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Case Management Jobs

Case Management Institute is excited to partner with companies

to bring you current job openings. 

Director of Case Management 

Director of Case Management: Global Care Management, LLC                                       Murietta, CA

Do you have at least 3 years’ experience in a Supervisory role?

Do you have at least 3 years in an acute care hospital with experience in Case Management?


Then this award winning hospital is looking for you! In this challenging and rewarding position you will: -Be responsible for all activities of the Case Managers and Social Workers Evaluate the patient care outcomes as well as the financial outcomes this system impacts

-This position collaborates with all hospital departments; medical staff, Home Health Care/Hospice agencies; durable medical equipment companies; nursing homes; and others to assure patient care coordination is efficient, of high quality and cost effective.

-Responsible for the operational functions of the department

-We have multiple leadership positions through out California - 


Required experience:

Previous management experience in case management in a hospital 


Educational and License Requirements:

Current California Registered Nurse License


Please email your resume to [email protected] or call cell: 202-770-0123

 

Director of Case Management 

Director of Case Management: Global Care Management, LLC                                       San Jose, CA

Do you have at least 3 years’ experience in a Supervisory role?

Do you have at least 3 years in an acute care hospital with experience in Case Management?


Then this award winning hospital is looking for you! In this challenging and rewarding position you will: -Be responsible for all activities of the Case Managers and Social Workers Evaluate the patient care outcomes as well as the financial outcomes this system impacts

-This position collaborates with all hospital departments; medical staff, Home Health Care/Hospice agencies; durable medical equipment companies; nursing homes; and others to assure patient care coordination is efficient, of high quality and cost effective.

-Responsible for the operational functions of the department

-We have multiple leadership positions through out California - 


Required experience:

Previous management experience in case management in a hospital 


Educational and License Requirements:

Current California Registered Nurse License


Please email your resume to [email protected] or call cell: 202-770-0123

 

Director of Case Management 

Director of Case Management: Global Care Management, LLC                                       Wildomor, CA

Do you have at least 3 years’ experience in a Supervisory role?

Do you have at least 3 years in an acute care hospital with experience in Case Management?


Then this award winning hospital is looking for you! In this challenging and rewarding position you will: -Be responsible for all activities of the Case Managers and Social Workers Evaluate the patient care outcomes as well as the financial outcomes this system impacts

-This position collaborates with all hospital departments; medical staff, Home Health Care/Hospice agencies; durable medical equipment companies; nursing homes; and others to assure patient care coordination is efficient, of high quality and cost effective.

-Responsible for the operational functions of the department

-We have multiple leadership positions through out California - 


Required experience:

Previous management experience in case management in a hospital 


Educational and License Requirements:

Current California Registered Nurse License


Please email your resume to [email protected] or call cell: 202-770-0123

 

Director of Case Management 

Director of Case Management: Global Care Management, LLC                                       Rancho Springs, CA

Do you have at least 3 years’ experience in a Supervisory role?

Do you have at least 3 years in an acute care hospital with experience in Case Management?


Then this award winning hospital is looking for you! In this challenging and rewarding position you will: -Be responsible for all activities of the Case Managers and Social Workers Evaluate the patient care outcomes as well as the financial outcomes this system impacts

-This position collaborates with all hospital departments; medical staff, Home Health Care/Hospice agencies; durable medical equipment companies; nursing homes; and others to assure patient care coordination is efficient, of high quality and cost effective.

-Responsible for the operational functions of the department

-We have multiple leadership positions through out California - 


Required experience:

Previous management experience in case management in a hospital 


Educational and License Requirements:

Current California Registered Nurse License


Please email your resume to [email protected] or call cell: 202-770-0123

 

ESP Social Worker

ESP Social Worker                                                                                                 Mattapan, MA

Job duties include:  

 • Provides individual counseling and supportive family counseling at ESP and conducts participant support groups.

• Participates in the intake screening process for potential participants, conducts a bio-psychosocial assessment.

• Conducts timely initial, annual, and semiannual psychosocial assessments in order to develop participants plan of care using assessments tools including PHQ-9, MOCA, and CDR.

