Registered Nurse - Case Manager TBI
Registered nurse case manager job at Decypher
Decypher is a leading integrator of professional, technology, and management solutions and services. We provide our services globally to Federal, Commercial, Local and State clients. Our employees are our most valuable asset and play an integral role in the success of Decypher and our clients. Working at Decypher is not a job, but a career where your talent and energy is respected, and you can personally make a difference. Decypher invites you to join our professional team.
DESCRIPTION
Decypher is seeking a Registered Nurse Case Manager/CAMO with heavy focus on Traumatic Brain Injury
RESPONSIBILITIES
Develops and implements a comprehensive Utilization Management plan/program
Performs data/metrics collection on identified program areas; analyzes and trends results, including over- and underutilization of healthcare resources
Analyzes medical referrals/appointments and general hospital procedures and regulations by monitoring specialty care referrals for appropriateness, covered benefits, and authorized surgery/medical procedures, laboratory, radiology and pharmacy
Reviews previous and present medical care practices for patterns; trends incidents of under-or over-utilization of resources incidental to providing medical care
Acts as referral approval authority for designated referrals per local/AF/DoD/national guidance and standards.
This job description is not intended to be all inclusive. Therefore, the employee may be requested to perform other reasonable duties as assigned by the immediate supervisor or other management as required.
QUALIFICATIONS
Bachelor's degree in nursing (BSN)
Registered Nurse License
Possess a minimum of two years of inpatient medical-surgical experience or acute rehabilitation within the last three years.
Possess one of the following certifications or obtain within 6 months of performance start date:
Commission for Case Manager Certification Certified Case Manager (CCM)
Certification of Disability Management Specialists Commission: Certified Disability Management Specialist (CDMS)
Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN)
American Board for Occupational Health Nurses Certified Occupational Health Nurse (COHN) or Certified Occupational Health Nurse-Specialist (COHN-S).
National Board for Certification in Continuity of Care: Advanced Certification in Continuity of Care (ACCC)
Commission on Rehabilitation Counselor Certification: Certified Rehabilitation Counselor (CRC)
Basic Life Support (BLS)
US Citizen
NACI background check
Compensation$38.54 per hour
At Decypher we believe that equal opportunity fuels innovation by using the strengths of individual differences. Therefore, we strive to provide a welcoming and inclusive work environment. Decypher is fully committed to a program of equal opportunity for all applicants and employees and will actively carry out all federal and state regulations and executive orders. We apply our equal opportunity policy to all employment decisions.
This position is not authorized for remote/telework
Registered Nurse - Utilization Manager
Registered nurse case manager job at Decypher
Decypher is a leading integrator of professional, technology, and management solutions and services. We provide our services globally to Federal, Commercial, Local and State clients. Our employees are our most valuable asset and play an integral role in the success of Decypher and our clients. Working at Decypher is not a job, but a career where your talent and energy is respected, and you can personally make a difference. Decypher invites you to join our professional team. Decypher is an equal opportunity/affirmative action employer committed to diversifying its workforce (M/F/D/V).
DESCRIPTION
Decypher is seeking a Registered Nurse - Utilization Management candidate to support Wright Air Force Base in Dayton, Ohio.
RESPONSIBILITIES
Assist inpatient discharge planning when needed, as directed. Duties may include
home safety patient/family interview, attending morning planning meeting, and
coordinating transfers, home durable medical equipment and/or home care
services, inpatient rehab, and/or skilled care.
Develop and implement a comprehensive Utilization Management plan/program
in accordance with MTF/AF/DHA goals and objectives.
Perform data/metrics collection on identified program areas; analyzes and trends
results, including over- and underutilization of healthcare resources and
ineffective or inefficient delivery of care. Identifies areas for intensive
management, improved and/or cost containment. Reports utilization patterns,
provides feedback and makes recommendations in a timely manner.
Analyze medical referrals/appointments and general hospital procedures by
monitoring specialty care referrals for appropriateness, covered benefits, and
authorized surgery/medical procedures, laboratory, radiology, and pharmacy.
Evaluate clinical practice patterns and trends and provides SGH and clinical areas with feedback.
Identify and refer potential cases to Disease Management, Case Management,
Discharge Planning, and the Deployment Availability Working Group.
Participate in Medical Management, Population Health Working Group, and care
coordination meetings as assigned.
Conduct nursing peer review as assigned.
Educate Patient Centered Medical Home (PCMH) staff on Utilization Management role.
Assist with PCMH team notification of patients admitted inpatient to civilian
hospitals or civilian emergency department visits.
Performs medical necessity reviews to include concurrent review for length of
stay (LOS) using approved clinical decision tool. Determines medical necessity of
services ordered or rendered. Communicates negative trends to the Chief of the
Medical Staff.
Navigate electronic health record, and TRICARE managed care contractor site.
Acts as referral approval authority for designated referrals MTF/AF/DHA
national guidance and standards. Includes processing and validating durable
medical equipment referrals for PRIME beneficiaries, to include authorization of
SHCP funds for active-duty beneficiaries. Refers all first-level review failures to
SGH or designated POC for further review and disposition.
Verify eligibility of beneficiaries using Defense Eligibility Enrollment Reporting
System (DEERS). Obtains pertinent information from patients/callers and
updates electronic medical record, local referral database, and other office
automation software programs as appropriate and directed.
Other duties as assigned.
QUALIFICATIONS:
Experience
A minimum of four (4) years experience in discharge planning or case
management is required for consideration of a candidate with an associate degree in
nursing.
Two years full-time experience in utilization management is required for
graduates with a Bachelor of Science in Nursing.
Full time employment in a nursing field within the last 36 months is mandatory.
Degree/Education
Associate Degree (ADN) or a Baccalaureate Degree (BSN) (preferred) program in nursing accredited by a national nursing accrediting agency recognized by the US Department of Education.
Certification
Basic Life Support (BLS)
Licensure/Registration
Must maintain a valid, unrestricted, and current registered nursing license
Must be US citizen.
At Decypher we believe that equal opportunity fuels innovation by using the strengths of individual differences. Therefore, we strive to provide a welcoming and inclusive work environment. Decypher is fully committed to a program of equal opportunity for all applicants and employees and will actively carry out all federal and state regulations and executive orders. We apply our equal opportunity policy to all employment decisions.
This job description is not intended to be all inclusive. Therefore, the employee may be requested to perform other reasonable duties as assigned by the immediate supervisor or other management as required.
Clinical Case Manager ($5,000 Holiday Bonus)
Los Angeles, CA jobs
Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs.
We're more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we serve is what sets us apart. Guided by our unwavering core values: Excellence, Compassion, Curiosity, and Integrity, we forge paths of success together. Join us in this transformative movement where you can contribute to making a profound difference every day.
At Vynca, our mission is to provide comprehensive care for
more quality days at home.
Join us now and receive a
$5,000 holiday sign-on bonus
when you sign your offer by
January 1, 2026
! The bonus will be paid out in installments, and we're happy to provide full details on request.
About the job
Internal Title: Clinical Lead Care Manager
We're seeking an exceptional Clinical Lead Care Manager (CLCM) to join our team. Under the direction of the ECM Clinical Manager, the CLCM serves as the client's primary point of contact and works with all their providers such as doctors, specialists, pharmacists, social services providers, and others to make sure everyone is in agreement about the client's needs and care. The CLCM manages client cases, coordinates health care benefits, provides education and facilitates member access to care in a timely and cost-effective manner. The CLCM collaborates and communicates with the client's caregivers/family support persons, other providers, and others in the Care Team to promote wellness, recovery, independence, resilience, and member empowerment, while ensuring access to appropriate services and maximizing member benefit.
This is a hybrid position that requires traveling throughout the Los Angeles County area up to 5 days per week.
This is a critical role and we're looking to fill it as soon as possible.
