse Case Manager position is in an area where proprietary staff is not available due to geography or availability due to case load. The Per Diem, field - based Nurse Case Manager will handle catastrophic and non - catastrophic assignments for industrially injured employees. The responsibilities include meeting with the injured workers, physicians and facilities and to effectively follow up and communicate with our customers. The Nurse Case Manager will work from home and also travel in a designated area up to 75% of the time.The customer base includes all customers currently contracted for field case management services. The position is critical for the customers we service who rely on our expertise to assist their injured employees with treatment and cost saving measurements. Required Qualifications: Registered Nurse - Active and unrestricted license in the state of practice Undergraduate Degree - Bachelors or Associates Degree Case Management experience Workers Compensation experience Proficiency with Microsoft Word and Microsoft Excel Ability to work independently in home and alternate site settings Access to reliable transportation that will enable you to travel to customer and patient sites within a designated area Preferred Qualifications: CCM UnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: RN, Case Manager, Case Management, Workers Compensation, Birmingham, Alabama, AL adb30c10-767a-486e-a885-a94497f4f435 *RN - Field Based Case Manager - Per Diem - Birmingham, AL* *Alabama-Birmingham* *731713*

1,135 jobs matching Nurse Case Manager

Field Nurse Case Manager III

Nurse Case Manager

Onsite Nurse Case Manager (Rn)

Nurse Case Manager RN Or LVN - Birmingham

Registered Nurse Case Manager

Onsite Nurse Case Manager (Rn)

RN Nurse Case Mgr I/Ii/Sr "Remote" 135166Vmj

Nurse Case Manager RN Or LVN - Birmingham

Registered Nurse Case Manager

RN - Field Based Case Manager - Per Diem - Birmingham, AL

Filter Results

Create a job alert for Nurse Case Manager at Birmingham, Alabama.

Great! You'll now receive job alerts for Nurse Case Manager at Birmingham, Alabama.

Resume Tools Resume Tools

Cover Letter Cover Letter

Mighty Recruiter Mighty Recruiter

Company Company

Resources Resources

About About

Help & Support Help & Support

Language Language

Customer Service Customer Service