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Top 50 Nurse Case Manager Skills

Below we've compiled a list of the most important skills for a Nurse Case Manager. We ranked the top skills based on the percentage of Nurse Case Manager resumes they appeared on. For example, 12.2% of Nurse Case Manager resumes contained Patient Care as a skill. Let's find out what skills a Nurse Case Manager actually needs in order to be successful in the workplace.

These Are The Most Important Skills For A Nurse Case Manager

1. Patient Care
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high Demand
Here's how Patient Care is used in Nurse Case Manager jobs:
  • Maintained communication with physicians and collaborated to provide high-quality, cost-effective patient care in the home setting.
  • Facilitate timely and appropriate discharges from the hospital and identify opportunities for improvements in patient care.
  • Case manager for chronic ventilator program assisting families with selecting skilled facilities for patient care
  • Ensured cost effective and quality patient care by appropriate utilization of medical resources.
  • Coordinate with community organizations to facilitate patient care and recovery.
  • Managed patient care by reviewing computerized files.
  • Consult with staff, skill personnel and interdisciplinary team to determine appropriate care for the patient care.
  • Attended regular meetings with health care team to optimize patient care and well-being of family members.
  • Participated in time management work groups to ensure metrics were met while providing quality patient care.
  • Customized and implemented patient care plans based on individual diagnoses and response to provided care.
  • Develop patient care plains, including assessments, implementation, evaluation and nursing diagnosis.
  • Required total management of patient care from Admission to Discharge and all required paperwork
  • Provided all tasks/skills associated with direct patient care within scope of practice.
  • Assessed the level of patient care needed after trauma or illness.
  • Direct patient care at home and at independent/assisted living facilities.
  • Develop, implement, evaluation of patient care plans.
  • Clarified state mandated policies that directly affected patient care.
  • Utilized strong assessment skills to determine necessary patient care.
  • Coordinate patient care in multiple Hospice settings Evaluate and admit to Hospice Care Supervise LPN and HHA
  • Manage and coordinate patient care with the physicians, physical tx., occupational tx, social worker, and dietician.

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136 Patient Care Jobs

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2. Health Care
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high Demand
Here's how Health Care is used in Nurse Case Manager jobs:
  • Collaborated with multidisciplinary team and health care systems.
  • Managed and coordinated health care for the patient from the hospital setting to the rehabilitation facility and to the home.
  • Coordinated and facilitated access to timely and appropriate health care services, and ensured continuity throughout client's recovery process.
  • Provided education regarding HIV disease to the community, health care providers, home health aides, patients and families.
  • Collaborated with health care team members to assess, facilitate and plan for the ongoing needs of pediatric high-risk patients.
  • Managed all needed documentation and paperwork required by Medicaid/Medicare and Country Style Health Care, Inc. for each consumer.
  • Case manager with a focus of educating clients in the proper use of their health care plan.
  • Assessed level of continuing care such as NH placement, home health care, etc.
  • Work with physicians and other health care members to ensure proper utilization of health resources.
  • Evaluate, coordinate and maintain patients health care throughout all patients phases of care.
  • Performed continuous health assessments and documented health care needs and client ailments.
  • Facilitated the coordination and integration of care between health care services.
  • Developed plans of care for patients with home health care needs.
  • Assist employers in decreasing worker's compensation and health care costs.
  • Empowered customers to become active participants in their health care needs.
  • Managed the health care needs of a 28 patient caseload.
  • Serve as liaison between patients and health care providers.
  • Assured compliance with state and federal health care mandates
  • Notified the health care provider of member abnormalities after careful review of the health risk assessment.
  • Out reached members, health care providers, guardians parents & other family members-the interdisciplinary team.

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272 Health Care Jobs

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3. Treatment Plans
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high Demand
Here's how Treatment Plans is used in Nurse Case Manager jobs:
  • Collaborated with physicians regarding treatment plans and quality issues.
  • Collaborate with physicians, health care professionals, payers and employers on patient's treatment plans and return to work.
  • Perform utilization review using evidenced based medical guidelines (MDA, ACOEM and ODG) for requested treatment plans.
  • Collaborate with other health care professionals to develop and revise treatment plans based on identified needs and assessment data.
  • Ensured efficacy by conducting ongoing assessments, monitoring changes in treatment plans and coordinating services with medical teams.
  • Coordinate treatment plans, problem solved, researched providers, negotiated services, interacted with health care professionals.
  • Identify high risk cases and develop care treatment plans with patients and physicians based on health care needs.
  • Provided comprehensive case management services, including creating treatment plans and connecting clients and families to appropriate resources.
  • Assessed progress and assisted in implementation of treatment plans by visiting homes, schools and service providers.
  • Prepare appropriate recovery based treatment plans and work with a team to implement them.
  • Identify treatment plans, oversee medical care and monitor an injured worker's progress.
  • Obtain, review and follow up with all external health service provider treatment plans.
  • Identified, provided and supported treatment plans throughout the continuum of care settings.
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans.
  • Coordinate and assist in directing the treatment plans for injured workers.
  • Modify treatment plans to comply with changes in patients' status.
  • Identified gaps or barriers in treatment plans.
  • Educated injured workers on injury dynamics, disability durations and individual treatment plans established by their physicians to promote compliance.
  • Interact with physicians and other providers to determine current medical status and future needs including alternative treatment plans.
  • Modified patient treatment plans as indicated by patients' responses and conditions.

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4. Hospice
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high Demand
Here's how Hospice is used in Nurse Case Manager jobs:
  • Initiated communication with attending physicians and hospice staff as needed to coordinate optimal care.
  • Performed hospice determination, face-to-face, and admission audits for Medicare regulatory requirements.
  • Participated in Interdisciplinary meetings with other staff and Hospice physician.
  • Performed clinical evaluations of patients to determine Medicare hospice eligibility.
  • Demonstrated appropriate notification of hospice team upon death.
  • Key Accomplishments: * Selected as RN to represent Iowa City Hospice in CR(Cancer Research) Magazine 2008.
  • Performed daily nurse visits, wound care, injections, IV therapy, and Hospice care.
  • Worked as Hospice Case Manager for three years and Medical Surgical Case Manager for 5 years.
  • Utilized strong assessment skills to determine appropriateness of hospice care per the current Medicare guidelines.
  • Evaluated patients in various home and health care setting to determine appropriateness for hospice admission.
  • Complied with Medicare - Hospice Benefit guidelines for quality and continuity of care.
  • Case management of hospice patients in long term care and home settings.
  • Planned, implemented, evaluated, and documented the hospice care provided.
  • Developed plan of care and certifications to justify Hospice care.
  • Case Managed Hospice patients with an Interdisciplinary team.
  • Evaluate hospice readiness and coordinate appropriate care.
  • Nurse Case Manager for home hospice patients.
  • Experience with inpatient hospice care.
  • Documented, tracked and reported timely patient care exceeding Medicare/Medicaid standards for homecare and hospice care patients.
  • Provided hospice care in outpatient settings ranging from assessment to development and implementation of care plans.

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4 Hospice Jobs

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5. Medical Conditions
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high Demand
Here's how Medical Conditions is used in Nurse Case Manager jobs:
  • Educated patient about medical conditions, alternative options available, and referred patient to available resources to maximize optimal outcomes.
  • Provided information to participants about their medical conditions and follow up instructions.
  • Ensured the Warrior received appropriate care related to identify medical conditions.
  • Experience with various medical conditions including Congestive Heart Failure, Chest Pain, Diabetes, Cancer, Alzheimer's and Hypertension.
  • Provided access to needed medical/mental health services in the community for low income children with rare and severe medical conditions.
  • Handle variety of medical conditions including trauma, orthopedic, cardiac arrest, respiratory failure, and burns.
  • Experience with various medical conditions including Parkinson's, Dementia, Diabetes, Cancer, and Alzheimer's.
  • Provide nurse care management services for over 100 service members with acute injuries or chronic medical conditions.
  • Facilitate care for an average case load of 20 Soldiers who have multiple medical conditions and complexities.
  • Evaluate Members with multiple chronic and post-acute medical conditions, physical, cognitive, and/or psychiatric disabilities.
  • Provide support and education to the patients regarding medical conditions, disease processes and treatment plans.
  • Care Coordination for Virginia Army National Guard Soldiers that have medical conditions requiring further care.
  • Educated clients on preventative health care, understanding of medical conditions and chronic disease processes.
  • Communicate with primary care physicians regarding current and changes in patients' medical conditions.
  • Managed acute and chronic medical conditions, performed assessments, and implemented care plans.
  • Case managed by assessing client's medical conditions and created nursing treatment plans.
  • Assisted Anthem members with complex medical conditions and situations in the Complex Care Program.
  • Provide education, resources, and support to mbrs with medical conditions as outlined and provided by their health benefits Emory Healthcare

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6. Utilization Review
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high Demand
Here's how Utilization Review is used in Nurse Case Manager jobs:
  • Case Manager, Wellington Regional Hospital Utilization review- Review patient data from admission to discharge determining criteria for admission.
  • Perform Utilization Review for physician's requests within Utilization Review guidelines/standards.
  • Submit requests for authorization of treatment to TPA utilization review department.
  • Performed Utilization review in accordance with company policy and procedure.
  • Preform Utilization review based on evidence based guidelines.
  • Perform Utilization Review according to established guidelines.
  • Coordinated weekly Utilization review meetings.
  • Maintained patient charts for utilization review and provided clinical information to third party payers in order to obtain authorization for care.
  • Nurse Case Manager for complex disease conditions, inpatient utilization review for hospitals, skilled nursing homes, and acute rehabilitation.
  • Assist with Discharge Planning, Utilization Review, Prior Authorization, Communication with Physician, Team Player, Compassionate
  • Worked with Utilization Review nurses in different hospital facilities for home care and other medical and surgical cases.
  • Assisted in obtaining National Certification for URAC (Utilization Review Accrediting Commission for UR and Case Management).
  • Reported to Vice President of Medical Affairs as well as Utilization Review Committee with data presentations monthly.
  • Perform utilization review (UR) on CA and NY claims, and other states upon request.
  • Served on various committees, Open Heart, Ethics, and Utilization Review.
  • Conduct utilization reviews in compliance with the state statutes.
  • Coordinate emergency and nonemergency transfers of patients, and complete Utilization reviews as needed with insurance providers.
  • Discharge planning and utilization review for 30 bed Orthropedic unit.
  • discharge planning, Utilization review, Quality Assurance.
  • BLUE CARE NETWORK Southfield MI AUDITING/UTILIZATION REVIEW/MANAGED CARE DUTIES: Acute Care/Rehab/Surgery Review.