• Actively participates in required meetings to include but not limited to Morning/Weekly Team, Plan of Care, and Family Meetings, arranges family meetings for IDT.

• Participates in the End of Life care team.

• Responsible for attending monthly service plan meetings for participants in assisted living and nursing home facilities.

• Provides individual counseling and supportive family counseling at ESP and conducts participant support groups.

• Manages clients during psychiatric hospitalizations.

• Assists/advocates for, clients and families with community resources and IDT.

• Works with financial staff for bi-annual financial re-determinations.  


Required experience:

• 1 year of experience working with the frail elder population (paid or volunteer experience) required.

• 2 years of professional experience, of which 1 year was in providing direct behavioral health therapy, to an adult population.

• Basic skills in Microsoft Office applications: Word, Excel and Outlook.  

• Experience with dementia care, substance abuse and end of life care preferred.  

• Case Management experience.  

• Critical thinking skills to problem solve individually and in a team setting.

• Bilingual English /Spanish, Haitian Creole, Russian, and/or Portuguese desirable.


License/Certification:

• MSW from an accredited school of social work, LCSW or LICSW required with current license.


Candidates should either email Joanne Tranford ([email protected]) or apply directly on the company website at (https://www.hhsi.us/about-us/join-our-team/).

 

Utilization Management Nurse

Utilization Management Nurse                                                                            Brockton, MA

Job duties include:  

 -Responsible for the evaluation of the medical necessity of continuing acute inpatient or psychiatric stays, LTAC, acute rehabilitation and skilled nursing stays utilizing a defined criteria set.

-Utilizes clinical skills to telephonically provide and facilitate utilization review, continued stay reviews and utilization management of all cases based on clinical experience and recognized guidelines.

-Responsible for obtaining the information necessary to assess a participant’s clinical condition, identifies ongoing clinical care needs and ensures that participants receive services in the most optimal setting to effectively meet their needs. 

-Collaborates with ESP interdisciplinary teams regarding management of members not meeting continuing stay criteria.

-Anticipates member’s post-discharge needs, managing transition of care or referring to Care Coordinator when appropriate.

-Maintains mandated timeframes, including those related to second level appeals.  

-Uses Patient Ping (a real-time notification system that provides an alert when patients receive care in the ED, hospital or post-acute setting) to track participant disposition and work with providers to establish necessity of emergency room transfers. 


Required experience:

- 2-3 years of acute care clinical nursing experience required.  

- 3+ years of recent experience in Utilization Review / Utilization Management preferred.

- 1-2 years of experience at a health plan or other Managed Care Organization (HMO/TPA/IPA/SCO, etc.) preferred.

- Experience using MCG/Milliman/InterQual criteria for medical necessity, setting and level of care, and concurrent patient management preferred.

- Basic Computer skills to include Microsoft Word, Excel, database use, data entry and Electronic Medical Record.


License/Certification:

- Bachelor's Degree in Nursing required.

- Current, valid, and unrestricted MA Registered Nurse (R.N.) license.


Candidates should either email Joanne Tranford ([email protected]) or apply directly on the company website at (https://www.hhsi.us/about-us/join-our-team/).

 

RN Case Manager I

case management jobs

RN Case Manager I: Element Care                                                                            Lynn, MA

Job duties include:  

-Develops a plan of care that corresponds with the physicians’ orders through assessment of patient's needs, condition, environment, and consultation with other health team members, at time of initial visit and updates plan of care regularly as necessary and documents this care following Element Care procedures. -Ensures the delivery of competent, quality patient care in the home. -Maintains an ongoing responsibility for assigned caseload. -Oversees the implementation and evaluation of individual patient plans of care. -Maintains communication with Commonwealth Care Alliance (CCA) and Element Care staff as well as the provider community as appropriate -Provides patient education opportunities. -Works with both members and their family members -Actively participates in team knowledge sharing activities. -Performs other duties, as assigned.


Required experience:

-Proficient in the use of Microsoft Office tools.

-Experience working with case management data systems.

-Ability to travel locally on a frequent basis.

