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

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:** *tennessee-Chattanooga* **Requisition ID:** *135166*

Dialysis RN Nurse Manager

Dialysis Clinic, Inc. Jasper ,TN

of life. Our mission is “the care of the patient is our reason for existence.” What’s yours? **The Nurse

Posted on October 18, 2017

**Overview** Did you know that some of the industry’s most talented and caring registered nurses are at DCI? Our nursing staff has helped DCI achieve the lowest mortality and hospitalization rates among large dialysis providers for the past 13 years in a row. We think our Nurses are pretty awesome; they make a difference in our patients' lives by helping them live longer and achieve a better quality of life. Our mission is “the care of the patient is our reason for existence.” What’s yours? **The Nurse Manager** is responsible for overseeing the management of the dialysis facility and the supervision of all nursing personnel in order to ensure a safe, efficient dialysis treatment for all patients. **Responsibilities** The following is a summary of what makes our team successful. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Oversees the review and evaluation of patient care in accordance with ESRD Network, regulatory agencies, DCI’s CQI program and the individual clinic’s requirements + Develops and implements standards of care, providing patient care in accordance with ESRD Network, regulatory agencies, DCI’s CQI program and the individual clinic’s requirements + In collaboration with the Education Coordinator plans for and provides the training and assessments of patient care staff + Coordinates the implementation of the DCI, CQI and Risk Management Programs with the Quality and Risk Manager + Collaborates with the Medical Director, Social Worker, Dietitian, Charge Nurses, Technical Managers, Staff Nurses and Technicians on any specific problem of patient care including selection of modality + Actively encourages and helps maintain open and free communication between staff, administration, physicians and patients + With the Clinic Operations Director and Medical Director, integrates unit activity as they relate to patient care, staff education, research projects and unit expansions **Supervisory Responsibilities:** + Coordinates with Medical Director the supervision of Nursing, Social Work, Dietitian, and Technical staff + Carries out supervisory responsibilities in accordance with the clinic's policies and procedures and applicable laws + Interviewing, hiring, and training employees; scheduling; appraising performance; in coordination with the Area Operations Director \#DCI **Qualifications** + Completion from an accredited Registered Nursing Program + Twelve months clinical nursing experience required + Six months experience in dialysis is required, twelve months preferred + Supervisory experience preferred **Certificates, Licenses and Registrations:** + Possesses and maintains a current license in the State as a Registered Nurse. + Maintains current CPR certification. DCI is a federal contractor and an Equal Opportunity/Affirmative Action Employer-Veterans/Individuals with Disabilities. If you are having difficulty using the online application system or would like to request other accommodations or application methods, please contact Doug Patterson at Accommodations@dciinc.org or 615-327-3061. Once a request has been made, DCI will initiate a discussion with you about your needs and whether an accommodation can be provided. DCI is committed to providing such accommodations where possible. Please do not call this number to check the status of applications as that information will not be provided For more information about equal opportunity please see: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf ; https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP\_EEO\_Supplement\_Final\_JRF\_QA\_508c.pdf ; https://www.dol.gov/ofccp/pdf/pay-transp\_formattedESQA508c.pdf ; and https://www.nlrb.gov/sites/default/files/attachments/basic-page/node-3788/employeerightsposter-8-5x11.pdf . **Job Location** _US-TN-Jasper_ **Posted Date** _4 days ago_ **ID** _2017-6800_ **\# of Openings** _1_ **Address** _300 Westfield Place_ **Category** _Nursing_

RN / Case Management Job In Chattanooga, Tennessee / Hospital

Kindred Healthcare Chattanooga ,TN

you to join our team and build a career that touches lives. As a Case Manager / CM