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2 Utilization Review Jobs

No jobs at selected location

7. Social Workers
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high Demand
Here's how Social Workers is used in Nurse Case Manager jobs:
  • Refer patient to physical therapist, speech pathologist, occupational therapist and medical social workers for those requiring specialized skills.
  • Work closely with interdisciplinary team of doctors, rehab therapist, and social workers to develop comprehensive individualized plan of care.
  • Work collaboratively with Medicaid, Social Workers and Community Programs to ensure patients receive services to which they are entitled.
  • Coordinated care for a caseload of patients, collaborating with social workers, chaplains, physicians and bereavement staff.
  • Collaborated with family members, doctors, and social workers, in other facilities to maintain smooth transitions of care
  • Collaborated with therapist, social workers and home health aides to provide total patient care and empowerment.
  • Coordinated the services of the social workers, chaplains, volunteers, and certified nursing assistants.
  • Coordinated with MD, family, social workers, and vendors for Plan of Care.
  • Received referrals from hospitals, physicians, social workers and self-referrals for home hospice care.
  • Followed clients through home visits and phone contacts in collaboration with team social workers.
  • Worked with medical social workers and patient s family on long term care placement.
  • Assess need for case management and assist with social workers safe discharge plan.
  • Coordinate with physicians, nurses, Social Workers, Financial Counselors as needed.
  • Coordinate between pediatricians, specialist, schools, social workers and foster parents.
  • Maintained extensive communication with physicians, social workers, chaplains and pharmacy.
  • Consult with Social Workers, Physicians, and allied health administration.
  • Coordinated a multi-disciplinary team including nurses, physical and occupational therapists, social workers and nursing aides.
  • Increased continuity of care for members by collaborating with physicians, social workers, and other Health care professionals.
  • Lead team of LPNs, CNAs, social workers, clergy and admission coordinators to provide individualized palliative care.
  • Worked closely with Social Workers and monitored triggers that indicated psychosocial complexity, and facilited Social Services imvolvement when necessary.

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8. IV
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high Demand
Here's how IV is used in Nurse Case Manager jobs:
  • Screen patients for elective and/or preventable admissions and conversions from outpatient to inpatient as medically necessary.
  • Determine case direction, establishing specific rehabilitation objectives and goals towards physical and psychological recovery.
  • Managed individual injuries by obtaining and assessing medical information related to the injury.
  • Improved quality of nursing care by implementing comprehensive nursing evaluations and assessments.
  • Monitor and evaluate rehabilitative progress and obtainment of goals.
  • Coordinate and monitor participation in appropriate rehabilitative programs.
  • Case Management and Follow-up of rehabilitative patients.
  • Managed patient's medication, received orders from physicians, administered PO, IM, SQ and IV medication.
  • Assessed Hepatitis B positive pregnant patients for exposure risk and provided Hepatitis B education to clients and close contacts.
  • Observed nurses and visited patients at PPEC and other community settings to ensure they were medically receiving services needed.
  • Adhere to departmental goals, objectives, standards of performance and policies and procedure, and regulatory compliance.
  • Review charts objectively to determine support for admission, stay, level or care and discharge readiness.
  • Discharge planning for individuals on acute rehab/skilled nursing unit and chronic vent floor.
  • Evaluated the effectiveness and results of currently offered health care and programs.
  • Documented case activities and action plans in a SOAP note format.
  • Received extensive training in nurse case management.
  • Manage IV infusion request from providers.
  • Collaborated with physician and other healthcare members to ensure patient receiving optimal care.
  • Coordinated services organizing, securing and integrating multiple components of the healthcare system to deliver those services needed by the member.
  • Address nursing, psychosocial, and medicals of patients of their families/caregivers.

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18 IV Jobs

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9. Durable Medical Equipment
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high Demand
Here's how Durable Medical Equipment is used in Nurse Case Manager jobs:
  • Communicate with claims examiners, physicians, physical/occupational therapists, durable medical equipment providers and human resource contacts.
  • Collaborated with pharmacy and durable medical equipment companies to order medications and equipment for patients.
  • Order durable medical equipment and coordinate delivery to patient.
  • Coordinate with physicians and Durable Medical Equipment Companies to ensure that the patients get the equipment they need without any difficulty.
  • Anticipated need for home health nursing or therapists and durable medical equipment in accordance with Medicare or private insurance guidelines.
  • Discharge Plan developed for each patient, including proper placement, durable medical equipment, and home health/outpatient services.
  • Coordinated home health and durable medical equipment for members when they were discharged from the hospital to home.
  • Coordinate acquisition and proper use of durable medical equipment (DME), home care and medication management.
  • Assess and evaluate the need for durable medical equipment, negotiate payment and monitor maintenance follow up.
  • Review request's for treatment, surgery, and durable medical equipment as well as medication requests.
  • Set up patients with home health care or durable medical equipment as ordered by their physician.
  • Recommended durable medical equipment (DME) to nurse case manager to ensure patient safety.
  • Implement care such as negotiating the delivery of durable medical equipment and nursing services.
  • Coordinate outpatient services such as Durable Medical Equipment through the Contract Health Office.
  • Obtained durable medical equipment, medications, testing within a PPO.
  • Procured durable medical equipment/ other services for client's needs.
  • Managed durable medical equipment needs of members.
  • Assist with qualifying child for Durable medical Equipment, Home Care follow-up with Primary MD.
  • Arranged for home nursing visits and any durable medical equipment that may be needed.
  • Administered medications, wound care, and ordered durable medical equipment .

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2 Durable Medical Equipment Jobs

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10. Community Resources
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high Demand
Here's how Community Resources is used in Nurse Case Manager jobs:
  • Coordinate service delivery from external providers and community resources as necessary, conducting cost analysis and negotiating fees.
  • Mobilize patient and family to employ healthy coping strategies, engage in shared decision-making and utilize VA/community resources.
  • Integrated community resources and collaborated with interdisciplinary team and physician to meet client needs.
  • Provided case management services in coordination with community resources to provide comprehensive care.
  • Establish working relationships with referral sources and community resources.
  • Maintain awareness of community resources and funding.
  • Referred to community resources as indicated.
  • Assist patients to community resources, upload surgical cases in electronic medical record, order proper equipment for surgeries.
  • Utilize community resources to help neonate and family to transition home post hospitalization in high risk situations.
  • Assess the options for care including use of benefits and community resources to update the care plan.
  • Provide referrals and continued follow up to community resources and medical providers as the clients condition dictates.
  • Acted as PATIENT ADVOCATE; identified and developed new community resources; assisted with problem solving.
  • Coordinate specialty services with local civilian community resources / out-patient services not available on post.
  • Assured funding, benefits and /or community resources were available to implement medical protocols.
  • Provided discharge planning in collaboration with community resources to meet needs.
  • Referred members to providers, plan resources and community resources.
  • Advocated for patient needs and accessed community resources.
  • Refer members to community resources.
  • Provide members with support thru advocacy, disease education and community resources.
  • Developed and implemented a plan to educate Medicare recipients on Medicare Part D. Refer enrollees to community resources.

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6 Community Resources Jobs

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11. Disease Process
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high Demand
Here's how Disease Process is used in Nurse Case Manager jobs:
  • Provided extensive teaching on disease process, medication teaching and administration and nutrition/diet teaching.
  • Facilitate targeted instruction on disease processes and methods to prevent disease progression.
  • Conduct record review to ensure supporting clinical documentation for diagnosed disease processes.
  • Provided teaching in areas of post-surgical care, disease process, medication administration, application of treatments, nutrition and hydration.
  • Provided education to patients and family on their disease process and also worked with PCP on patient's plan of care.
  • Educate on disease process so members can gain the knowledge and skills to be proactive in their wellness to promote positive outcomes
  • Identified and assisted clients in the management of company targeted disease processes of congestive heart failure, diabetes, asthma.
  • Enabled patient to slow progression of disease process by encouraging proactive pursuit of asthma treatment services and support.
  • Skilled at patient assessment, teaching, and implementing the management of multiple disease process.
  • Delivered extensive patient education on complex specialty issues as well as multiple disease processes.
  • Educated patients and families on numerous medications, treatment options and disease processes.
  • Provide patient with teaching and education information on their specific disease process.
  • Provided teaching to patients and caregivers about their disease processes and medications.
  • Managed patient specific care plans to manage disease process improve patient outcomes.
  • Educated patients and families on death/dying, disease process and management.
  • Teach patient disease process and medication function and side effects.
  • Educated patients and their families regarding disease processes and medications.
  • Teach client/family about medication and their disease process.
  • Educated on disease processes and treatments and practices
  • Coordinate services and educate the patient/caregiver on diagnosed disease process and methods to prevent reoccurence or complications.

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12. Insurance Companies
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high Demand
Here's how Insurance Companies is used in Nurse Case Manager jobs:
  • Prepared insurance authorizations using ICD9 coding, worked directly with various insurance companies case managers.
  • Assisted physicians and other clinicians with medication orders, communicating with pharmacies and insurance companies.
  • Communicated with insurance companies for authorization for skilled nursing visits.
  • Managed workers compensation claims for numerous insurance companies.
  • Collaborated with insurance companies to obtain authorizations.
  • Interacted with physicians, insurance companies, patients and their families, and outside medical personnel.
  • Formed working relationships with other nurse case managers, patients, and work comp insurance companies.
  • Assessed patient status & notify doctors and insurance companies for authorization based on clinical changes.
  • Worked with physicians and insurance companies to manage care and discharge planning of I.C.U.
  • Performed initial reviews, concurrent reviews, and denial appeals to insurance companies.
  • Developed and marketed a cardiac home care program to physicians and insurance companies.
  • Negotiate rates with out-of-network insurance companies as needed.
  • Travel Case Manager for Workers Comp Insurance Companies.
  • Manage patients with chronic disease, coordinating information flow among multi-disciplinary medical team, pharmacological, and insurance companies.
  • Conducted precertification of inpatient and outpatient psychiatric services for four major insurance companies nationwide.
  • Coordinate Pre-certifications with insurance companies and manage appeals for services denied.
  • Obtain pre-certification; continue stay and medical update to insurance companies, Medicare and Medicaid.
  • Can work telephonically to maintain open dialogue with claimants and insurance companies.
  • Discharge planning, utilization review for various insurance companies including medicaide, review for unbilled claims and retro reviews/submissions.
  • Obtained preauthorization and authorization for home health patients from insurance companies and HMO's.