What you'll do
Hybrid (in-person and remote) care management duties as described below:
Assess member needs in the areas of physical health, mental health, SUD, oral health, palliative care, memory care, trauma-informed care, social supports, housing, and referral and linkage to community-based services and supports
Oversees the development of the client care plans and goal settings
Offer services where the member resides, seeks care, or finds most easily accessible, including office-based, telehealth, or field-based services
Connect clients to other social services and supports that are needed
Advocate on behalf of the client with health care professionals (e.g. PCP, etc.)
Utilize evidence-based practices, such as Motivational Interviewing, Harm Reduction, and Trauma-Informed Care principles
Conduct outreach and engagement activities in order to facilitate linkage to the ECM program and log activity in the Client Relationship Management (CRM) system
Evaluate client's progress and update SMART goals
Provide mental health promotion
Arrange transportation (e.g., ACCESS)
Complete all documentation, including outcome measures within the timeframes established by the individual care plans
Maintain up-to-date patient health records in the Electronic Medical Record (EMR) system and other business systems
Complete monthly reporting to ensure program compliance
Attend training as assigned
Your experience & qualifications
Active LCSW, LMFT, LPCC, or LVN license in California required
1-2 years of experience as a care manager, care navigator, or community health worker supporting vulnerable populations.
2 or more years preferred.
Willing and able to work Monday-Friday 8:30am-5:00pm, both in the field and remotely, with flexibility for potential evenings and weekends.
Working knowledge of government and community resources related to social determinants of health
Excellent oral and written communication skills
Positive interpersonal skills required
Clean driving record, valid driver's license, and reliable transportation
Must have general computer skills and a working knowledge of Google Workspace, MS Office, and the internet
Bilingual (English/Spanish)
preferred
Additional Information
The hiring process for this role may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks.
Background Screening: A background check, which may include a drug test or other health screenings depending on the role, will be required prior to employment.
Scope: This job description is not exhaustive and may include additional activities, duties, and responsibilities not listed herein.
Vaccination Requirement: Employees in patient, client, or customer-facing roles must be vaccinated against influenza. Requests for religious or medical accommodations will be considered but may not always be approved.
Employment Eligibility: Compliance with federal law requires identity and work eligibility verification using E-Verify upon hire.
Equal Opportunity Employer: At Vynca Inc., we embrace diversity and are committed to fostering an inclusive workplace. We value all applicants regardless of race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other protected group under federal, state, or local law.
Workers Compensation Telephonic Nurse Case Manager (Remote)
California jobs
Company Details
Berkley Medical Management Solutions (BMMS) provides a different kind of managed-care service for W.R. Berkley Corporation. We believe focusing on an injured worker's successful and speedy return to work is good for people and good for Berkley's insurance operating units. BMMS was first started in 2014 by reimagining the relationship between medical need and technology to deliver the best outcome for injured workers and Berkley's operating units. Our goal was clear: combine solid clinical practices, proven return-to-work strategies and robust software into one system for seamless management of workers' compensation cases.
To get it right, we started with a flexible technology platform that allowed for impressive customization without sacrificing the ability for expansion and continued innovation. We deploy integrated systems to give W.R. Berkley Companies recommendations and professional services for managing each individual case in an efficient and appropriate manner. The power of our technology takes medical bill-review services and clinical advisory services to a new level. Our unique marriage of technology, software platforms, data analytics and professional services ensures we provide Berkley's operating units with reliable results, and reduced time and expenses associated with case management.
Responsibilities
As a Telephonic Nurse Case Manager, you will assess, plan, coordinate, monitor, evaluate and implement options and services to facilitate timely medical care and return to work outcomes of injured workers.
Coordinate and implement medical case management to facilitate case closure
Timely and comprehensive communication with with employers, adjusters and the injured workers.
Assess appropriate utilization of medical treatment and services available through contact with physicians and other specialist to ensure cost effective quality care
Review and analyze medical records and assess data to ensure appropriate case management process occurs while providing recommendations to achieve case progress and movement to closure
Responsible for assigned caseloads, which may vary in numbers, territory and/or by state jurisdiction
Acquire and maintain nursing licensure for all jurisdictions as business needs require
Coordinate services to include home services, durable medical equipment, IMEs, admissions, discharges, and vocational services when appropriate and evaluate cost effectiveness and quality of services
Document activities and case progress using appropriate methods and tools following best practices for quality improvement
Reviewing job analysis/job description with all providers to coordinate and implement disability case management. This includes coordinating job analysis with employer to facilitate return to work.
Engage and participate in special projects as assigned by case management leadership team
Occasionally attend on site meetings and professional programs
Foster a teamwork environment
Maintaining and updating evidence based medical guidelines (such as Official Disability Guidelines, MD Guidelines and all required state regulated guidelines) in reference to the injured worker treatment plan and work status.
Obtain and maintain applicable state certifications and/or licensures in the state where job duties are performed.
Obtain case management professional certification (CCM) within 2 years of hire
Qualifications
Minimum 2 years of experience in workers compensation insurance and medical case management preferred
Minimum of 4 years medical/surgical clinical experience required
Ability to work standard business hours in the either Central Standard Time, Mountain Standard Time or Pacific Time Zone (Monday through Friday, 8:00 AM to 5:00 PM CST/MST/PST).
Exhibit strong communication skills, professionalism, flexibility and adaptability
Possess working knowledge of medical and vocational resources available to the Workers' Compensation industry
Demonstrate evidence of self-motivation and the ability to perform case management duties independently
Demonstrate evidence of computer and technology skills
Oral and written fluency in both Spanish and English a plus
Education
Graduate of an accredited school of nursing and possess a current RN license.
A Compact Nursing License is strongly preferred. A California license is ideal but not mandatory. Candidates must be willing and able to obtain a California license within 90 days of their start date.
Additional Company Details ******************
The Company is an equal employment opportunity employer
We do not accept any unsolicited resumes from external recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees
• Base Salary Range: $80,000 - $88,000
• Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Additional Requirements • Domestic U.S. travel required (up to 10% of time) Sponsorship Details Sponsorship not Offered for this Role Not ready to apply? Connect with us for general consideration.
Auto-ApplyCase Manager RN
Upland, CA jobs
Evaluates the clinical status of patients using evidence based criteria to determine medical necessity for hospitalization, clinical progression and continued acute care needs. Utilizes information about clinical condition, prior level of functioning and anticipated treatment plan to support a safe, smooth transition to other levels of care.
MINIMUM QUALIFICATIONS
Education: Graduate of a nursing program, leading to RN licensure.
Experience: Three years' acute hospital experience preferred. Experience in utilization review, discharge planning and/or case management is preferred. For Per Diem positions 1-2 years previous acute inpatient adult case management experience is required.
Knowledge and Skills: Knowledge of common disease processes, knowledge of health care delivery systems, demonstrates understanding of common reimbursement methodologies. Able to manage competing priorities and effectively prioritizes work.
License and Certifications: Current RN licensure in the State of California and a current American Heart Association (AHA) BLS card are required.
Equipment: Basic computer skills with working knowledge of Word. Willingness to learn all aspects of the Business Services, Case Management, Emergency Department and hospital wide electronic medical record systems.
Physical Requirements: Must be able to perform the essential physcial requirements of the job as noted in the job description.
PAY RANGE
$47.90 - $71.84
The posted pay range reflects the lowest to highest pay that was available for this position at the time of posting and may be subject to change. Salary offers are determined by candidate's relevant experience and skills. For per diem positions, a standard rate is used based on market data and not the candidate's individual experience.
Auto-ApplyCase Manager II
San Diego, CA jobs
The Case Manager (CM) II position is specific to the Recuperative Care Program (RCP) and is responsible for the performance and outcomes of their assigned caseload, serving single women and men who need respite/recuperative attention following an injury, illness, or behavioral health complication while experiencing homelessness. The Case Manager II delivers specialized medical case management services, develops professional and empathetic relationships with clients while providing interventions related to housing and creates plans with clients to stabilize health and achieve self-sufficiency. The CM II demonstrates the ability to provide community resources that lead to housing and income.