Posted on October 17, 2017

Kindred Transitional Care Hospitals has a career opportunity for you as a Case Manager! As a division of Kindred Healthcare, we play a vital role in the recovery process for chronic, critically ill and medically complex patients who require acute care and rehabilitation over an extended period.  Your career growth begins when you join an interdisciplinary team, where doctors, nurses, therapists and other experts work together to form individualized care plans for our patients and residents. Opportunities through our development programs, training seminars and university partnerships, not only allow for continual career growth but emphasize our commitment to investing in our employees and developing future healthcare leaders.  The goal of our team is to deliver intensive, multidisciplinary care and transition patients' home or to a lower level of care as quickly and safely as possible. Each employee's dedication is essential to meet and exceed the needs of each patient, resident and family we serve. Ranked as one of Fortune magazine's "Most Admired Healthcare Company" for 8 years, Kindred welcomes you to join our team and build a career that touches lives.  As a Case Manager / CM you will:   Coordinate management of care for a specified patient population in a single hospital.  Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies.  Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs.  Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management and discharge planning.   Case Manager, Case Management, CM, Utilization Review, CCMC, RN, Registered Nurse, Hospital, Healthcare, Long Term Acute Care, Transitional Care Hospitals, ACLS, ANA, Acute care, Admissions Nurse, Admission Nurse, BLS, BSN, cardio nurse, cardio RN, cardio registered nurse, cardiac nurse, cardiac RN, cardiac registered nurse, case management, case manager, critical care, ER, Emergency Room, Healthcare, health care, Homecare, home care, home health, homehealth, hospital, ICU, intensive care unit, MSN, medical, medical care, med surg, med-surg, medicare, Nurse, Nurse Care Manager, Nurse Job, Nurse Jobs, oncology RN, oncology nurse, oncology registered nurse, palliative care nurse, ortho nurse, ortho RN, ortho registered nurse, palliative care RN, palliative care registered nurse, registered nurse, RN Job, RN Jobs, Registered Nurse Job, Registered Nurse Jobs, Nursing, Oasis, PRN, PDM, progressive care nurse, rehab RN, rehab registered nurse, rehab nurse, Registered Nurse, Registered Nurse Case Manager, RN, R.N., RN Case Manager, skilled visit, staff RN, staff nurse, staff registered nurse, step down unit, step-down unit, step down unit RN, tele, telemetry, telemetry nurse, telemetry RN, travel nurse, travel RN, travel registered nurse, visit nurse, hospital nurse. hospital RN  #MON-HD  #LI-HD    Qualifications:   As a Case Manager / CM you will have:   Appropriate minimum degree for preferred licensure or certification or commensurate experience in a related healthcare field.   Healthcare professional licensure preferred as Registered Nurse, Respiratory Therapist, Physical Therapist, Occupational Therapist or Social Worker.   Appropriate certification in Case Management preferred; for example, Commission for Case Manager Certification (CCMC); Association of Rehabilitation Nurses (ARN) certification.   Three years clinical experience. Prefer experience in Case Management, Quality Management, Utilization Review, or discharge planning.   If you are a current Kindred/RehabCare employee Click Here .

RN / Case Management Job In Chattanooga, Tennessee / Hospital

HCA Chattanooga ,TN

for those suffering from cardiovascular events when every minute matters. The case manager

Posted on October 15, 2017

Case Mix Coordinator RN HCC

Pruitthealth Fort Oglethorpe ,GA

BY LAW:** Current, active and unrestricted Registered Nurse \(RN\) licensure in state of practice\.