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13. Medical Care
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high Demand
Here's how Medical Care is used in Nurse Case Manager jobs:
  • Provided short-term medical care/monitoring and educated patient, family, and private caregivers in care at home and disease management.
  • Reviewed claims for appropriateness of medical care and cost-effectiveness of treatments rendered.
  • Provide direction for prompt, appropriate medical care, cost containment, return to work, and promote maximum medical improvement.
  • Provided expert and compassionate medical care to patients including educating clients on diabetic care, would care, and physical restrictions.
  • Assist soldiers with profiles connect with medical care and understand options available for being medically boarded or returning to duty.
  • Update students charts, contact parents, assist parents in finding free or low cost medical care in the community.
  • Direct contact for spouses of wounded members for follow up regarding medical care and appointment schedules.
  • Coordinate care among employee, supervisor, medical care provider, labor union, EHS Department.
  • Ensured patients received appropriate and timely medical care to facilitate safe return to work.
  • Oversee the general psychiatric and medical care of adolescents enrolled in mental health treatment.
  • Assess appropriateness and coordinate medical care for 45 cases for early return to work
  • Coordinated, managed, and assessed medical care and return to work efforts.
  • Coordinated between carriers, medical care providers, employers and employees.
  • Provide medical care to various types of patients including IV Rx
  • Coordinated telephonic and on site home medical care.
  • Provide on-site medical care for injured co-workers.
  • Authorize medical care with the appropriate criteria.
  • Audit medical care of the disability patient.
  • Facilitate medical care in a timely manner and interact with strategic partners to obtain or clarify clinical information.
  • Coordinated care with APN/MD and other healthcare medical providers to ensure access to primary health care and medical care specialty appointments.

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4 Medical Care Jobs

No jobs at selected location

14. RN
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high Demand
Here's how RN is used in Nurse Case Manager jobs:
  • Served on committee to develop/revise national internal treatment guidelines for company with medical director Dr. Melissa Bean.
  • Instructed patient/families/caregivers/ regarding management of identified and potential physical, emotional and environmental health concerns.
  • Maintained a professional and amicable working relationship with plaintiff and defense attorneys.
  • Establish collaborative relationships and work as an intermediary between clients, injured workers, employers, providers, and attorneys.
  • Tracked patient participation in treatment through direct contact with physicians, attorneys and facilities at various scheduled intervals.
  • Coordinated the safe and timely return to work of employees experiencing lost time due to injury.
  • Communicated and kept appointments with patients, medical providers, attorneys, employers and insurance carriers.
  • Developed and instructed childbirth and newborn care classes available to women living in Arlington County.
  • Assisted with discharge planning of international patients to Central America, Middle East and China.
  • Attended physician appointments to discuss medical diagnosis, treatment plan, and occupational concerns.
  • Led team through multiple external audits and sales presentation with excellent outcomes.
  • Coordinated return to work issues between client, physician, and employers.
  • Provided care as a weekend and evening PRN Nurse Case Manager.
  • Developed and instituted Lunch & Learn for Case Management Staff.
  • Expedited employee's return to work when appropriate.
  • Applied Reiki Therapy to patients requesting alternative medicine services.
  • Supervised 14 staff; 7 RNs, 6 Psych Techs, and 1 Administrative Asst.
  • Supervised 17 staff; 8 RNs, 8 Psych Techs, and 1 Administrative Asst.
  • Managed daily Schedules and assignment for 10 RN, 8 CNA, 4 RT .
  • Collaborated with pulmonologist, nephrologists, internal medicine, respiratory therapists and physical therapists to provide evidence based care.

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14 RN Jobs

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15. Medical Records
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average Demand
Here's how Medical Records is used in Nurse Case Manager jobs:
  • Reviewed cases and medical records for eligibility to authorize transfers from the hospital setting to the sub-acute setting for rehabilitation.
  • Audited electronic medical records selected by fiscal intermediary and composed cover letters to highlight documentation supporting payment of claims.
  • Analyze authorizations and medical records in accordance with specified departmental policies and procedures.
  • Reviewed medical records and interviewed injured employees.
  • Obtained medical records to confirm ongoing disability.
  • Review medical records, submit status reports, and billing invoices, made recommendations regarding fitness for duty issues.
  • Reviewed claimant's medical records and made recommendations to the claims analysts based on available information.
  • Assessed and navigated the electronic medical records and the patient care software (OASIS).
  • Reviewed medical records and nurse calls to check for specific quality measures and care delivered.
  • Review and abstract relevant data from medical records, using Surgical Compliance Improvement Process.
  • Recorded patient's medical history, vital statistics and test results in medical records.
  • Review of claimant's medical records to insure proper services are rendered.
  • Maintain medical records and reports for claim management and medical review.
  • Review of Medical records, medications, consultations and appointments.
  • Organize and obtain medical records.
  • Obtain medical records from providers telephonically during initial contact, and follow up with written correspondence if necessary.
  • Perform QA of patient's medical records, authorizations, and assess nursing skill for homecare services.
  • Call medical providers and specialists to retrieve medical records pertaining to the claim being processed.
  • Manage cases of children in foster care system Request medical records Tracked statistics for each nurse and reported findings to management
  • Play Part in the Interdisciplinary Team Evaluate Client's Medical Records Assisting Medical Doctor Administration of Medication and Treatment

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1 Medical Records Jobs

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16. Medication Management
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average Demand
Here's how Medication Management is used in Nurse Case Manager jobs:
  • Collaborated with multidisciplinary team to provide primary care, case management, medication management, and administration of IV medications/TPN.
  • Coordinate with physicians and psychiatrists for physical and mental health evaluations, observations and medication management.
  • Evaluated medication management and communicated observed patient response to various therapies to our staffed physicians.
  • Provide patient/ family teaching focused on medication management and issues relevant to recovery.
  • Work with child psychiatrist to maintain monthly medication management appointments for therapeutic children.
  • Educated patients and families on chronic disease and medication management usage and safety.
  • Provided education groups sessions to students on medication management and side effects.
  • Executed assessments and reviews, including coordination of pain medication management.
  • Monitor medication management and adherence to medical treatment.
  • Provided patient education and medication management.
  • Traveled to multiple patient homes daily, performing various and complex therapies based on patient needs, education and medication management.
  • Make home visits for patients for wound care, injections, medication management and well check follow ups.
  • Provide IV therapy, wound care therapy, Medication management, disease management and patient education.
  • Assisted with medication management, housing, payee for residents who had difficulty paying their bills.
  • Experienced in OASIS documentation, IV administration, wound care, pain management and medication management
  • Provide health education, and medication management teaching to clients as needed.
  • Directed facility's Medication Management program to private clients in their homes.
  • Managed case for residents, provided wound care, IV's ostomy care and assessed/instructed on medication management.
  • Provide comfort, counseling, and education to families in regards to disease progress and medication management.
  • Evaluate and coordinate patient care with-in all disciplines Wound care Medication management, electronic documentation.

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17. Primary Care Services
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average Demand
18. Interqual
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average Demand
Here's how Interqual is used in Nurse Case Manager jobs:
  • Streamline patient throughput by identifying the most appropriate level of care using InterQual standards.
  • Utilize InterQual criteria to assure appropriate levels of care are utilized.
  • Reviewed clinical documentation for medical necessity,quality of care and utilization in accordance with InterQual criteria.
  • Reviewed admissions for appropriate bed status and determined estimated length of stay using Milliman or InterQual criteria.
  • Review charts for admission criteria using Interqual software and make recommendations to residents and interns accordingly.
  • Utilized Interqual criteria for medical necessity and reimbursement.
  • Utilize Interqual Criteria in the utilization management process.
  • Approved; Denied; or Elevated authorization requests to Medical Director based on Medicare Guidelines; Interqual Guidelines and nursing judgment.
  • Perform discharge planning and utilization reviews using the McKesson Interqual Program for all specialties within the acute care arena.
  • Utilized accepted criteria (Interqual) and case management standards as defined by CMSA in the review process.
  • Provided thorough supervision for day-to-day level of care in accordance with Interqual and other payer guidelines.
  • Case management and utilization review of medical record daily using Midas and Interqual tools.
  • Enter cases using specialized computer programs specific to ICD-10 coding and Interqual criteria.
  • Assess patient's appropriate level of care using Interqual criteria.
  • Utilize Interqual and DRG's to justify patient admission.
  • Used Interqual software for UR.
  • Used Interqual and M&R criteria.
  • review patient's charts daily doing Interqual on patient stays updating insurance companies with patient progress and plan of care
  • Use of Milliman and Interqual criteria.
  • Lead Case manager, ICU & Peds (UR, transfers, discharges, DMEs) InterQual

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19. Medical Necessity
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Here's how Medical Necessity is used in Nurse Case Manager jobs:
  • Reviewed and adjudicated workers compensation claims for justifiable jury and medical necessity in accordance with medical standards and insurance policies.
  • Utilized clinical skills in processing requests for authorization of services, reviewing for medical necessity and appropriateness of treatment.
  • Initiated and provided authorizations as well as denials for admission and/or outpatient consultations based on medical necessity.
  • Monitor medical management of care for PIP patients including establishing medical necessity and causality of injuries.
  • Perform utilization review ensuring admissions meet criteria for appropriateness of care and medical necessity.
  • Review of medial information for determination of medical necessity and approval of time off.
  • Performed medical necessity/Utilization reviews on treatment requests using appropriate clinical and statutory guidelines
  • Obtained clinical updates for concurrent review to establish medical necessity.
  • Reviewed cases for medical necessity.
  • Monitor labs, radiography and care of patient to ensure medical necessity and cost effectiveness while remaining a patient advocate.
  • Evaluate Patient Care Plans, Assess for Medical Necessity, Authorize/Coordinate Patient Care, Submit Review Medical Doctor to Review
  • Reviewed cases for medical necessity of the appropriate treatment in areas of Medical Management and Worker's compensation.
  • Evaluated and responded to provider appeals for denied claims to determine if medical necessity and/or criteria met.
  • Review clinical information pertaining to request for transplant (organ and bone marrow) for medical necessity.
  • Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness.
  • Evaluate and review patients for medical necessity of care on a daily basis.
  • Reviewed prior and retroactive reviews for medical necessity; ensured HIPAA compliance.
  • Provided clinical reviews both telephonically/on-site to insurance payer sources, to establish medical necessity required for authorization of payment.
  • Performed utilization review for medical necessity and referred questionable services to physician advisors for review and decision-making.
  • Review All aspects of the patients health care needs for medical necessity based on their Chronic conditions.