Essential Functions
The Case Manager II will maintain a high case load of fifteen clients
Creates an individualized care plan that includes coordinated services within the organization's health clinic, residential, social services, and other resources within and outside the community to meet the clients' basic and extended needs.
Creates client discharge plan to prepare for shelter exit.
Provides individualized, intensive, short-term support to clients referred by health plans, hospitals, or clinics to safely recover from acute illness or injury, which can include assessing, evaluating, crisis intervention, applications for benefits, information, education, advocacy, and other supportive services; coordinates and facilitates client orientation, meetings, and events.
Coordinates level and type of care with the referring health insurance and the RCP team; navigates various health insurance requirements and expectations; communicates actively with health insurance on behalf of clients.
Assesses clients for employment, social security, and disability insurance eligibility; gathers records, assists with completing applications for benefits, provides referrals to community resources, schedules services/treatment with providers, and monitors progress.
Completes ongoing risk assessment and case plan updates.
Transport clients to medical and other social service needs.
Occasionally pick up client medications and deliver them to the client.
Participates in weekly Case Conferencing with the RCP team of medical, residential, and case management services staff, and/or client Health Insurance.
Utilizes a strength-based / trauma-informed approach to services, uses Motivational Interviewing techniques, and CREED to encourage positive change.
Enters, monitors, and updates client databases regularly and consistently. Updates outside (Clarity) database every 30 days
Adheres to budgets, follows program goals and evaluations, and maintains policies and procedures.
On-time completion of assigned training and policies.
Performs other duties as assigned.
Qualifications
Bachelor's Degree in a Social Services field or 4yrs equivalent experience, and two (2) years of experience working with underserved populations in a social service setting; and two (2) years of health care/case management experience; and strong knowledge of health insurances and medical/clinical terminology and care.
Bilingual (English and Spanish) is a plus.
Demonstrated basic understanding of principles of Housing First, Trauma Informed Care, Conflict Resolution, Motivational Interviewing, Low Barrier Operations and Prevention and Diversion practices, Housing First, social services, case management, eviction prevention, and crisis intervention.
Basic user of MS Office
Ability to pass fingerprinting and background checks upon employment.
Must have a valid California Driver's License and be able to qualify for insurance coverage.
Participate in an annual Tuberculosis screening and/or other screenings when necessary
The Pay Rate for this role is based on several factors including the candidate's experience, qualifications, and internal equity. The initial offer usually falls between the minimum and midpoint of the applicable salary range. Pay Band N4: $23.90 - $31.43 (Midpoint: $26.80)
Auto-ApplyCase Manager I - Nestor
San Diego, CA jobs
The Case Manager I (CM) is responsible for the leadership and functioning of their assigned case load. Case Managers develop professional and empathetic relationships while providing clients with connections to appropriate housing, programs and resources through one-on-one Case Management that develop individualized case plans that promote client progression towards obtaining and maintaining self-sufficiency.
Essential Functions
Provides ongoing intensive support to clients which can include assessing, evaluating, and coordinating services, crisis intervention, and applications for benefits & referrals to community resources.
Communicates and advocates to landlords to support clients in obtaining and maintaining housing placement.
Prepares, presents, and documents client cases.
Participates as a member of a multidisciplinary team that prepares and presents client case presentations.
Assesses clients for employment, social security, and disability insurance eligibility, gathers records, and schedules treatment.
Complete intakes including paperwork and psychosocial assessments for all new participants and document accordingly.
Develop a comprehensive case plan for each client and encourage clients to carry out goals
Complete and upload all documentation required to shared database in a timely fashion
Conduct regular searches for new and updated resources in the county
On-time completion of assigned training and policies.
Performs other duties as assigned.
Qualifications
Bachelor's Degree (some grants require this level of education) in a Social Services field or equivalent experience.
At least 6 months of experience working with underserved families in a social service setting.
Basic user of MS Office.
Be at least 21 years of age with a minimum of 3 years of driving experience; possess a valid California driver's license; and have no Class 1 or more than two Class 2 violations within the past 36 months.
Participate in an annual Tuberculosis screening and/or other screenings when necessary.
MUST be bilingual (English/Spanish)
MUST be able to pass a background check and Live scan.
The Pay Rate for this role is based on several factors including the candidate's experience, qualifications, and internal equity. The initial offer usually falls between the minimum and midpoint of the applicable salary range. Pay Band N3: $21.82 - $28.07 (Midpoint: $24.56)
Auto-ApplyHospice RN Case Manager
Fort Worth, TX jobs
Job Description
Reliant at Home is seeking a Full-Time Hospice RN Case Manager to cover Fort Worth and surrounding areas. Hospice experience preferred. Home Care Home Base EMR experience is a plus!
Reliant at Home is a multi-site, Texas only Home Health, Hospice, Caregivers, and Rehab company with 14 locations in Texas - including five Hospice locations (Fort Worth, Plano, Teague, The Woodlands, and San Antonio). The Reliant at Home Bluebird Promise is our commitment to live up to our higher calling by fulfilling our Values, Culture Priorities, and Service Pledge. Care is our higher calling. We believe care is more than the service we provide to patients who need help at home. It also means caring for our Reliant at Home family, the families and loved ones of the patients we serve, our referral partners and providers, and our local communities. Serving others is what we were meant to do.
Join Reliant at Home's winning culture - named Fortune TOP TEN in the USA Best Workplaces for Aging Services and certified Great Place to Work 2020-2021, 2021-2022, 2022-2023, 2023-2024, and 2024-2025!
Responsibilities:
Initial and ongoing comprehensive assessments of the impact of the terminal disease on the patients physical, functional, psychological, and environmental needs as evidenced by documentation, clinical record, case conference, team report, evaluations, and ADLs, (i.e., risk for grief, cultural and spiritual, verbal and non-verbal).
Apply specific criteria for admissions and re-certifications to hospice care to establish appropriate levels of care and the patient's eligibility.
Implement/develop/document the plan of care to ensure quality and continuity of care and recommend revisions to the plan as necessary.
Consult with and educate the patient and family regarding disease process, self-care techniques, end-of-life care, nutrition and dietary needs. Prioritize any needs with the members of the IDG. Provide training to other staff as needed.
Determine scope and frequency of service needed based on acuity and patient/family needs. Assess the ability of the caregiver to meet the patient's immediate needs upon admission and throughout care.
Initiate appropriate preventative and rehabilitative nursing procedures.
Applies concepts of infection control and standard precautions in coordinating and performing patient care activities to prevent contamination and transmission of disease.
Provide clinical directions to the Hospice Aide and LPN/LVN to ensure quality and continuity of service provided.
Prepare clinical and progress notes that demonstrates progress towards established goals. Ensure continuity of quality patient care delivered with appropriate documentation.
Inform physician and other personnel of changes in the patient's needs and outcomes of interventions, while evaluating patient and family response to care.
Monitor assigned cases to ensure compliance with requirements of third-party payor.
Demonstrate commitment, professional growth and competency.
Promote Agency philosophy and administrative policies.
Perform on-call responsibilities and provide on-call service to patients and families as assigned.
Provide effective communication to patient, family, team members, and other health care professionals.
Requirements:
Graduate of an accredited Diploma, Association or Baccalaureate School of Nursing.
Current license as a registered nurse (RN) and/or accordance with the Board of Nurse Examiners rules for Nurse Licensure Compact (NLC), current Driver's License.
Two years' experience as a Registered Nurse in a clinical care setting preferred, hospice preferred.
Nursing skills as defined as generally accepted standards of practice. Good interpersonal skills preferred in palliation of end-of-life. Proof of current CPR. Must read, write and comprehend English.
Reliable transportation. Valid and current auto liability insurance.