Posted on October 18, 2017

**Case Mix Coordinator RN HCC** **Description** **JOB PURPOSE:** Responsible for coordinating assessments for each resident including Resident Assessment Instrument \(RAI\), RAPS and Care Plan\. This includes all admission, quarterly, annual and significant change assessments as well as any required Medicare assessment\. Responsibilities include maintaining accurate and timely assessments, meeting all automation requirements as defined by the regulations, facilitating a functioning interdisciplinary team, accurate reporting of Resource Utilization Groups \(RUGs\) to all departments, maintaining roster and census reports and monitoring of all reports generated by this department\. **KEY RESPONSIBILITIES:** 99. Facilitates communication between nursing center departments and patient/family members to provide an effective assessment/care plan process\. 99. Establishes open lines of communication with consultants\. Have effective interviewing skills for the purpose of collecting information from patients, families, and staff members\. 99. Conduct/coordinate patient \(or family\) interviews for assessment purposes\. 99. Evaluates each patient’s condition and medical data to determine special needs, or the need to amend the admission assessment\. 99. Has a comprehensive understanding of nursing resource material and understands how to incorporate such information into care plans \[i\.e\., nursing journal articles that relate to specific patient care topics \(bowel& bladder retraining, restraint assessment & use, fall assessments, skin assessments, etc\.\)\] 99. Establishes open lines of communication with interdisciplinary team members in order to provide a comprehensive and holistic patient care plan\. 99. Maintains schedule of assessment/care plan meetings\. Coordinate schedule with nursing center staff and others \(family, therapists’ etc\.\) to provide for appropriate participation\. 99. Ensures care is provided in accordance with patient’s wishes\. Coordinate the development of a care plan \(preliminary and comprehensive\) for each patent that identifies problems/needs, appropriate interventions, measurable goals, and assign responsibilities for delivery of care\. 99. Provides that patient assessment and care plans are completed in a timeframe that is in accordance with current regulations\. 99. Facilitates education to inform associates of the patient’s care plan prior to administering care\. 99. Coordinates the review of each assessment/care plan for accuracy \(including timeliness appropriate signatures and dates etc\.\) 99. Signs and dates each assessment to certify its completion\. 99. Monitors the RAI process for accuracy according to the RAI guidelines and other accepted standards\. 99. Educates the interdisciplinary team and other staff members as needed in the RAI process\. 99. Conducts physical assessment of patient to provide accurate RAI process\. 99. Assesses patient needs and make recommendation for skilled rehabilitative services as well as maintenance therapy services\. 99. Conducts patient care conferences\. May be required to direct and implement nursing service educational programs in reference to patient assessment and care\. 99. May be required to meet with all shifts for the purposes of planning, coordinating, and implementing patient care\. 99. Assists in compliance with Federal, State, and Local regulations in relation to scheduling, performing, and implementing patient care plans\. 99. May be required to make management reports and participate in special assignments\. 99. Complies with specific time limitations in terms of scheduling and planning patient care\. **Qualifications** **MINIMUM EDUCATION REQUIRED:** Nursing Degree from an accredited college or university, or is a graduate of an accredited/approved RN program\. **MINIMUM EXPERIENCE REQUIRED:** A minimum of one \(1\) year of experience as a supervisor in a hospital, long\-term care facility, or other related health care center\. **MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:** Current, active and unrestricted Registered Nurse \(RN\) licensure in state of practice\. **ADDITIONAL QUALIFICATIONS: \(Preferred qualifications\)** Nursing service administration experience and RAI experience preferred **Job** Nursing **Primary Location** Georgia\-Fort Oglethorpe **Schedule** Full\-time **Overtime Status** Non\-Exempt **Shift** 1st Shift **Job Posting** Sep 9, 2017, 11:51:02 AM **Req ID:** 1703428

Dir Case Mgmt

Community Health Systems Tullahoma ,TN

**Description:** Oversees a staff of case managers responsible for patient care coordination.

Posted on October 18, 2017

Travel Licensed Practical Nurse LPN Long Term Care LTC

One Staff Medical Bridgeport ,AL

JOB DESCRIPTION: Travel Licensed Practical Nurse LPN Long Term Care LTC City: BRIDGEPORT, Alabama

Posted on October 16, 2017

Travel Rn-Dialysis Nurse - Chronic Dialysis Travel Nurse Needed For Ja

Foundation Medical Staffing Jasper ,TN

For this assignment in Tennessee, a qualified candidate would need a TN or Compact license and at least a year of dialysis experience. This thirteen week assignment will be in an outpatient setting. Tennessee is a wonderful

Posted on October 18, 2017

Case Workers Needed In Northern GA & Surrounding Areas

Jones Agency Dalton ,GA

Job Description: Caseworkers Needed. No Experience Needed.Help families apply for Mortgage Protection CoverageFull/Part Time PositionsFull training and mentorship!Ca

Posted on October 18, 2017

Concurrent Review Nurse - Utilization Management (Case Management) Ful

CHI Memorial Chattanooga ,TN

planning, appropriate referral to case management, and high dollar claims review. The Concurrent Review