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20. Physical Therapy
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Here's how Physical Therapy is used in Nurse Case Manager jobs:
  • Coordinated any referral for Physical therapy, Occupational therapy, speech therapy, Medical social worker and any other required services.
  • Registered nurse- certify and audit chiropractic / physical therapy bills and medical treatment for a worker's compensation/rehabilitation company
  • Coordinate patient care with medical care provider, physical therapy, occupational therapy and medical social worker.
  • Set up physical therapy per injury with re-evaluation with physician and injured worker/Employer.
  • Managed care with family, personal physicians, physical therapy, and occupational therapy
  • Coordinated Diagnostic testing, physical therapy, physician appointments for Injured workers.
  • Attend appointments to attorneys, medical providers, and physical therapy to monitor the treatment plan and goals of current treatment.
  • Developed the training for the cardiac home program for nursing, physical therapy, occupational therapy, and home health aide.
  • Managed caseload of over 350 clients, setting appointments, treatments, physical therapy, emergency and specialist care.
  • Coordinate care as approved by the insurer for physical therapy, durable medical equipment and home health services.
  • Worked with physical therapy to help ensure patients met goals set for them according to their needs.
  • Coordinate care with surgeons, diagnostic testing, physical therapy and primary care physicians, etc.
  • Retrieve all doctor notes and physical therapy notes post appointments for each client.
  • Coordinated medical and physical therapy appointments for employees injured on the job.
  • Coordinated physical therapy and surgeries for special needs children.
  • Performed case management and pre-certification reviews of surgical, diagnostic and physical therapy services.
  • Worked well with other disciplines such as PT (Physical Therapy), OT (Occupational Therapy) and Speech therapy.
  • Provided total care for homebound patients with daily physical therapy, allowing them to remain in their homes with family.
  • Lead and supervise the SN, Physical Therapy, Occupational Therapist, Medical Social Work, andHome Health Assistant.
  • Coordinate RNs, LPNs, and Physical therapy frequencies.

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21. Providers
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Here's how Providers is used in Nurse Case Manager jobs:
  • Participated in coordinating clinically based activities between the members, providers, and community based health organizations.
  • Communicated with requesting providers, service providers via telephone and fax to request needed information.
  • Communicated with members and providers to assess quality and appropriateness of care post-hospital discharge.
  • Negotiated treatment requests between providers and physicians.
  • Collaborate with a variety of external providers to obtain necessary services, equipment, and home modifications required by the clients.
  • Coordinate discharge and transport details; follow-up with insurance providers to facilitate reimbursement; Organize Family and IDC team meetings.
  • Facilitate the coordination of care for the veteran population assigned to staff SCI/D physicians and/or other providers as appropriate.
  • Collaborated with providers, employers, injured workers, third party administrators, and attorneys on BWC claim cases.
  • Coordinated requested services with network providers on placing durable medical equipment and oxygen supplies to patients in their home.
  • Document discharge summary to HAIMS to influence care outcomes by collaborating with medical providers of the interdisciplinary team.
  • Serve as primary contact for members and providers for management of chronic conditions and case management needs.
  • Assess patients for mental health and substance abuse issues and make referral to appropriate community providers.
  • Coordinate patient care with providers and ensure continuity of care for over 200 patients.
  • Worked with providers and supervisors to return employees to work as soon as possible.
  • Coordinate with parents and outpatient providers to ensure that treatment is after discharge.
  • Developed training materials for Providers, which incorporate 5-Star and HEDIS metrics.
  • Coordinate care with multiple providers across all levels of sites of care.
  • Provided guidance for medical providers, review, and managed care.
  • Interact closely with physicians, employees and external healthcare providers.
  • Coordinated workers' compensation medical benefits between injured employees and treating healthcare providers, including meeting with claimants and healthcare providers.

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22. High Risk
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Here's how High Risk is used in Nurse Case Manager jobs:
  • Identify patients with potential for high risk complications and coordinate the appropriate supported self-care with the patient and care coordination team.
  • Monitor patients for High risk status for re-hospitalization arranging with PCP and High Risk management Clinics to follow post hospitalization.
  • Manage a caseload of high risk, high cost, and complex patients by assessing the injured/disabled individual s needs.
  • Provide case management support to those that have been identified as high risk for an adverse health outcomes.
  • Provided case management via telephone, to high risk pregnant women, who were being monitored through home-technology.
  • Provided case management for high risk obstetrical patients and NICU babies as well as children with special needs.
  • Negotiated rates for high risk medical, catastrophic, transplants, and HIV and rehabilitation cases.
  • Participate in face to face visits with high risk members at point of service as needed.
  • Access technology systems for identifying high risk patients through referrals from insurance payer information data base.
  • Post discharge calling on all patients and created a census for our high risk patients.
  • Case management for high risk behavioral health cases and medical board review.
  • Identify high risk, high cost, or high utilization cases.
  • Overflow care of high risk pregnancy, adult and geriatric patients.
  • Analyzed high risk patients and provided care according to requirement.
  • Nurse Case-manager for 35-45 high risk patients a week.
  • Nurse Case Manager Health Coach for high risk members.
  • Managed high risk patients with multiple socio-economic, medical and safety issues.
  • provide emergency assessment for clients and case manage high risk clients.
  • Case manage an LPN, assigned to high risk of rehospitalization team.
  • Review readmissions of the high risk population to identify possible causes of readmissions !

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23. LPN
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Here's how LPN is used in Nurse Case Manager jobs:
  • Supervised LPNS directly and indirectly.
  • Directed LPNs and Home Care Aides in carrying out the established plan of care.
  • Managed, supervised, and evaluated two LPNs to ensure quality care and documentation.
  • Delegated tasks to the LPN, as well as assisted in training.
  • Supervised care provided by LPN and/or home health aides.
  • Supervised teams of licensed practical nurses, or LPNs.
  • Supervised/oriented RN, LPN, CNA staff.
  • Delegate patient visits as appropriate to LPN.
  • Monitored LPN and PCA work.
  • Serve as a Charge Nurse to RN's, LPN's and CNA's as well as other ancillary staff.
  • Make 8 to 12 visits daily, supervise HHA's, LPN's.
  • Manage LPN's and CNA's to provide the best patient care.
  • Delegate appropriate jobs to LPN's and HHA's.
  • Supervised LPN's and HHA's.
  • Trained new nurses on the computer and oriented them to their job, and supervised a staff of CNAs and LPNs.
  • Charge nurse with the responsibility to supervise 2 RNs, 2 LPNs, and a health assistant.
  • Coordinate care with other disciplines.Supervise Home Health Aides and LPN as needed.
  • Provided skilled nursing cares and supervised nurse aides and Lpn's.
  • Served as educator to RNs and LPNs.
  • Lead a top-performing team of RNs and LPNs, including prioritizing work_low to meet nursing goals.

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24. Diabetes
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Here's how Diabetes is used in Nurse Case Manager jobs:
  • Provided group diabetes education classes at community centers and physician offices.
  • Coordinate and developed two disease management programs for cardiovascular and diabetes.
  • Continue responsibilities of Diabetes Case Manager position.
  • Educate patients with multiple diagnosis such as CHF, diabetes, cardiac, post-op, urological, respiratory and neurological.
  • Provide disease management education for chronic conditions (chronic obstructive pulmonary disease, diabetes, heart failure, renal disease)
  • Educated and assessed patients with type 1, type 2, and gestational diabetes in diabetes self-management education and training.
  • Worked with clients having a diagnosis of Asthma, Diabetes, Hypertension, High Risk Maternity, substance Abuse.
  • Plan, develop, and execute community health screenings, targeting high-risk populations and hosting quarterly diabetes support groups.
  • Provided individual and classroom teaching for chronic disease management with focus on diabetes, obesity and smoking related illnesses.
  • Cared for and provided housing and supervision for a high-risk foster child who suffered from diabetes.
  • Achieved a case load of 275 clients (Diabetes, CAD and respiratory disease).
  • Nurse leading Diabetes Special Needs Plan disease management program for Medicare seniors.
  • Created patient education programs on Asthma, Diabetes and Infant CPR.
  • Assisted in education on Diabetes in a total of 8 classes.
  • Case Manager for diabetes and pregnant mothers.
  • Case Management of Diabetes and Infectious Diseases.
  • Conducted health and wellness classes for the * community: Diabetes Journey For Control, CDSMP, and Asthma Ready Communities.
  • Recruited to manage 200 cases of U.S. railroad systems employees primarily suffering from diabetes.
  • Trained as Diabetes Educator by Brody School of Medicine at ECU.
  • Case Manager of high-risk, co-morbid clients (ie: hyperlipidemia, hypertension, depression, diabetes, etc.)