Why Should You Apply?
You want to be a part of a company with a strong future
You want to be a part of the solution in caring for seniors that need quality people in their corner
You want to be on an amazing team with a positive and award-winning company culture
You want to work alongside kind people that seek to do the right thing and put patients first
You want to live out your calling and are more than happy to help
You want to give back to the local community by participating in service projects
You are eager to discover what sets Reliant at Home's Bluebird Nation apart
Other Benefits
Competitive compensation package
Mileage reimbursement for work related travel
Company vehicles available for select roles
Medical, vision, and dental insurance
Health Savings Account available with company contribution
Generous paid holidays and vacation
401k with company match
Company sponsored life insurance
Now is the time for you to be involved in the care of our patients and the exciting expansion of Reliant at Home!
Home Health RN Case Manager - Roanoke
Fort Worth, TX jobs
Job Description
Reliant at Home is seeking a PRN RN Case Manager to cover Roanoke, TX and surrounding areas! Home Health experience is not required. Homecare Homebase knowledge is a plus!
About Reliant at Home Reliant at Home is a multi-site Home Health, Hospice, Caregivers, and Rehab company with 14 locations in Texas - including five Hospice locations (Fort Worth, Plano, Teague, The Woodlands, and San Antonio). The Reliant at Home Bluebird Promise is our commitment to live up to our higher calling by fulfilling our Values, Culture Priorities, and Service Pledge. Care is our higher calling. We believe care is more than the service we provide to patients who need help at home. It also means caring for our Reliant at Home family, the families and loved ones of the patients we serve, our referral partners and providers, and our local communities. Serving others is what we were meant to do.Join Reliant at Home's winning culture - named on the Fortune Best Workplaces for Aging Services in the USA in 2020 (#10), 2022 (#15), and 2023 (#11) and a certified Great Place to Work 2020, 2021, 2022, 2023, 2024, and 2025
Responsibilities:
Assess patient's condition during every visit and chart your observations
Perform evaluation tasks, including vital signs and medication review
Administer medication as prescribed by the patient's Physician
Dress or redress open wounds and assess the progress of healing
Educate patients and their families on proper home health care strategies and procedures
Coordinate with Occupational Therapists, Physical Therapists, Physicians, and anyone else involved in the patient's care plan
Provide palliative care as needed to keep the patient comfortable
Make recommendations for devices or tools that might improve the patient's quality of life
Listen to the patient and respond to concerns or requests
Why Should You Apply?
You want to be a part of a company with a strong future
You want to be a part of the solution in caring for seniors that need quality people in their corner
You want to be on an amazing team with a positive and award-winning company culture
You want to work alongside kind people that seek to do the right thing and put patients first
You want to live out your calling and are more than happy to help
You want to give back to the local community by participating in service projects
You are eager to discover what sets Reliant at Home's Bluebird Nation apart
Now is the time for you to be involved in the care of our patients and the exciting expansion of Reliant at Home!
Bilingual RN Care Manager (Remote Flexible - Spanish Speaking)
Riverside, CA jobs
Team
At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve.
We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.
Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.
We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions.
At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare.
Our Values
Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.
Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.
Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.
Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.
Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.
In the News
Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most
TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team
Axios: Pair Team collects $9M for Medicaid-based care
About the Opportunity
Pair Team is building a team of deeply passionate individuals ready to change primary care operations for those who need it most. We are looking for a highly motivated full-time Registered Nurse Care Manager who is willing to think creatively and empathically to help our team change the way people access healthcare.
We seek a full-time Registered Nurse Care Manager to play a critical role in our whole-person, interdisciplinary care model by supporting patient-driven care plans to drive improved outcomes for individuals living with Serious Mental Illness, Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. The Registered Nurse Care Manager will work in a team-based model with a lead care manager community health worker, behavioral health care manager, and nurse practitioner to contribute their clinical expertise towards improving the individuals quality of life through activities such as health education and complex care management.
This position primarily allows for remote work; however, it includes 1-2 times a month on-site visits in the community alongside a fellow PairMate. You can expect to engage in these in-person activities 1-2 times per month, close to your city, while the majority of your duties, approximately 90%, will be performed from your home
What You'll Do
Primarily work with and support a caseload of individuals with complex medical needs
Work with individual to identify health/wellness goals and incorporate goals into a Shared Care Plan
Educate individuals on medical and behavioral health conditions (including medication) to improve health literacy
Provide medication reconciliation in collaboration with the individuals's pharmacy
Provide care management services such as coordinating prescriptions and completing prior authorizations
Track and assure that all required assessments and screenings are performed
Collaborate with multidisciplinary care team to identify and address barriers to care
Identify clinical needs and triage escalations, providing brief interventions as necessary, with support from nurse practitioner clinicians
Collaborate on care issues with Enhanced Care Management team by participating in systematic case reviews
Consult with Enhanced Care Management team about clinical concerns or questions, provide educational training on chronic disease states, prevention, treatment, meds, and healthy living
Build trust and develop relationships with individuals experiencing homelessness, living with Severe Mental Illness/Substance Use Disorder, and living with multiple chronic conditions
Use relationship-based strategies to engage individuals in care, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system
Seeks to listen openly to individuals and meets them where they are - understanding that adopting an “it's not my fault but it is my problem” attitude in all communication styles and approaches
What You'll Need
Must hold active Registered Nurse license issued by the state of California
Located in California (Preferred)
Previous experience in care coordination or case management
2-3+ years of experience working for a health plan or at-risk provider
Bilingual - English/Spanish
Strong technical skills and comfort with new technology innovation, past experience with CRM databases, basic Google suite, email, and video conferencing
Must have quiet and HIPAA-compliant at-home work environment with reliable Internet connection and cell phone
Strong understanding of cultural fluency
Demonstrated professional or personal lived experience working closely with individuals experiencing complex chronic needs, homelessness, or Severe Mental Illness/Substance Use Disorder
Empathetic with a drive to reduce barriers to healthcare and social services for underserved communities
Preferred Qualifications
A fantastic listener and skilled at “reading people” - able to understand how others may be feeling or thinking based on nuances, uncomfortable silences, or questions they ask
Excellent communication skills
Takes accountability to resolve a patient's needs to the best of his/her/their abilities
Comfortable building relationships with new people
Zest for problem solving, seeking answers, and thinking outside the box
Detail-oriented and organized self-starter
Reliable and comfortable in an ever-changing environment
Because We Value You
Salary: $80,000 - $95,000
Comprehensive health, vision & dental insurance
401k
Opportunity for rapid career progression with plenty of room for personal growth!
Monthly $100 work from home expense stipend
Flexible vacation policy with unlimited time off
Work entirely from the comfort of your own home - no office
We provide the equipment needed for the role
Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law.
Pair Team participates in E-Verify to verify employment eligibility for new hires.
Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use.
We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to ***********************.
Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!
Auto-ApplyBilingual RN Care Manager (Remote Flexible - Spanish Speaking)
Fresno, CA jobs
Team
At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve.
We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.
Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.
We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions.
At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare.
Our Values
Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.
Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.
Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.
Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.
Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.
In the News
Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most
TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team
Axios: Pair Team collects $9M for Medicaid-based care
About the Opportunity
Pair Team is building a team of deeply passionate individuals ready to change primary care operations for those who need it most. We are looking for a highly motivated full-time Registered Nurse Care Manager who is willing to think creatively and empathically to help our team change the way people access healthcare.
We seek a full-time Registered Nurse Care Manager to play a critical role in our whole-person, interdisciplinary care model by supporting patient-driven care plans to drive improved outcomes for individuals living with Serious Mental Illness, Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. The Registered Nurse Care Manager will work in a team-based model with a lead care manager community health worker, behavioral health care manager, and nurse practitioner to contribute their clinical expertise towards improving the individuals quality of life through activities such as health education and complex care management.