Posted on October 18, 2017

Description:JOB SUMMARY\\:Works collaboratively with physicians, staff and other health care professionals within his/her Division to review and monitor members utilization of health care services with the goal of maintaining high quality cost effective care. The role includes providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. This includes providing referral authorization, concurrent review, proactive discharge/transition planning, appropriate referral to case management, and high dollar claims review. The Concurrent Review Nurse - Utilization Management is an integral member of the health care team as well as the Divisional Care Management team. Collaborates with the Divisional Care Management team on system-wide quality improvement/performance improvement initiatives.ESSENTIAL FUNCTIONS\\:Performs initial, concurrent and retrospective reviews on all inpatient, facility and appropriate home health services.Ensures appropriate placement and monitors level and quality of care.Responsible for the proactive management of acutely and chronically ill patients with the objective of improving quality outcomes and decreasing costs.In conjunction with, and under the supervision of physicians, evaluates and provides feed-back to treating physicians regarding a member's discharge plans and available covered services including identifying alternative levels of care that may be covered.Presents facility-patient status updates and addresses barriers to discharge/transition at regularly held concurrent review rounds.Monitors all utilization reports to assure compliance with reporting and turnaround times.Addresses care issues with Director of Care Management, Physician Advisor and Chief Medical Officer/Medical Director as appropriate.Coordinates an interdisciplinary approach to support continuity of care. Provides utilization management, transfer coordination, discharge planning, and issuance of all appropriate authorizations for covered services as needed for members.Coordinates identification and reporting of potential high dollar/utilization cases to reinsurer and finance department for appropriate reserve allocation.Consults with physicians, health care providers and outside agencies regarding continued care/treatment or hospitalization.Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.Clarifies health plan medical benefits, policies and procedures for members, physicians, medical office staff, contract providers, and outside agencies.Review per diem patients daily for medical necessity to ensure reimbursementResponsible for the early identification and assessment of members for potential inclusion in a comprehensive case management program. Refers members for case Management accordingly.Actively participates in the discussion and notification processes that result from the clinical utilization reviews with the facilities.Reviews any service denials and gathers necessary supporting documentation from chart audits and follows up according to procedures.Prepares CMS compliant notification letters of NON-certified and negotiated days within the established time frames. Reviews all NON-certification files for correct documentation.Assists in the identification and reporting of Potential Quality of Care concerns.Responsible for assuring these issues are reported to the Quality Improvement Department.Provides backup for Case Manager.Work as an interdisciplinary team member within Divisional Care Management departments.Other duties as assigned within Population Health Care ManagementAccountability for results\\:Understands and self-manages to support facility/CIN-level success goals, including improvements in quality, cost of care and member experience for the facility/CIN s population.Identifies opportunities for improvement (at individual, clinic and facility/CIN levels) and actively works with healthcare and facility/CIN team to correct or improve results.Qualification:Education\\:Bachelor of Science in Nursing required; Masters of Science in Nursing preferred. Will accept equivalent experience in lieu of degree if the candidate obtains his/her BSN within 3 years post hire.Experience\\:Minimum 3 years clinical experience as Registered Nurse (RN) required.Minimum 5 years utilization management experience preferred.Demonstrated experience in utilization management, facility concurrent review, discharge planning, and transfer coordination.Experience with Indicia (formally Milliman Care Guidelines) authorization criteria preferred.Must have excellent computer skills and ability to learn new systems.Must have strong organizational (time management) skills, strong interpersonal skills, the ability to handle multiple priorities with strong attention to detailKnowledge of and practical use of good business English, spelling, arithmetic, practices and the ability to communicate effectively using written and verbal skills. Proficient in email communications and internet usage along with basic use of Microsoft Excel and Word.Knowledge of information technology to evaluate care effectiveness (care process, outcomes and cost)Ability to work autonomously within matrix environment without direct supervision or support.License/Certification\\:Current unrestricted license, as a registered nurse, in state(s) of practice is required.American Heart Association (AHA) Basic Life Support (BLS) for the Healthcare Provider certified or obtained by the end of the orientation period (approximately six (6) weeks).Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire.Additional Responsibilities\\:Demonstrates a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times.Adheres to and exhibits our core values\\: Reverence\\: Having a profound spirit of awe and respect for all creation, shaping relationships to self, to one another and to God and acknowledging that we hold in trust all that has been given to us.Integrity\\: Moral wholeness, soundness, uprightness, honesty and sincerity as a basis of trustworthiness. Compassion\\: Feeling with others, being one with others in their sorrows and joys, rooted in the sense of solidarity as members of the human community.Excellence\\: Outstanding achievement, merit, virtue; continually surpassing standards to achieve/maintain quality.Maintains confidentiality and protects sensitive data at all times.Adheres to organizational and department specific safety standards and guidelines.Works collaboratively and supports efforts of team members.Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff and the broader health care community.Catholic Health Initiatives and its organizations are Equal Opportunity Employers. CBCHINOTICEThis position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.<br/> Associated topics: business development, case manager, case management, development manager, liaison, manage, plan, project, project development, resource development<img src="http://www.jobg8.com/Tracking.aspx?oIieBJxSO4nWp06q1Jkadwo" width="0" height="0" />

819 jobs matching Nurse Case Manager

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

Dialysis RN Nurse Manager

RN / Case Management Job In Chattanooga, Tennessee / Hospital

RN / Case Management Job In Chattanooga, Tennessee / Hospital

Case Mix Coordinator RN HCC

Dir Case Mgmt

Travel Licensed Practical Nurse LPN Long Term Care LTC

Travel Rn-Dialysis Nurse - Chronic Dialysis Travel Nurse Needed For Ja

Case Workers Needed In Northern GA & Surrounding Areas

Concurrent Review Nurse - Utilization Management (Case Management) Ful

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