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25. Medication Administration
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Here's how Medication Administration is used in Nurse Case Manager jobs:
  • Provide hands-on-nursing care to patient s including wound management, medication administration reminders, reordering and profiling medication with hospice pharmacy.
  • Scheduled and coordinated doctor appointments; maintained HIPPA regulations; oversaw medication administration and management and physician orders.
  • Maintained nursing station: including reference materials, client insurance and health related information and medication administration records.
  • Provided instruction to patients and household members regarding in home care medical care techniques and medication administration.
  • Skilled at medication administration, planning, coordination and delivery of all interdisciplinary team interventions.
  • Provide medication administration in combination with skilled nursing visits to variety of patients.
  • Participated in therapy, provided medication administration, education regarding such.
  • Assessed and educated patients and their families with medication administration.
  • Evaluated current medications via the medication administration records.
  • Review self medication administration with patients for competency.
  • Re-certified AMAP employee on medication administration.
  • Teach patients home medication administration.
  • Direct care and management of TBI clients and medication administration education and training for newly employed patient care technicians.
  • Provided direct patient care for medication administration and teach/train patients on how to administer at home.
  • Provide personal care, lab draws, IV therapy, wound care, and medication administration.
  • Perform intramuscular/ subcutaneous injections, immunizations, medication administration, and venipuncture blood draws per physician orders.
  • Delegate medication administration to CMTs and perform medication demonstration and ongoing competencies.
  • Managed caseload for 30-35 patients, providing education, treatments, venipuncture, injection/medication administration and wound care.
  • Conduct psycho-educational sessions Facilitate group therapy and multidisciplinary treatment planning Nursing intake assessments / Medication administration
  • Provided nursing care to post operative and homebound patients Assessment, medication administration, wound care, personal care.

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26. Care Coordinator
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Here's how Care Coordinator is used in Nurse Case Manager jobs:
  • Maintained regular communication with the patient-care coordinator.
  • Care coordinator for home care patients, performing required CMS/485 documentation in a timely, accurately, and efficiently manner.
  • Assume a consultation, coordination, and advisory role between Care coordinators, providers, and commands.
  • Serve as a patient care coordinator for active duty service members who are returning from deployment.
  • Introduced self to patient and family and explains clinical Case Manager/Care Coordinator role.
  • Maintained regular communication with the patient care coordinator and other hospice staff.
  • Worked as one of the first nurse care coordinators on the floor.
  • Implemented clinical practices, procedures and standards for LVN Care Coordinators.
  • Serve as Clinical Care Coordinator for the Warrior Transition Service.
  • Care Coordinator/Case Manager for 550 aircrew and dependents.
  • Care Coordinator Nurse for the Inland Empire.
  • Acted as a clinical resource to department care coordinators, providedexpertise and clinical knowledge.

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27. Mental Health Services
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Here's how Mental Health Services is used in Nurse Case Manager jobs:
  • Connect clients to social services, mental health services, health and governmental agencies.

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28. Medical Treatment
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Here's how Medical Treatment is used in Nurse Case Manager jobs:
  • Work very closely with TPA adjusters with constant communication regarding injured workers medical treatment and work status activity.
  • Authorize medical treatment and associated diagnostic testing on assigned claims as allowed by state or policy jurisdictions.
  • Reviewed medical for approval of medical treatment and presentation to medical physician team on treatment denials.
  • Assess medical treatment for reasonable/necessary and actively assist with return to work.
  • Assisted with medical management/coordination of medical treatment for workers' compensation claims.
  • Assessed and implemented medical treatment within parameters of specific health plan benefits
  • Determined the extent of medical treatment recommended.
  • Assist in coordinating the injured worker's medical treatment via telephone contact with the claimant, adjuster and treating providers.
  • Coordinated clients' medical treatment and return to work with goal of ensuring appropriateness of care while managing costs.
  • Reported to Claims Examiner every 30 days regarding status of medical treatment for each Injured Worker.
  • Review medical treatment and work status of injured workers and relay work status to managers.
  • Assessed medical treatment and services to determine further appropriate services needed for the individual.
  • Educate and guide employees and managers with the injury reporting and medical treatment process.
  • Review requests for medical treatment on Worker's Compensation Injuries.
  • Recommended course of medical treatment.
  • Maintain professional working relationships with workers compensation team that includes onsite occupational health and medical treatment facilities for injured workers.
  • Educated injured workers and employers regarding all aspects of medical treatment from pre-op to post-op and rehabilitation.
  • Assess referrals for case management needs including but not limited to medical treatment, psychosocial or financial needs.
  • Coordinate the Medical treatment of the injured worker and his return to work when appropiate.
  • Work closely with Physician Reviewers to help guide the claimants medical treatment.

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29. Symptom Management
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Here's how Symptom Management is used in Nurse Case Manager jobs:
  • Provided comprehensive education to staff and caregivers in the administration of medications necessary for symptom management and pain control.
  • Developed trusting relationships with both patients and caregivers by responding immediately to their general concerns and symptom management issues.
  • Provide education to patients and families based on particular hospice diagnoses and symptom management.
  • Coordinated with the interdisciplinary team regarding symptom management and plan of care.
  • Provided comprehensive physiological and psychological care for patients at the end stage of their lives, including pain and symptom management.
  • Provide Holistic Nursing care to clients who are in the process of dying or in need of symptom management.
  • Provided quality nursing care with special emphasis on symptom management, emotional support, and end of life care.
  • Managed patients' cases including pain and symptom management, education, admissions and weekend on-call after-hours support.
  • Provide symptom management, lead palliative care, and support patients and their families at end of life.
  • Educated patients and caregivers on the end stage disease process, safety issues and relevant symptom management.
  • Offer teaching and education to patients and families on disease progression, treatment options and symptom management.
  • End of life care, pain and symptom management, providing compassionate listening and counseling skills.
  • Monitored patient status, modified plan of care as necessary, with focus on symptom management.
  • Developed and increased knowledge of pain and symptom management for Palliative Care patients' through-out hospital.
  • Assisted with funeral planning, medication/symptom management, served as a liaison between doctor and patient.
  • Perform Assessment and symptom management and other care measures required throughout the hospice process.
  • Assist in symptom management treatment and palliative care through support and education.
  • Pain and symptom management under supervision of attending MD and Medical Director.
  • Reviewed patients in hospital setting to Assess appropriateness for In-Patient setting for symptom management at end of life.
  • Served as afterhours triage nurse, performed home visits for symptom management/death visits.

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30. Appropriate Level
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Here's how Appropriate Level is used in Nurse Case Manager jobs:
  • Collaborated with patients and families to place patient in appropriate level facility post-discharge.
  • Determine medical necessity and appropriate level of care.
  • Assisted hospital based Discharge Planner in establishing criteria to ensure appropriate level of care setting to the lower level of care.
  • Determine medical necessity of treatment, justify the appropriate level of care, and the authorized lengths of stay.
  • Assessed inpatient and outpatient services for medical necessity and appropriate level of care for financial risk HMO contracts.
  • Focus on reduction of Length of stay and optimization of appropriate level of acuity and delivery of services.
  • Ensured appropriate level of care for patient, at the same time ensuring medicare money being spent appropriately.
  • Negotiated rates with out-of-network providers to provide the appropriate level of care and monitor cost savings.
  • Advanced review of admissions through telephonic review to ensure medical necessity and appropriate level of care.
  • Conduct field visits and telephonic reviews to ensure medical necessity and appropriate level of care.
  • Documented pertinent information regarding progress of the patient and assessments for appropriate level of care.
  • Completed assessments and determined the appropriate level of services for new members.
  • Coordinate care with on-site physicians to determine appropriate level of care.
  • Reviewed inpatient/observation admissions to ensure appropriate level of care and medical necessity using InterQual critieria.
  • Review initial physical assessment for medical necessity to determine appropriate level of treatment and duration.
  • Review all pending inpatient and observation patients medical records for appropriate level of care, using Interqual Criteria and clinical experience.
  • Identify and modify barriers to goals, outcomes and timeframes while optimizing appropriate levels of care and cost efficiency.
  • Completed IRF PAI documentation in a timely manner to optimize reimbursement and ensure appropriate level of care for patients.
  • Performed telephonic and onsite reviews to validate appropriate levels of care.
  • Admit to appropriate level of service utilizing health assessment data.

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31. Pain Management
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Here's how Pain Management is used in Nurse Case Manager jobs:
  • Provide individualized disease management, health coaching and chronic pain management for clients to ensure optimal recovery and well-being.
  • Educated patients and their families on disease processes, medical-surgical procedures, including medication and pain management techniques.
  • Promoted medication and pain management techniques to support disease management and recovery and maintain wellness.
  • Established appropriate treatment plans in compliance with applicable insurance regulations Referred cases to health/ disease and chronic pain management programs.
  • Collaborated with primary MD's and Hospice Medical Director as needed to meet patients' changing pain management needs.
  • Educated patients and families on wound care, disease management, medication administration, nutrition, and pain management.
  • Determined if patient treatments such as physical therapy, pain management, testing and surgery were appropriate and necessary.
  • Assisted the physician in educating the family on death and dying process, grief and loss and pain management
  • Perform direct palliative patient care as needed during home visits including assessment, symptom and pain management.
  • Performed pain management and made patients comfortable, maintain quality of life for terminally ill patients.
  • Provided education on end of life care, pain management and hands on care.
  • Implemented palliative (comfort) care/pain management to relieve suffering.
  • Pain management, palliative care, wound care.
  • Pain management, patient and family counseling.
  • Pain Management Program Coordinator R.N.
  • Coordinate their medical appointments, Physical Therapy, Rehabilitation, Radiological examinations, Specialty appointments and Pain management.
  • Worked in a multi-disciplinary pain management center.
  • Assisted with pain management, wound care, personal care and IV therapy.
  • Develop individual POC Managed all health concerns with a focus on pain management.
  • Pain management initial assessments Routine visits and admissions Provide emotional support to patients and their families Collaborated with all team members

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32. Health Education
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low Demand
Here's how Health Education is used in Nurse Case Manager jobs:
  • Provided health education including patient screening programs for blood pressure, cardiovascular and smoking cessation.
  • Evaluated health education needs of patients and provided necessary training and instruction.
  • Provided necessary health education training for patients and caregivers.
  • Develop and present health education and promotion programs, such as training workshops, conferences, and community presentations.
  • Coordinate Social Services for At-Risk High School Students Develop Health Education Curriculum Provide Nursing Care to At-Risk High School Students
  • Provided health education and case management to high risk pregnant women and at risk children and their family.
  • Provide training/ health education to foster/birth parent and staff in the practice of preventive health and safety measures.
  • Provide health education and coaching on core conditions, educate on disease process and healthy lifestyle changes.
  • Implement interventions based on data including health education measures for clients and increased safety procedures for employees.
  • Planned, organized and directed Hospice care utilizing the nursing process with emphasis on community health education.
  • Provide community-based mental health education and outreach for public school (PTA) and juvenile justice system.
  • Supplied health education, assessment, and monitoring to members enrolled in chronic disease management program.
  • Educated patients and their caregivers regarding health education, disease prevention, diet, physical activity.
  • Conducted complete health risk assessments to provide members with disease specific and general health education.
  • Provide health education and consultation services to clients and family members.
  • Implemented health education and acted as patient - physician liaison.
  • Provide health education, coaching and decision support for members.
  • Group and individual health education and home safety assessments.
  • Provided health education and advice to clients.
  • Provided multi-disciplinary service planning, counseling, material aids and health education.