This position primarily allows for remote work; however, it includes 1-2 times a month on-site visits in the community alongside a fellow PairMate. You can expect to engage in these in-person activities 1-2 times per month, close to your city, while the majority of your duties, approximately 90%, will be performed from your home
What You'll Do
Primarily work with and support a caseload of individuals with complex medical needs
Work with individual to identify health/wellness goals and incorporate goals into a Shared Care Plan
Educate individuals on medical and behavioral health conditions (including medication) to improve health literacy
Provide medication reconciliation in collaboration with the individuals's pharmacy
Provide care management services such as coordinating prescriptions and completing prior authorizations
Track and assure that all required assessments and screenings are performed
Collaborate with multidisciplinary care team to identify and address barriers to care
Identify clinical needs and triage escalations, providing brief interventions as necessary, with support from nurse practitioner clinicians
Collaborate on care issues with Enhanced Care Management team by participating in systematic case reviews
Consult with Enhanced Care Management team about clinical concerns or questions, provide educational training on chronic disease states, prevention, treatment, meds, and healthy living
Build trust and develop relationships with individuals experiencing homelessness, living with Severe Mental Illness/Substance Use Disorder, and living with multiple chronic conditions
Use relationship-based strategies to engage individuals in care, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system
Seeks to listen openly to individuals and meets them where they are - understanding that adopting an “it's not my fault but it is my problem” attitude in all communication styles and approaches
What You'll Need
Must hold active Registered Nurse license issued by the state of California
Located in California (Preferred)
Previous experience in care coordination or case management
2-3+ years of experience working for a health plan or at-risk provider
Bilingual - English/Spanish
Strong technical skills and comfort with new technology innovation, past experience with CRM databases, basic Google suite, email, and video conferencing
Must have quiet and HIPAA-compliant at-home work environment with reliable Internet connection and cell phone
Strong understanding of cultural fluency
Demonstrated professional or personal lived experience working closely with individuals experiencing complex chronic needs, homelessness, or Severe Mental Illness/Substance Use Disorder
Empathetic with a drive to reduce barriers to healthcare and social services for underserved communities
Preferred Qualifications
A fantastic listener and skilled at “reading people” - able to understand how others may be feeling or thinking based on nuances, uncomfortable silences, or questions they ask
Excellent communication skills
Takes accountability to resolve a patient's needs to the best of his/her/their abilities
Comfortable building relationships with new people
Zest for problem solving, seeking answers, and thinking outside the box
Detail-oriented and organized self-starter
Reliable and comfortable in an ever-changing environment
Because We Value You
Salary: $80,000 - $95,000
Comprehensive health, vision & dental insurance
401k
Opportunity for rapid career progression with plenty of room for personal growth!
Monthly $100 work from home expense stipend
Flexible vacation policy with unlimited time off
Work entirely from the comfort of your own home - no office
We provide the equipment needed for the role
Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law.
Pair Team participates in E-Verify to verify employment eligibility for new hires.
Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use.
We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to ***********************.
Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!
Auto-ApplyBilingual RN Care Manager (Remote Flexible - Spanish Speaking)
Los Angeles, CA jobs
Team
At Pair Team, we're an innovative, mission-driven company reimagining how Medicaid and Medicare serves the most underserved populations. As a tech-enabled medical group, we deliver whole-person care - clinical, behavioral, and social - by partnering with organizations deeply connected to the communities we serve.
We're building a care model that empowers clinicians and care teams to do what they do best: provide compassionate, high-impact care. At Pair Team, we leverage AI and automation to reduce administrative burden, streamline coordination, and ensure patients receive timely, personalized support.
Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients.
We're one of the largest Enhanced Care Management providers in California and are on track to build the nation's largest clinically integrated network supporting high-need patients. Our model has demonstrated real impact, including a 58% reduction in emergency department visits and a 29% reduction in hospital admissions.
At Pair Team, were not just delivering care - we're building the future of more equitable, community-driven healthcare.
Our Values
Lead with integrity: We keep our commitments and take responsibility for our actions. We are dependable and choose authenticity over perfection.
Embrace challenges: We leave our egos at the door and step forward into discomfort instead of back into safety. We help each other to learn and provide feedback using candor and kindness.
Break through walls: We go the extra mile for our patients, partners and one another, and we run toward hard things. We are resilient in our push for consistent improvement and challenge the status quo.
Act beyond yourself: We build each other up and respect boundaries. We seek first to understand and assume positive intent.
Care comes first: We hold ourselves to the highest standards for our patients. We are relentless in the pursuit of our mission, and ensure that we are taking care of ourselves in order to care for others.
In the News
Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most
TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team
Axios: Pair Team collects $9M for Medicaid-based care
About the Opportunity
Pair Team is building a team of deeply passionate individuals ready to change primary care operations for those who need it most. We are looking for a highly motivated full-time Registered Nurse Care Manager who is willing to think creatively and empathically to help our team change the way people access healthcare.
We seek a full-time Registered Nurse Care Manager to play a critical role in our whole-person, interdisciplinary care model by supporting patient-driven care plans to drive improved outcomes for individuals living with Serious Mental Illness, Substance Use Disorder, experiencing homelessness, and/or those who have high medical needs. The Registered Nurse Care Manager will work in a team-based model with a lead care manager community health worker, behavioral health care manager, and nurse practitioner to contribute their clinical expertise towards improving the individuals quality of life through activities such as health education and complex care management.
This position primarily allows for remote work; however, it includes 1-2 times a month on-site visits in the community alongside a fellow PairMate. You can expect to engage in these in-person activities 1-2 times per month, close to your city, while the majority of your duties, approximately 90%, will be performed from your home
What You'll Do
Primarily work with and support a caseload of individuals with complex medical needs
Work with individual to identify health/wellness goals and incorporate goals into a Shared Care Plan
Educate individuals on medical and behavioral health conditions (including medication) to improve health literacy
Provide medication reconciliation in collaboration with the individuals's pharmacy
Provide care management services such as coordinating prescriptions and completing prior authorizations
Track and assure that all required assessments and screenings are performed
Collaborate with multidisciplinary care team to identify and address barriers to care
Identify clinical needs and triage escalations, providing brief interventions as necessary, with support from nurse practitioner clinicians
Collaborate on care issues with Enhanced Care Management team by participating in systematic case reviews
Consult with Enhanced Care Management team about clinical concerns or questions, provide educational training on chronic disease states, prevention, treatment, meds, and healthy living
Build trust and develop relationships with individuals experiencing homelessness, living with Severe Mental Illness/Substance Use Disorder, and living with multiple chronic conditions
Use relationship-based strategies to engage individuals in care, understanding that many may have lived personal experiences causing them to be initially hesitant or distrusting of the health care system
Seeks to listen openly to individuals and meets them where they are - understanding that adopting an “it's not my fault but it is my problem” attitude in all communication styles and approaches
What You'll Need
Must hold active Registered Nurse license issued by the state of California
Located in California (Preferred)
Previous experience in care coordination or case management
2-3+ years of experience working for a health plan or at-risk provider
Bilingual - English/Spanish
Strong technical skills and comfort with new technology innovation, past experience with CRM databases, basic Google suite, email, and video conferencing
Must have quiet and HIPAA-compliant at-home work environment with reliable Internet connection and cell phone
Strong understanding of cultural fluency
Demonstrated professional or personal lived experience working closely with individuals experiencing complex chronic needs, homelessness, or Severe Mental Illness/Substance Use Disorder
Empathetic with a drive to reduce barriers to healthcare and social services for underserved communities
Preferred Qualifications
A fantastic listener and skilled at “reading people” - able to understand how others may be feeling or thinking based on nuances, uncomfortable silences, or questions they ask
Excellent communication skills
Takes accountability to resolve a patient's needs to the best of his/her/their abilities
Comfortable building relationships with new people
Zest for problem solving, seeking answers, and thinking outside the box
Detail-oriented and organized self-starter
Reliable and comfortable in an ever-changing environment
Because We Value You
Salary: $80,000 - $95,000
Comprehensive health, vision & dental insurance
401k
Opportunity for rapid career progression with plenty of room for personal growth!