-Minimum of three (3) years experience as a licensed, registered nurse, preferable five (5) years, including home care clinical experience. 

-Ability to Speak Spanish and/or Khmer (Added Plus) 


License/Certification:

-Registered Nurse currently licensed in the Commonwealth of MA

-Bachelor of Science degree in Nursing preferred.


-Job is Currently Remote, but will return to office & patient sites 


Why Element Care? -Work Life Balance and Job Flexibility -Sense of Fulfillment that comes with working with this population


Please email your resume to HR at: [email protected]

 

CASE MANAGER 

Case Manager: Global Care Management, LLC                                                             Charlotte, NC- Partial Work From Home

Job duties include:  

Our client is a health care benefit plan asset manager for self-funded employer plan sponsors. The Company employs a fully integrated, comprehensive medical risk management program that improves health care outcomes for plan participants and significantly reduces claim cost for employer clients.


Position Summary:

Our client is seeking a full-time RN Case Manager to join their team. This position is the liaison between the Clinical Management department and the Stop Loss (SL) Marketing department and is responsible for risk identification, assessment, and reporting of SL renewals and administration within procedures and policies. There is a focus on Utilization Management.


Required experience:

Five or more years of experience in utilization review/case management in the self-insured environment. Experience with TPA, SL reinsurance contract administration, risk management and quality assessment preferred.


Educational Requirements:

Bachelor’s degree (or higher) in Health Care Administration, Nursing or related field from a four-year college or university or equivalent combination of experience and education. 


Please email your resume to [email protected]

 

CASE MANAGER 

Case Manager: Global Care Management, LLC                                                             Galveston, TX

Job duties include:  

The RN Care Manager position requires a thorough understanding of clinical, financial, administrative, and psychosocial components of the healthcare continuum. The RN care Manager is responsible for providing assessments, planning, interventions, and follow up for patients an family members across the continuum of care. These services are provided onsite to facilitate the creation of and adherence to, a treatment plan and optimize patient health. In conjunction with the interdisciplinary team, this position proactively addresses potential or actual clinical and/or psychosocial needs identified through screening to ensure developmental, level of care and health status transitions are safe, seamless, and coordinated. 


Required experience:

One to three years of nursing experience required Strong communication skills - both oral and written 


Educational and License Requirements:

BSN and Texas Registered Nurse license 


Please email your resume to [email protected]

 

CASE MANAGER 

Case Manager: Global Care Management, LLC                                                             Charlotte, NC

Job duties include:  

Our client is a health care benefit plan asset manager for self-funded employer plan sponsors. The Company employs a fully integrated, comprehensive medical risk management program that improves health care outcomes for plan participants and significantly reduces claim cost for employer clients.


Position Summary:

Our client is seeking a full-time RN Case Manager to join their team. This position is the liaison between the Clinical Management department and the Stop Loss (SL) Marketing department and is responsible for risk identification, assessment, and reporting of SL renewals and administration within procedures and policies.


Required experience:

Five or more years of experience in utilization review/case management in the self-insured environment. Experience with TPA, SL reinsurance contract administration, risk management and quality assessment preferred.


Educational Requirements:

Bachelor’s degree (or higher) in Health Care Administration, Nursing or related field from a four-year college or university or equivalent combination of experience and education. 


Please email your resume to [email protected]

 

CASE MANAGER 

Case Manager: Global Care Management, LLC                                                           Attleboro, MA

Job duties include:  

Working in collaboration with the patient/family/legal representative, social workers, physicians, and interdisciplinary team, the RN case manager is accountable for assessing, coordinating and facilitating patient progression through the continuum of care in an efficient, cost effective manner. The RN Case Manager must achieve this through early assessment of pre-admission level of care, post hospital discharge needs, review of available resource and timely, focused communication with the healthcare team and patient/family/legal representative. Position will also have responsibility for coordinating the bundle payment program.


Required experience:

Prior discharge planning, utilization review and coordination of care


Educational Requirements:

BSN Graduate of an accredited school of nursing


License/Certification:

RN with current Massachusetts license required


Please email your resume to [email protected]

 


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