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33. Milliman
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low Demand
Here's how Milliman is used in Nurse Case Manager jobs:
  • Used Milliman Guidelines to review and critique clinical information in order to facilitate appropriate level of care following hospital discharge.
  • Utilized Milliman Guidelines and Medical Policy to deliver authorization according to URAC standards.
  • Evaluate care based on facility Utilization and Milliman Care Guidelines.
  • Performed utilization review using Milliman guidelines.
  • Employed Milliman care guidelines and the QNXT claims processing system to conduct concurrent review, utilization management and prior authorization.
  • Utilized Milliman, Medicare and Medi-Cal, InterQual and SI/IS to establish the medical appropriateness of treatment plans.
  • Determined medical necessity of the requested admission using MCG (Milliman) Guidelines.
  • Possess basic knowledge of McKesson (InterQual) and Milliman Care Guidelines.
  • Review and process authorization requests based on the Milliman Care Guidelines.
  • Educated on Milliman care guidelines, CPT and ICD9 codes.
  • Experience in the use of Milliman Care Guidelines and InterQual.
  • Adhere to CMS and Milliman Care Guidelines.
  • Utilized InterQual & Milliman Criteria.
  • Perform utilization & concurrent review of inpatient & outpatient services based on medical necessity according to Milliman & Interqual guidelines.
  • Utilized Milliman criteria for preauthorization and concurrent review of hospital admissions.
  • Utilize Milliman & Robertson or Inter- Qual criteria for the management of complex/chronic cases, and utilization management in general.
  • Managed and coordinated acute, short stay and long term care of patient utilizing Interqual and Millimans Care Guidelines.
  • Assured clients were meeting medical criteria for admission based on Milliman and Interqual Standards.
  • Utilized Milliman and Interqual to determine severity of Illness and intensity of treatment.
  • Coordinated services using Alineo, Aerial, Milliman and Lotus computer programs.

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34. Picc
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Here's how Picc is used in Nurse Case Manager jobs:
  • Administer medications, IV medications, PICC and central line care, lab draws and do wound and catheter care.
  • Initiated, maintained, and inserted PICC lines, IV access sites, and accessed port sites.
  • Provided all PICC and cardiology care and education to patients in each medical/surgical group as consulted.
  • Performed clinical tasks according to home health policies ranging from IM injections to PICC line care.
  • Conduct physical and psychological assessments, administers oral, IV, and PICC line medications.
  • Experience with PICC lines, home infusions, wounds, major and minor surgeries.
  • Access through PICC, Ports and capable of inserting peripheral IV's.
  • Provided PICC line insertions for inpatients and started PICC Team.
  • Administer Medications; provide PICC line care and maintenance.
  • Assist on the floor as needed with IV insertion and medications, PICC line care and medication administration and Suprapubic catheters.
  • Provide educational supportin the field for clinical staff via skill in services- PICC lines/IV management and EMR training.
  • Cared for clients by starting IVs, accessing Ports, assisting with therapy using PICC lines.
  • Managed medications, catheter care, picc line care, and provided assistance with daily activities.
  • Manage respiratory concerns and ventilator issues, PICC lines, gastroenterology and urology needs.
  • Evaluated PICC, Ports, IV sites, changed dressings as indicated.Professional
  • Maintained PICC lines, Port-a Cath and peripheral lines.
  • Placed PICC lines and peripheral IV's in home-bound patients * Taught IV classes including central line de-clotting protocols Select Home Health
  • Performed wound evacuation, Ng-tubes, G-tubes, IV's, IVIG, Picc/Central lines, Ports and Foleys.

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35. Medical Needs
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low Demand
Here's how Medical Needs is used in Nurse Case Manager jobs:
  • Collaborated with multidisciplinary health care team to ensure all medical needs were addressed.
  • Facilitated patient connections with community resources to assist with complex medical needs.
  • Participate in interdisciplinary team process to manage behavioral and medical needs.
  • Developed long-range plans that recognized personal, emotional and medical needs.
  • Interviewed injured workers on referral and in regular follow up to determine medical needs, progress and adherence to treatment plan.
  • Assured appropriate implementation and ongoing monitoring of patient discharge plans, medical needs and equipment/supplies Clinical Staff Nurse, Case manager
  • Case Managers facilitate clinical solutions and coordinate cost management opportunities for members with short and long term medical needs.
  • Accompanied and attended PCP appointments with clients to advocate client's medical needs and prioritize plan of care.
  • Evaluated patient's physical condition and developed a care plan to address the medical needs of the patient.
  • Utilize nationally appropriately to Medical Director when medical needs of services are not met based on the criteria.
  • Insure the medical needs of the client/family are the primary consideration when validating the decision for transfer.
  • Assess and determine patient's acuity of care to ensure his/her medical needs are met accordingly.
  • Request and review records to ensure medical needs are met while at the facility.
  • Assist Soldiers in developing SMART goals specific to their medical needs.
  • Educated patients & families based upon their individual medical needs.
  • Managed medical needs for children in State foster care custody.
  • Ensured the client's medical needs were addressed.
  • Assessed member's medical needs.
  • Review provider requests through fax or telephone to ensure medical needs for services requiring preauthorization.
  • Followed up on all of the medical needs of each client.

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36. Vital Signs
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low Demand
Here's how Vital Signs is used in Nurse Case Manager jobs:
  • Complete Pre-Employment physical including urine drug screens, eye examinations, hearing test, vital signs, and weights.
  • Performed function such as maintaining medication schedules, performing health assessments, monitoring vital signs and providing IM medications.
  • Monitor vital signs, assess health progress and provide nursing services, treatments and diagnostic procedures requiring specialized skills.
  • Provided physical assessments to include: Vital Signs and medical history for the outpatient program patients.
  • Monitored patient for any adverse reactions to medications as well as monitoring patient's vital signs.
  • Monitored patients during exercise sessions via ECG, vital signs, patient statements, and observations.
  • Interviewed patients to obtain medical information and measure their vital signs, weight and height.
  • Obtain consent from the subjects' cardiologist to establish parameters for vital signs and weight.
  • Performed intakes and obtained vital signs obtained patient legal consent and scanned into AHLTA.
  • Care includes vital signs, mental status assessment along with skilled nursing care.
  • Monitored vital signs, such as blood pressure and pulse.
  • Volunteered in mobile unit taking vital signs and blood sugars.
  • Record patients' medical information and vital signs.
  • Administered Glucose test and Vital signs.
  • Obtain vital signs (temp., pulse, resp., B/P, pulse ox).
  • Conduct Study procedures including recruitment/enrolling of participants, vital signs, phlebotomy, and study drug administration.
  • Reviewed medical data such as lab, diagnostic test results, and vital signs.Sent educational materials to members.
  • Obtained and documented vital signs of newborns while assisting in NICU as well as well baby nursery.
  • Assessed patients an monitored vital signs.
  • Case Manger load of 70-100 patients Medicaid Processing Staffing Human Resources Field Nurse: Wound Care/Diabetic Management/ Vital Signs Teaching patient/care givers

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1 Vital Signs Jobs

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37. Medical Services
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low Demand
Here's how Medical Services is used in Nurse Case Manager jobs:
  • Facilitated direct care medical services for at-home patients, including Medicare, Medicaid and insurance coverage.
  • Evaluate the quality of necessary medical services and utilize criteria for authorizing appropriate services.
  • Developed reports outlining medical services provided and patient progress updating insurers weekly.
  • Coordinated medical services and attended medical appointments with injured worker.
  • Coordinated funding of medical services.
  • Conducted In -Services to Managed Health Care Plans, providing information pertaining to Barlow admission criteria and medical services.
  • Assist patients to receive appropriate medical services and find placement at proper level of care for optimum recovery.
  • Review requests for prior authorization of medical services such as surgeries, pain management, home health care.
  • Assist with coordination of community resources including behavioral, social and medical services as needs are identified.
  • Assessed, planned, implemented, coordinated, monitored and evaluated medical services and RTW options.
  • Manage the medical care of injured workers from date of injury to discharge from medical services.
  • Set up member insurance cases and provide approval of necessary medical services.
  • Arranged medical services for injured workers in various states across the country.
  • Assisted elderly and disabled clients with selection of appropriate medical services.
  • Coordinate with vendors in order to supply DME and medical services.
  • Manage and coordinate medical services cost-effectively to promote maximum medical improvement and return to work as per Medical Disability Advisors guidelines.
  • Negotiate rates with providers regarding medical services for the injured client's Maintain profit margins for budget of 2.6 million dollars
  • Coordinate all medical services to facilitate claimant recovery, expedite P&S and return claimant to pre-injury functional capability.
  • Provide care coordination, prior approval for medical services/equipment * Initiate and maintain Home Care Waiver program.
  • provided managed care to children enrolled under Children's Medical Services network.