Monthly $100 work from home expense stipend
Flexible vacation policy with unlimited time off
Work entirely from the comfort of your own home - no office
We provide the equipment needed for the role
Pair Team is an Equal Opportunity Employer. At Pair Team, we value diversity and strive to provide an inclusive environment for all applicants and employees. All applicants will be considered without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, marital status, age, disability, political affiliation, military service, genetic information, or any other characteristic covered by federal, state, or local law.
Pair Team participates in E-Verify to verify employment eligibility for new hires.
Any offer of employment at Pair Team is conditioned upon passing a pre-employment background check. Following a conditional job offer, candidates will undergo comprehensive employment background checks, including; criminal history, reference checks, and driving records if a role requires vehicle use.
We do not conduct any TA business outside of our @pairteam.com emails. If you're ever concerned about spam or fraudulent activity, please reach out to ***********************.
Note: Please be aware that while we sincerely appreciate your interest, due to the high volume of requests, we're unable to respond to general position inquiries via email. To apply for a position with us, please submit your application for the role you are interested in. Our team regularly reviews applications and will reach out to candidates whose qualifications align with our current openings listed below. Thank you!
Auto-ApplyHome Health RN Case Manager - Tyler
Tyler, TX jobs
Job Description
Reliant at Home is seeking a PRN RN Case Manager to cover Tyler, TX and surrounding areas! Home Health experience is not required. Homecare Homebase knowledge is a plus!
About Reliant at Home Reliant at Home is a multi-site Home Health, Hospice, Caregivers, and Rehab company with 14 locations in Texas - including five Hospice locations (Fort Worth, Plano, Teague, The Woodlands, and San Antonio). The Reliant at Home Bluebird Promise is our commitment to live up to our higher calling by fulfilling our Values, Culture Priorities, and Service Pledge. Care is our higher calling. We believe care is more than the service we provide to patients who need help at home. It also means caring for our Reliant at Home family, the families and loved ones of the patients we serve, our referral partners and providers, and our local communities. Serving others is what we were meant to do.Join Reliant at Home's winning culture - named on the Fortune Best Workplaces for Aging Services in the USA in 2020 (#10), 2022 (#15), and 2023 (#11) and a certified Great Place to Work 2020, 2021, 2022, 2023, 2024, and 2025
Responsibilities:
Assess patient's condition during every visit and chart your observations
Perform evaluation tasks, including vital signs and medication review
Administer medication as prescribed by the patient's Physician
Dress or redress open wounds and assess the progress of healing
Educate patients and their families on proper home health care strategies and procedures
Coordinate with Occupational Therapists, Physical Therapists, Physicians, and anyone else involved in the patient's care plan
Provide palliative care as needed to keep the patient comfortable
Make recommendations for devices or tools that might improve the patient's quality of life
Listen to the patient and respond to concerns or requests
Why Should You Apply?
You want to be a part of a company with a strong future
You want to be a part of the solution in caring for seniors that need quality people in their corner
You want to be on an amazing team with a positive and award-winning company culture
You want to work alongside kind people that seek to do the right thing and put patients first
You want to live out your calling and are more than happy to help
You want to give back to the local community by participating in service projects
You are eager to discover what sets Reliant at Home's Bluebird Nation apart
Now is the time for you to be involved in the care of our patients and the exciting expansion of Reliant at Home!
RN Quality Review/Clinical Manager Home Health
Fort Myers, FL jobs
A career with Brookdale has never been more rewarding! Brookdale is the only national full-spectrum senior living solutions company and committed to providing the best options for our over 110,000 residents we serve. The services that we offer ensure residents continue to live the lives that they
want while also meeting all of their needs along the way. Every day our
associates collaborate to guarantee this promise is fulfilled in more than 1,150
communities in 47 states. Our Senior Living Solutions include: Independent
Living, Assisted Living, Memory Care, Skilled Nursing, Continuing Care
Retirement, Therapy, Hospice, Home Health, and Personalized Living.
Job Description
Key responsibilities include:
* Supports the efforts of the agency in managing quality of clinical care, utilization, documentation, outcome & process management through education, associate interaction, & electronic review of patient records & reporting systems
* Training & development of clinical staff in OASIS, coding & documentation competencies are critical components of this role
* Responsible for outcome management through implementation of best clinical practices and working within a team environment
Qualifications
We seek the following principal qualifications:
* Registered Nurse state licensure
* 5 years of experience working for a Medicare certified home health agency with 2 years in clinical review, QA, or a management role responsible for coding and review
* Home Health Coding certification - HCS-D
* OASIS certification - COS-C or HCS-O
* HomeCare HomeBase EMR experience a plus
Additional Information
All your information will be kept confidential according to EEO guidelines.
RN Quality Review/Clinical Manager Home Health
Fort Myers, FL jobs
A career with Brookdale has never been more rewarding! Brookdale is the only national full-spectrum senior living solutions company and committed to providing the best options for our over 110,000 residents we serve.
The services that we offer ensure residents continue to live the lives that they
want while also meeting all of their needs along the way. Every day our
associates collaborate to guarantee this promise is fulfilled in more than 1,150
communities in 47 states. Our Senior Living Solutions include: Independent
Living, Assisted Living, Memory Care, Skilled Nursing, Continuing Care
Retirement, Therapy, Hospice, Home Health, and Personalized Living.
Job Description
Key responsibilities include:
* Supports the efforts of the agency in managing quality of clinical care, utilization, documentation, outcome & process management through education, associate interaction, & electronic review of patient records & reporting systems * Training & development of clinical staff in OASIS, coding & documentation competencies are critical components of this role * Responsible for outcome management through implementation of best clinical practices and working within a team environment
Qualifications
We seek the following principal qualifications: * Registered Nurse state licensure * 5 years of experience working for a Medicare certified home health agency with 2 years in clinical review, QA, or a management role responsible for coding and review * Home Health Coding certification - HCS-D * OASIS certification - COS-C or HCS-O * HomeCare HomeBase EMR experience a plus
Additional Information
All your information will be kept confidential according to EEO guidelines.
Home Health RN Case Manager - Denton County
Denton, TX jobs
Job Description
Reliant at Home is seeking a PRN RN Case Manager to cover Denton, TX and surrounding areas! Home Health experience is not required. Homecare Homebase knowledge is a plus!
About Reliant at Home Reliant at Home is a multi-site Home Health, Hospice, Caregivers, and Rehab company with 14 locations in Texas - including five Hospice locations (Fort Worth, Plano, Teague, The Woodlands, and San Antonio). The Reliant at Home Bluebird Promise is our commitment to live up to our higher calling by fulfilling our Values, Culture Priorities, and Service Pledge. Care is our higher calling. We believe care is more than the service we provide to patients who need help at home. It also means caring for our Reliant at Home family, the families and loved ones of the patients we serve, our referral partners and providers, and our local communities. Serving others is what we were meant to do.Join Reliant at Home's winning culture - named on the Fortune Best Workplaces for Aging Services in the USA in 2020 (#10), 2022 (#15), and 2023 (#11) and a certified Great Place to Work 2020, 2021, 2022, 2023, 2024, and 2025
Responsibilities:
Assess patient's condition during every visit and chart your observations
Perform evaluation tasks, including vital signs and medication review
Administer medication as prescribed by the patient's Physician
Dress or redress open wounds and assess the progress of healing
Educate patients and their families on proper home health care strategies and procedures
Coordinate with Occupational Therapists, Physical Therapists, Physicians, and anyone else involved in the patient's care plan
Provide palliative care as needed to keep the patient comfortable
Make recommendations for devices or tools that might improve the patient's quality of life
Listen to the patient and respond to concerns or requests
Why Should You Apply?
You want to be a part of a company with a strong future
You want to be a part of the solution in caring for seniors that need quality people in their corner
You want to be on an amazing team with a positive and award-winning company culture
You want to work alongside kind people that seek to do the right thing and put patients first
You want to live out your calling and are more than happy to help
You want to give back to the local community by participating in service projects
You are eager to discover what sets Reliant at Home's Bluebird Nation apart
Now is the time for you to be involved in the care of our patients and the exciting expansion of Reliant at Home!
Home Health RN Case Manager - Dallas
Plano, TX jobs
Job Description
Reliant at Home is seeking a PRN Home Health RN in Dallas County! Home health experience preferred. Home Care Home Base EMR a Plus!
About Reliant at Home Reliant at Home is a multi-site Home Health, Hospice, Caregivers, and Rehab company with 14 locations in Texas - including five Hospice locations (Fort Worth, Plano, Teague, The Woodlands, and San Antonio). The Reliant at Home Bluebird Promise is our commitment to live up to our higher calling by fulfilling our Values, Culture Priorities, and Service Pledge. Care is our higher calling. We believe care is more than the service we provide to patients who need help at home. It also means caring for our Reliant at Home family, the families and loved ones of the patients we serve, our referral partners and providers, and our local communities. Serving others is what we were meant to do.Join Reliant at Home's winning culture - named on the Fortune Best Workplaces for Aging Services in the USA in 2020 (#10), 2022 (#15), and 2023 (#11) and a certified Great Place to Work 2020, 2021, 2022, 2023, 2024, and 2025
Responsibilities:
Assess patient's condition during every visit and chart your observations
Perform evaluation tasks, including vital signs and medication review
Administer medication as prescribed by the patient's Physician
Dress or redress open wounds and assess the progress of healing
Educate patients and their families on proper home health care strategies and procedures
Coordinate with Occupational Therapists, Physical Therapists, Physicians, and anyone else involved in the patient's care plan
Provide palliative care as needed to keep the patient comfortable
Make recommendations for devices or tools that might improve the patient's quality of life
Listen to the patient and respond to concerns or requests
Requirements:
RN required
Home health required
Knowledge of OASIS required
Why Should You Apply?
You want to be a part of a company with a strong future
You want to be a part of the solution in caring for seniors that need quality people in their corner
You want to be on an amazing team with a positive and award-winning company culture
You want to work alongside kind people that seek to do the right thing and put patients first
You want to live out your calling and are more than happy to help
You want to give back to the local community by participating in service projects
You are eager to discover what sets Reliant at Home's Bluebird Nation apart
Now is the time for you to be involved in the care of our patients and the exciting expansion of Reliant at Home!
RN Care Manager
Dallas, TX jobs
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity
Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status.
Part and Full Time Benefits Eligibility
Medical, Dental, Vision insurance
401(k)
Associate assistance program
Employee discounts
Referral program
Early access to earned wages for hourly associates (outside of CA)
Optional voluntary benefits including ID theft protection and pet insurance
Full Time Only Benefits Eligibility
Paid Time Off
Paid holidays
Company provided life insurance
Adoption benefit
Disability (short and long term)
Flexible Spending Accounts
Health Savings Account
Optional life and dependent life insurance
Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan
Tuition reimbursement
Base pay in range will be determined by applicant's skills and experience. Role is also eligible for team based bonus opportunities. Temporary associates are not benefits eligible but may participate in the company's 401(k) program.
Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year.
The application window is anticipated to close within 30 days of the date of the posting.
Minimum Requirements
Graduate from Accredited Nursing School and a minimum of 5-7 years of relevant experience required.
Knowledge of value-based care models is preferred.
Experience working in SNF and HH environments preferred.
Previous Care Management, Case Management, or Care Coordination preferred.
Certifications, Licenses, and other Special Requirements
RN license required.
Physical Demands and Working Conditions
Standing
Walking
Sitting
Use hands and fingers to handle or feel
Reach with hands and arms
Stoop, kneel, crouch crawl
Ability to lift: up to 50 pounds
Vision
Requires interaction with co-workers, residents or vendors
Occasional weekend, evening or night work if needed to ensure shift coverage
On-Call on an as needed basis
Possible exposure to communicable diseases and infections
Potential injury from transferring, repositioning, or lifting residents
Exposure to latex
Possible exposure to blood-borne pathogens
Possible exposure to various drugs, chemical, infectious, or biological hazards
Subject to injury from falls, burns, odors, or cuts from equipment
Requires Travel: Frequently
Brookdale is an equal opportunity employer and a drug-free workplace.
The RN Care Manager serves as a liaison among Brookdale teams, residents, families, and healthcare providers within our communities, promoting coordination, communication, and collaboration at Brookdale's HealthPlus communities. This role encompasses the identification, coordination, communication, and implementation of services essential for enhancing residents' quality of life and achieving an optimal level of wellness. Works closely with primary and specialty care providers to formulate resident-specific care plans, ensuring that the delivery of medically necessary services aligns with established care plans. Serving as a resident advocate, they actively contribute to identifying and improving service delivery, closing gaps in care, and understanding key interventions and care protocols relevant to treating residents in place.
Educates and explains Brookdale's care pathways as determined by individual diagnosis and healthcare needs.
Monitors and communicates quality performance measures, and assists with training and education of teams to ensure quality outcomes for residents. This involves effective communication and collaboration with providers and other healthcare entities, such as managed care coordinators, insurance providers, and external healthcare partners responsible for coordinating resources and supplies pertinent to resident needs.
Reviews the current population's medical diagnoses to identify care needs. Assists in assessing the health, functional, and psycho-social status of residents.
Coordinates services required to enhance optimum wellness and manage chronic conditions.
Collaborates with hospice, palliative, and home health services/therapy as indicated.
Provides advanced care planning education to residents and families/responsible parties. Helps ensure each resident has a completed Advanced Care Plan, inclusive of goals of care. Communicates with healthcare providers to ensure care delivery is consistent with the resident's Advanced Care Plan(s) Participates in collaborative care reviews (CCR) and care conferences.
Provides resources for residents and families to make informed decisions regarding choices in meeting healthcare needs and effectively champions the benefits of residing and receiving care and services at the community. This includes informing them about opportunities to enhance care and the benefits of an IE-SNP plan or other benefit opportunities.
Applies quality improvement methodology to analyze, enhance, and manage outcomes, striving to achieve quality measure goals. Collaborates with Health and Wellness Directors (HWD) to ensure compliance with service plans, while working with providers to attain value-based outcomes for our residents. This includes coordinating and communicating care for each resident.
Provides oversight, coordination, and family communication during resident hospitalization and rehab stays. Ensures return to the community where appropriate.
Communicates information promptly to the appropriate care provider regarding changes in residents' health/well-being, personal needs, risk management issues, customer service issues, and family, or outside health care provider concerns.
Facilitates continuity of care for those residents receiving home health care, hospice services, and other third-party healthcare-related services.
Completes documentation as required by Brookdale or state regulatory agencies.
This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.
Auto-ApplyRN Care Manager
Charlotte, NC jobs
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity
Brookdale Senior Living Resident Care Manager- Registered Nurse (RN) Required - Area: Charlotte, NC
A very unique opportunity to enhance healthcare delivery in multiple Brookdale assisted living and memory care communities in the area.
Brookdale HealthPlus is a unique service offered to our senior living residents and the Care Manager position is an exciting new role designed to enhance healthcare services within Brookdale's assisted living and memory care communities. The Brookdale HealthPlus program is offered in limited Brookdale locations and is a unique opportunity. This role offers the opportunity to redesign the way care is provided at Brookdale.
Prior experience as a care manager, case manager, care navigator supporting chronic disease management is a plus. Experience using robust electronic charting systems and data interpretation a plus.
Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status.