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38. CMS
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low Demand
Here's how CMS is used in Nurse Case Manager jobs:
  • Continue to work with physicians and residence to provide performance improvement initiatives in documentation and medical necessity requirements by CMS.
  • Created a value based model of nurse case management for SNF level of care for managed care patients and CMS-BPCI-model 3.
  • Provided personalized service to patients with Sunshine Health and CMS insurance and all MMA in the state of Florida.
  • Performed initial admission assessment of every patient hospital wide and ensured the proper admission status per CMS guidelines.
  • Skilled in completing OASIS, CMS-485, re-certifications, resumption of care reports and discharge summaries.
  • Identify deficiencies, take corrective action, and be in compliance with CMS guidelines.
  • Monitored all patients for the purpose of adherence to CMS criteria for inpatient stay.
  • Perform CMS audits for Surgical Care Improvement Project/CHF/CAP/AMI compliance according to Medicare guidelines.
  • Managed A&G coordinators, remaining 100% CMS compliant.
  • Adhered to URAC and CMSA guidelines in performance of case management responsibilities
  • Reviewed and processed authorizations, ensuring request met CMS criteria.
  • Performed Quality assurance every month using AHCA and CMS guidelines.
  • Completed patient assessment and OASIS documentation according to CMS guidelines.
  • Appropriate documentation in patients records to meet CMS standards.
  • Maintained 100% compliance with CMS regulated data collection.
  • Full compliance with Current NYS CMS Regulations maintained.
  • Managed mobile office and direct CMS billings.
  • Exhibited knowledge of clinical documentation requirements per Health plans, and CMS guidelines, DRG/code assignment and clinical conditions and procedures.
  • Assigned role of educator in the NCM group - responsible for orientation and training of new NCMs.
  • Contracted with Assesscare, Inc. in Evansville and PCMS in Texas.

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23 CMS Jobs

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39. CNA
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low Demand
Here's how CNA is used in Nurse Case Manager jobs:
  • Participated in team approach care with CNA, team coordinator, social worker, Medical director, chaplains and bereavement counselors.
  • Provide individual care for diabetic, hypertensive, and asthmatic clients Serve as resource for Medical Assistants and CNA's.
  • Worked with and supervised CNA's, monitored consistency of following care plan and identifying new concerns or problems.
  • Welcome CNA students to observe and assist with minor treatments within their scope of practice.
  • Direct supervision and assignments of CNA's assigned to my patient case load.
  • Provide field supervision and documentation of LVN's and CNA's practice.
  • Team Leader for CNA pilot, supervising a team of 4 nurses.
  • Conduct In-services for nurses and CNA's every other month.
  • Provided training for newly hired care assistants/CNA's
  • Interview and hire new CNA's/PCA's.
  • Supervised LPN, CNA's.
  • Assign CNA/PCA for new clients.
  • Complete OASIS recertification assessments and provide supervisory visits to ensure competency and compliance of CNA staff in client homes.
  • Make CNAs visits every 14 days update plan of care as client s status changes.
  • Case Management and Supervision of CNAs for a variety of clients.
  • Oversee, team of CNAs, physical therapists, occupational therapists.
  • Managed medical assistants and CNAs.
  • Supervised CNAs performance on site.
  • Care planning and case managagment activities * CNA/In- Home Aide delegation/re-delegation and evaluations.
  • Provided continuing education and annual review performance evaluations for CNAs.

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3 CNA Jobs

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40. Life Care
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low Demand
Here's how Life Care is used in Nurse Case Manager jobs:
  • Provide expert testimony, nursing standard of care opinions, Disability Cost Analysis, Life Care Planning and paralegal services.
  • Completed in depth admissions, and care plans for case management with a focus on end of life care.
  • Provide end of life care and education, encourage patients to voice their opinions and die with dignity.
  • Worked in multiple settings, providing end of life care for adult patients with different end stage diagnoses.
  • Managed end of life care of terminally ill patient and provided support to their family.
  • Provided end of life care to patients in their homes and residents of nursing homes.
  • Educated patients and families regarding self-care techniques and end-of-life care and adequate pain control.
  • Assess, diagnose, plan, implement and evaluate end of life care.
  • Provided management of symptoms associated with end of life care, I.e.
  • Educate and instruct patients and families regarding self-care techniques and end-of-life care.
  • Provide education to families and caregivers of end of life care.
  • Participated in educational programs about hospice and end of life care.
  • Developed expertise in pain management and holistic end of life care.
  • Provided skilled palliative end of life care in the community setting.
  • Manage caseload and provide physician directed end of life care.
  • Provided holistic end of life care to patient and family.
  • Managed end of life care for terminally ill patients.
  • Managed symptoms and end of life care.
  • Experience included a wide range of case management referrals, including Life Care Plans and Home Health Care Assessments.
  • Key Achievements Worked with Palliative patients and help them through their end of life care.

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1 Life Care Jobs

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41. SNF
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low Demand
Here's how SNF is used in Nurse Case Manager jobs:
  • Coordinated out-of-area inpatient acute transfers to in-network acute care and/or SNF facility.
  • Arranged home health care for patient discharge, assisted patient and family in SNF placement, Outpatient Infusion Clinic.
  • Provided and managed care for patients in their homes and in facilities (ALF and SNF).
  • Implemented discharge planning with multidisciplinary teams and arranged home health, DME, SNF/LTAC placement.
  • Staff Nurse SNF, Alzheimer's Unit Coordinator, Clinical Coordinator & MDS Coordinator.
  • Approved Admissions, Transfers to SNF, Discharge/HHC.
  • Implement patient transfer to SNF/ECF, rehab.
  • Arranged home health, DME, SNF, LTAC or hospice to ensure continuity of care.
  • Communicate daily with CM of SNF's, hospitals, and DCM's.
  • Advanced knowledge of criteria for SNF, ALF, LTC.
  • Provide inpatient and SNF case management, utilization review, and discharge planning for a moderate sized HMO in Orange County.
  • Obtained clinical information for authorization of hospital level care, home-care, snf /rehab facility care & DME.
  • Pre-authorized and managed length of stay for assigned patients the SNF (Skilled Nursing Facility) setting.
  • Refer patient to sub acute setting as needed eg transitional care, SNF, or LTCF.
  • Managed and completed all documentation/ paperwork necessary for billing for the snf unit.
  • Facilitate a smooth transitions of care from hospital to SNF or home.
  • Coordinated DME and Home health care Facilitated SNF transfers Educated patients on medication and disease process and follow-up care
  • Interact with clients, family members, physicians, hospitals, and SNFs effectively on a daily basis.
  • Coordinate hospice patient's care at their residence, including RCFEs, SNFs, homes
  • Case Management- precerting and Recerting for snf stay.

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42. MDS
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low Demand
Here's how MDS is used in Nurse Case Manager jobs:
  • Establish individual MDS schedules and coordinate assessment activities.
  • Complied with all applicable facility policies and procedures, federal and state regulations regarding submission of the MDS.
  • Worked as a Case Manager and MDS coordinator for Patient Care (home care agency).
  • Maintained accurate Minimum Data Set (MDS) and development of the interdisciplinary Plan of Care
  • Manage the data entry function to ensure the accuracy of the MDS.
  • Input patient information and MDS's in computer charts in timely manner.
  • Coordinated the timely completion of Medicare, and Rugged HMO MDS assessments.
  • Experience in MDS and care planning for long term care.
  • Complete MDS-HC Maintain member records and resolve variances.
  • Created authorization files in WMDS.
  • Experience with MDS reporting & ICD 9/10 coding.
  • Monitored the assignment of residents to Resource Utilization Groups (RUGs) and the payment periods associated with the MDS schedules.
  • Coordinate the RAI process assuring the timeliness, and completeness of the MDS, CAAs, and Interdisciplinary Care Plan.
  • Completed all MDS assessments for facility (101 beds) * Participated in planning and adjustments of Medicare assessments scheduling.
  • Complete MDS assessments for Medicare Track and ensure Medicare Certifications are signs by MD.
  • Create legal documents and orders for MDs to sign.
  • Developed and maintained on-going MDS schedules for each resident.
  • Managed a clinic of 1500 pts, 5 MDS and 2 Fellows was responsible for scheduling of clinic appts.
  • Collaborated with MDs and outside agencies to develop cost effective care regimens for improved patient outcomes.
  • Completed MDS on patients Submit referral to insurance Cooperates and participates in improvement process Attends meetings as requested

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19 MDS Jobs

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43. Concurrent Reviews
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low Demand
Here's how Concurrent Reviews is used in Nurse Case Manager jobs:
  • Conducted hospital concurrent reviews, determining medical necessity and appropriate length of stay.
  • Communicate with payers and provide concurrent reviews regarding patient care during hospitalization.
  • Collaborated with interdisciplinary team for concurrent reviews and discharge needs.
  • Perform initial and concurrent reviews in accordance with department criteria.
  • Support medical audits and concurrent reviews as needed.
  • Completed pre-certification and concurrent reviews for patients requiring in-patient behavioral health services utilizing InterQual criteria.
  • Perform utilization management, including pre-service authorizations, concurrent reviews and post-service reviews.
  • Obtained pre-authorization and performed concurrent reviews for inpatient levels.
  • present Reviewed Inpatient admissions, concurrent reviews, prior authorizations for Medicaid contract.
  • Completed admissionreviews as well as concurrent reviews of all traditional and managed Medicareinsured patients using Interqual criteria.

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44. Disease Management
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low Demand
Here's how Disease Management is used in Nurse Case Manager jobs:
  • Identified high-risk or high-cost patients for possible case management intervention and aligned patients with chronic disease for possible disease management intervention.
  • Encourage member participation in Case Management, Disease Management and Wellness programs and initiate enrollment and referral process.
  • Provide medical, disease management and prevention education to patients from economically and ethnically diverse community.
  • Provide care coordination to members in assigned disease management programs or complex case management.
  • Develop individualized care plan for disease management participants as indicated by program protocols.
  • Coordinated with Manager, participation of staff in several Disease Management Committees.
  • Developed and revised individualized proactive care plans for at-home disease management.
  • Experienced nurse providing Medicare members coordination to disease management programs.
  • Case management/discharge planning/disease management education for all patients
  • Applied in depth knowledge of disease management to ensure quality customer service standards and to maintain client confidentiality.
  • Utilize internal and external resources to engage member in appropriate disease management or mental health needs.
  • Performed comprehensive review, screening and management of potential disease management cases for heart failure members.
  • Assisted discharge clients needing chronic disease management with establishing a physician in the outpatient setting.
  • Educate members on disease processes, disease management interventions and health insurance benefits.
  • Educate patient and family on disease management and health maintenance.
  • Identify high risk clients for appropriate disease management programs.
  • Assessed member's needs and encouraged / administered member education related to disease management and application of standards of care.
  • Conduct field nursing assessments, exercise appropriate nursing interventions and patient teaching on health promotion and disease management .
  • Determine ADL functioning prior to health change coverage Use concepts of disease management into practice.
  • Coordinate care of patient with other disciplines Disease management education Wound Care (specialty wounds requiring frequent changes) '