Base pay in range will be determined by applicant's skills and experience. Role is also eligible for team based bonus opportunities. Temporary associates are not benefits eligible but may participate in the company's 401(k) program.
Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year.
Minimum Requirements
Graduate from Accredited Nursing School and a minimum of 5-7 years of relevant experience required.
Knowledge of value-based care models is preferred.
Experience working in SNF and HH environments preferred.
Previous Care Management, Case Management, or Care Coordination preferred.
Certifications, Licenses, and other Special Requirements
RN license required.
Physical Demands and Working Conditions
Standing
Walking
Sitting
Use hands and fingers to handle or feel
Reach with hands and arms
Stoop, kneel, crouch crawl
Ability to lift: up to 50 pounds
Vision
Requires interaction with co-workers, residents or vendors
Occasional weekend, evening or night work if needed to ensure shift coverage
On-Call on an as needed basis
Possible exposure to communicable diseases and infections
Potential injury from transferring, repositioning, or lifting residents
Exposure to latex
Possible exposure to blood-borne pathogens
Possible exposure to various drugs, chemical, infectious, or biological hazards
Subject to injury from falls, burns, odors, or cuts from equipment
Requires Travel: Frequently
Brookdale is an equal opportunity employer and a drug-free workplace.
The RN Care Manager serves as a liaison among Brookdale teams, residents, families, and healthcare providers within our communities, promoting coordination, communication, and collaboration at Brookdale's HealthPlus communities. This role encompasses the identification, coordination, communication, and implementation of services essential for enhancing residents' quality of life and achieving an optimal level of wellness. Works closely with primary and specialty care providers to formulate resident-specific care plans, ensuring that the delivery of medically necessary services aligns with established care plans. Serving as a resident advocate, they actively contribute to identifying and improving service delivery, closing gaps in care, and understanding key interventions and care protocols relevant to treating residents in place.
Educates and explains Brookdale's care pathways as determined by individual diagnosis and healthcare needs.
Monitors and communicates quality performance measures, and assists with training and education of teams to ensure quality outcomes for residents. This involves effective communication and collaboration with providers and other healthcare entities, such as managed care coordinators, insurance providers, and external healthcare partners responsible for coordinating resources and supplies pertinent to resident needs.
Reviews the current population's medical diagnoses to identify care needs. Assists in assessing the health, functional, and psycho-social status of residents.
Coordinates services required to enhance optimum wellness and manage chronic conditions.
Collaborates with hospice, palliative, and home health services/therapy as indicated.
Provides advanced care planning education to residents and families/responsible parties. Helps ensure each resident has a completed Advanced Care Plan, inclusive of goals of care. Communicates with healthcare providers to ensure care delivery is consistent with the resident's Advanced Care Plan(s) Participates in collaborative care reviews (CCR) and care conferences.
Provides resources for residents and families to make informed decisions regarding choices in meeting healthcare needs and effectively champions the benefits of residing and receiving care and services at the community. This includes informing them about opportunities to enhance care and the benefits of an IE-SNP plan or other benefit opportunities.
Applies quality improvement methodology to analyze, enhance, and manage outcomes, striving to achieve quality measure goals. Collaborates with Health and Wellness Directors (HWD) to ensure compliance with service plans, while working with providers to attain value-based outcomes for our residents. This includes coordinating and communicating care for each resident.
Provides oversight, coordination, and family communication during resident hospitalization and rehab stays. Ensures return to the community where appropriate.
Communicates information promptly to the appropriate care provider regarding changes in residents' health/well-being, personal needs, risk management issues, customer service issues, and family, or outside health care provider concerns.
Facilitates continuity of care for those residents receiving home health care, hospice services, and other third-party healthcare-related services.
Completes documentation as required by Brookdale or state regulatory agencies.
This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.
Auto-ApplyNurse Case Manager
San Diego, CA jobs
is based out of our San Diego, CA office.
Mainstay Medical
Mainstay Medical is a medical device company focused on marketing an innovative implantable neurostimulation system, ReActiv8 , for people with disabling chronic mechanical Low Back Pain. The company is headquartered in Dublin, Ireland, with subsidiaries operating in Ireland, the United States, Australia, Germany, and the Netherlands.
The Role
Oversees the coordination and execution from patient identification to implant. Case Managers are responsible for empathetic communication, education, and management of implant logistics for patients, ensuring a smooth and efficient path to implantation of ReActiv8 . Case Managers collaborate closely with field-based teams on patient pipelines. This individual will take ownership and manage the ReActiv8 patient funnel and provide timely and accurate updates to multiple team members. The incumbent will be a professional who demonstrates strong business acumen and collaborates effectively with field-based teams, providing timely, and accurate documentation in a web or cloud-based system.
Position Responsibilities:
Acts as a subject matter expert on ReActiv8 , conducts clinical review of patient's medical records, assuring complete and quality case documentation for all levels of review.
Provides education for patients and family members on the ReActiv8 system, therapy and the prior authorization process.
In conjunction with the Therapy Managers, will oversee patients progress to implant, navigating, evaluating and driving the most effective pathway to approval, while making necessary adjustments.
Posses stong understanding on the need for patient documentation and will log all interactions and outcomes accurately within a cloud or web-based system.
Acts as a liaison between physicians, their office staff and patients, leveraging empathy, warmth and a customer service mindset in all interactions including field teams when providing timely case updates.
Advocates for patients needs and preferences, while always respecting patient confidentiality.
Facilitates communication and coordination amongst team members, facilitating regular pipeline calls to ensure cases are progressing forward towards pull through.
Develops, implements, and manages a plan of action for each patient in collaboration with the Therapy Manager (TM) and patient. Demonstrates strong documentation skills for each plan of action within a web or cloud-based system.
Regularly collaborates with team and field teams to ensure patient barriers are removed or addressed, and internal and external resources are aligned to facilitate the implant process.
Works with patients and care providers to ensure quick and easy access to surgical scheduling, and implantation of ReActiv8 .
Manages multiple priorities and deadlines simultaneously, while handling a high patient volume.
Ensures compliance with policies, in particular patient confidentiality (HIPAA) in all Mainstay Medical interactions.
Provides clear and effective communication via multiple methods (in-person, in-writing, on the phone and in front of small and mid-sized audiences).
Demonstrated ability to work independently as well as part of a team that values collaboration and openness while balancing workloads to ensure patients are always prioritized.
Strong acumen and desire to critically evaluate caseloads, bringing forward insights and opportunities via KPIs.
Ability and willingness to shift work schedule to a different time-zone as business dictates.
Willingness to assist others in Commercial Operations with patients and/or special projects as requested from both inside and outside the department.
Qualifications:
Education level: BSN, RN, or equivalent required.
Experience in care coordination, case management, and some knowledge of insurance- required.
Experience in direct patient care, in medical office or hospital setting with coding and prior authorization experience.
Knowledge of health insurance industry practices/functions to include Medicare, Medicaid, and all types of commercial and managed care organization's coverage policies.
Skilled at patient engagement and interaction; experience in patient education.
Strong organizational skills with a keen eye and attention to detail.
Clear written and verbal communication skills-both in-person, in-writing and over the phone.
Strong abilities in Microsoft Word, Outlook, Excel, PowerPoint.
3+ years of experience working with a cloud or web-based documentation system required.
Strong problem solver and capable of finding solutions to challenges or process gaps.
Demonstrated interactions of maintaining a caring, empathetic, and patient-centric approach in all interactions.
The salary range for this position is $82,000 to 110,000/year; however, base pay offered will take into account a range of factors, including job-related knowledge, skills, and experience. The total compensation package includes a range of medical, dental, vision, financial, and other benefits, as well as equity.
Mainstay Medical is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to gender, race, color, religious creed, national origin, age, sexual orientation, gender identity, physical or mental disability, and/or protected veteran status. Mainstay Medical participates in E-Verify.
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