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3 Disease Management Jobs

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45. HHA
demand arrow
low Demand
Here's how HHA is used in Nurse Case Manager jobs:
  • Coordinate services of DME vendors, therapists, labs, infusion services and arrange for HHA/ PCA staff.
  • Establish HHA plan of care as well as indirectly and directly supervising the plan of care per regulations.
  • Assist in making HHA assignments, prepare POC for the aide and supervise aide in the home
  • Supervised scheduling for HHA program, conducted monthly HHA meetings and education requirements.
  • Educate staff and families; assign and supervise hospice HHA's as needed.
  • Supervised LPN's and HHA's per state and federal regulations.
  • Trained HHA and PCA special skills required for their individual cases.
  • Developed 2000 and 2001 educational program for HHA Maintained employee records
  • Develop HHA care plans and supervise HHA's regularly.
  • Supervised and educated HHA's for patient care.
  • Perform supervisory visits of LPN/HHA.
  • Schedule every field visits for all disciplines including SN, PT, OT, ST, MSW, and HHA.
  • Completed In-services for the HHA and PCA as require by the NY Dept.
  • Supervised eight RNS and 2 LPNS, and 4 HHAS.
  • Coordinated care with other members of the health care team such as therapists, MSW and CHHAs
  • Supervised a multidiscipline team of SN/PT/OT/MSW/ST/HHA.
  • Contracted with home health agencys for Nurses, Physical Therapists, Occupational Therapists, Resp.Therapists, HHA's, MSW's.
  • Served as supervisor for other field staff including RNs, LVNs, and HHA.
  • Supervised and monitored care provided by LVNs and HHAs.
  • Supervised and monitored care provided by LVNs and HHAs Involved in committees - improvement projects.

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46. Emotional Support
demand arrow
low Demand
Here's how Emotional Support is used in Nurse Case Manager jobs:
  • Collaborate with interdisciplinary medical team to provide complex patient care and emotional support to patients and their families.
  • Provided behavioral/emotional support and supervision for those with dementia and Alzheimer's.
  • Provide emotional support and provide medical advice.
  • Provided emotional support and companionship to clients.
  • Respond to calls for pain/crisis management, medication issues, anticipatory grief and emotional support, time-of-death visits, and admissions.
  • Assist patients and families with care at home through direct care, education, emotional support and management of resources.
  • Controlled health care resources and purchase services for patients, and provided emotional support and provided medical advice.
  • Provide clinical and emotional support to family and patients as they enter the end stage of life.
  • Assisted patients' in transition from hospital to home, providing emotional support to patient and families.
  • Provide direct nursing care, education and emotional support to terminally ill patients and their families.
  • Perform blood draws, catheter insertions, caregiver education, instruction and emotional support.
  • Provided emotional support for patients and families at the end of patient lives.
  • Provide emotional support and reassurance during dying process to patient and family.
  • Provided emotional support to patients and families throughout the disease process.
  • Provided care and emotional support to the actively dying patient.
  • Provide counseling, emotional support to family as needed.
  • Provided emotional support to patients and loved ones.
  • Provide emotional support to patients and their families.
  • Provide patients and family with emotional support.
  • provide patient's with emotional support & reassurance.

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47. Staff Members
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low Demand
Here's how Staff Members is used in Nurse Case Manager jobs:
  • Served as a clinical consultant to rehabilitation staff members.
  • Head, Medical-Surgical Nursing: provided leadership and management of over 140 military and civilian staff members on three medical-surgical units.
  • Provide information, guidance, and training for other staff members; including 15 case managers and 13 administrative staff.
  • Interfaced with physicians and staff members to reduce length of stay while maintaining the highest standard of care.
  • Provide resources for nurses, staff members, students, and family members on a daily basis.
  • Mentor to new staff members without any Workers Comp experience or who were new to company.
  • Act as mentor to staff members on the unit; attend nurse practice council meeting monthly.
  • Directed and supervised other staff members; certified nursing assistants (8).
  • Train, instruct staff members, patients, and families as needed.
  • Communicate with attending physicians, hospice staff members and other agencies.
  • Delegate tasks to caregivers and staff members within scope of practice.
  • Inform providers/staff members of patients' urgent health care needs.
  • Evaluate, instruct, and assess staff members as needed.
  • Served as a trainer/mentor to existing and new staff members.
  • Provide formal and informal education to other staff members.
  • Participated in education of new staff members as assigned.
  • Supervised 4-6 staff members during any given shift
  • Oriented and mentored new staff members
  • Communicate clearly and appropriately educates team members, physicians, clients, facility staff members, and the general public.
  • Key Accomplishments: * Teamed with interdisciplinary staff members to establish a collaborative approach to nursing.

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19 Staff Members Jobs

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48. Copd
demand arrow
low Demand
Here's how Copd is used in Nurse Case Manager jobs:
  • Provided end of life direct care to COPD, CHF, cancer, and numerous other life limiting illnesses.
  • Nurse case manager for medicare members to assist them in disease management for diabetes, CHF, and COPD.
  • Performed case management for patients with diabetes, asthma, pain control, COPD, and CAD.
  • Assisted patients with multiple chronic diagnoses including COPD and asthma.
  • Assessed and educated patients as to disease processes - CHF, COPD, Diabetes, CAD, PVD, CVA.
  • Work mostly with COPD, CHF, DM and elderly members.
  • Managed caseload of 30-40 homecare patients with a wide variety of ailments from CHF, COPD to wound care and education.
  • Treated patients with chronic and acute health problems such as MI, arrhythmias, asthma, COPD and pneumonia.
  • Instructed and supervised staff in implementation of a healthcare model specifically designed for clients with COPD and CHF.
  • Provide ambulatory case management for CHF, COPD, DM, CVA, CKD/ESRD, and co-morbidities.
  • Educated patients on multiple chronic diagnoses including COPD, asthma and cancer.
  • Provide diabetic ,HIV ,COPD , Asthma and substance abuse education related to opioid addiction.

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49. Physician Orders
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low Demand
Here's how Physician Orders is used in Nurse Case Manager jobs:
  • Implemented doctors discharge orders from previous facilities and physician orders in rehabilitation setting.
  • Perform routine and specialized nursing procedures following physician orders and approved treatment plan.
  • Transcribed and initiated physician orders.
  • Followed physician orders as directed.
  • Obtain physician orders, and authorization from Adjusters, coordinate orders and referrals to appropriate providers and therapies.
  • Obtain physician orders and M11Q forms; insure timely completion/ submission of OASIS-C and re-certifications.
  • Initiate the plan of care and necessary revisions including obtaining written physician orders for changes.
  • Visited terminally ill patients in their residence to assess and treat per physician orders.
  • Coordinate in-home care and physician orders for both palliative and hospice clients.
  • Completed oasis, 485 and physician orders using the Lewis program.
  • Follow up with, execute, and properly document physician orders.
  • Provided seamless case management of each claim per physician orders.
  • Worked independently in the home following physician orders.
  • Review physician orders and patient charts for documentation deficiencies to ensure quality, while providing coaching to RNs to improve documentation.
  • Skilled use of EPICare computer system for all documentation, including physician orders, and e-scripts directly to pharmacies.
  • Complete management of care.Physician orders, home visits, family interaction and addressing any concerns they may have.

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6 Physician Orders Jobs

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50. CHF
demand arrow
low Demand
Here's how CHF is used in Nurse Case Manager jobs:
  • Involved in data collection on the Blue Cross Blue Shield of Massachusetts CHF incentive program.
  • Worked with electronic CHF program for early assessment of heart failure to prevent hospitalization.
  • Direct nurse-member contact in the Health Suite as needed, including CHF Clinic.
  • served; with emphasis on CHF and Diabetes.
  • Supervised home health aides and nursing staff across New Haven, Fairfield, and Litchfield Counties.

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Nurse Case Manager Jobs

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20 Most Common Skills For A Nurse Case Manager

Patient Care

16.5%

Health Care

11.4%

Treatment Plans

11.0%

Hospice

6.4%

Medical Conditions

5.7%

Utilization Review

5.7%

Social Workers

4.8%

IV

3.8%

Durable Medical Equipment

3.5%

Community Resources

3.4%

Disease Process

3.2%

Insurance Companies

3.2%

Medical Care

3.0%

RN

3.0%

Medical Records

2.9%

Medication Management

2.7%

Primary Care Services

2.6%

Interqual

2.5%

Medical Necessity

2.5%

Physical Therapy

2.3%
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Typical Skill-Sets Required For A Nurse Case Manager

Rank Skill
1 Patient Care 12.2%
2 Health Care 8.4%
3 Treatment Plans 8.2%
4 Hospice 4.7%
5 Medical Conditions 4.2%
6 Utilization Review 4.2%
7 Social Workers 3.5%
8 IV 2.8%
9 Durable Medical Equipment 2.6%
10 Community Resources 2.5%
11 Disease Process 2.4%
12 Insurance Companies 2.3%
13 Medical Care 2.2%
14 RN 2.2%
15 Medical Records 2.2%
16 Medication Management 2.0%
17 Primary Care Services 1.9%
18 Interqual 1.9%
19 Medical Necessity 1.8%
20 Physical Therapy 1.7%
21 Providers 1.7%
22 High Risk 1.5%
23 LPN 1.3%
24 Diabetes 1.3%
25 Medication Administration 1.3%
26 Care Coordinator 1.3%
27 Mental Health Services 1.3%
28 Medical Treatment 1.0%
29 Symptom Management 0.9%
30 Appropriate Level 0.9%
31 Pain Management 0.8%
32 Health Education 0.8%
33 Milliman 0.8%
34 Picc 0.8%
35 Medical Needs 0.7%
36 Vital Signs 0.7%
37 Medical Services 0.7%
38 CMS 0.7%
39 CNA 0.7%
40 Life Care 0.7%
41 SNF 0.7%
42 MDS 0.7%
43 Concurrent Reviews 0.6%
44 Disease Management 0.6%
45 HHA 0.6%
46 Emotional Support 0.6%
47 Staff Members 0.6%
48 Copd 0.6%
49 Physician Orders 0.6%
50 CHF 0.5%
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31,342 Nurse Case Manager Jobs

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