23 Case Managers jobs in the United States

• Conduct research to support legal proceedings
• Assist with the drafting and reviewing of legal documents
• Investigate facts to help in the negotiation of legal disputes
• Monitor and ensure compliance with state and federal regulations
• Record and store client information

• Previous experience as a paralegal or other legal field
• Familiarity with legal research
• Ability to prioritize and multitask
• Excellent written and verbal communication skills
• Deadline and detail-oriented

• Oversee daily operations between site management and staff to ensure quality care of assigned clients
• Coordinate and facilitate meetings, including ISP meetings, with individuals, families, guardians, SSA representatives, and other care team members.
• Serve as a primary advocate for assigned individuals, ensuring their needs, preferences, and rights are respected and upheld.
• Monitor service delivery, ensuring quality and compliance with all applicable Ohio DODD rules and regulations for multiple assigned sites.
• Maintain accurate documentation and records as required by Beautiful Minds Group policies and Ohio DODD standards.
• Team work mentality, exceptional drive and accountability
• Provide crisis intervention and problem-solving support as needed.
• Participate in ongoing professional training and development to remain informed of best practices and regulatory requirements.

• Minimum of 3-5 years of direct experience working within the MRDD field as a Residential Manager
• Thorough understanding of Ohio Department of Developmental Disabilities (DODD) guidelines and regulations.
• Experience developing, implementing, and monitoring Individual Service Plans (ISPs) for multiple clients and sites.
• Exceptional organizational, interpersonal, and communication skills.
• Valid Ohio driver's license, reliable transportation, and current auto insurance.
• Ability to pass a criminal background check per Ohio DODD standards.
• Possess valid and up to date relevant certifications such as CPR/First Aid and 8hr DSP Certification recognized by the Ohio DODD
• High School Diploma or Equivalent

• Experience managing multiple sites and staff members
• Knowledge and familiarity with local community resources.

• Collaborative and supportive team environment.
• Opportunities for professional development and career advancement.
• Rewarding role making a meaningful difference in the lives of individuals and families.

Provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients / caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient satisfaction, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team. Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence based practice, and to reduce the risk of readmission.

Essential Job Functions:

• Obtains or ensures acquisition of appropriate pre-certifications authorizations from third party payers and placement to appropriate level of care prior to hospitalization utilizing medical necessity criteria and third party payer guidelines.
• Obtains or facilitates acquisitions of urgent/emergent authorizations, continued stay authorizations, and authorizations for post-acute services as needed and with compliance with all regulatory and contractual requirements.
• Documents, monitors, intervenes/resolves, and reports clinical denials/appeals and supports retrospective payer audit denials; collaboratively formulates plans of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor, and third party payers, etc.
• Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all WTH staff regarding utilization review.
• Assumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care; delegates to others as appropriate.
• Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes.
• Interviews and collects patient specified data and chart review related to readmission and appropriately notifies care team.
• Communicates telephonically and electronically with outpatient providers in an effort to enhance the continuum of care.
• Integrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities; practice and governmental commercial payer guidelines.
• Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies.
• Assumes responsibility for WTH required continued education and owns professional growth.
• Performs other duties as assigned or required.

Job Specifications:

• Education: Bachelor of Science in Nursing preferred. Associate or Diploma of Nursing required.
• Licensure, Registration, Certification: Current licensure as Registered Nurse in the state of Tennessee. AHA Basic Cardiac Life Support preferred. ACM, CCM or other certification applicable to Case Management within 3 years of hire preferred.
• Experience: Minimum 3 years of recent acute clinical care experience preferred. Preferred experience in care facilitation and management and utilization review.
• Knowledge, Skills and Abilities: Strong communication skills. Ability to develop and maintain positive relationships with customers internal and external to WTH Enterprise. Care coordination / discharge and transition planning and community resource knowledge preferred.

Nondiscrimination Notice Statement: We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, disability, religion, national origin, gender, gender identity, gender expression, marital status, sexual orientation, age, protected veteran status, or any other characteristic protected by law.

• Education:

• Experience:

• Licensure, Registrations & Certifications:

• Assesses patient and develops plan of care, establishes mutually agreed upon goals with the patient, caregivers, and/or family members.
• Develops an appropriate and safe aide plan of care based on the patient's medical, psychosocial, and emotional needs and environmental and financial factors that affect the current and future patient status.
• Supervises the care rendered by the CNA and LPN within the patient's home and ensures compliance with the established plan of care.

• Renders professional nursing care, including the administration of medicine and drugs, monitoring IV's, performing venipuncture, inserting intravenous catheters, performing the more complex as well as routine treatments as prescribed by the physician or as indicated by the resident's condition.

• Obtains referrals for other skilled services as indicated.
• Provides emotional support and education to patients and their families.
• Ensures the compliance with established infection control procedures by all caregivers and/or family members.
• Ensures the accurate documentation of assessments, care plans, goals, medications, communications, and interventions.
• Reviews and revises the plan of care every 60 days and as needed.
• Reports significant changes in the patient's condition promptly to the attending physician.
• Utilizes nursing skills to independently administer intermittent safe, timely and effective nursing care and therapeutic treatment in the patient's home as ordered by the physician.
• Evaluates and documents the effectiveness of the plan of care as developed by all members of the interdisciplinary team working with the patient.
• Actively participates in Home Health interdisciplinary group meetings and home health care conferences.
• Submits completed documentation in accordance with established standards for timeliness and accuracy.
• Complies with Home Health quality, satisfaction, and regulatory compliance standards to ensure they are either met or exceeded.
• Works continually to identify new approaches that improve the quality and timeliness of Home Health care.
• Follows all Hospice policies and procedures and ensures compliance with all federal and state laws, regulations, and JCAHO requirements.
• Mentors' new employees as requested.
• Completes all required professional education including continuing nursing education hours and mandatory in-services to maintain professional licensure.

• Performs other related job duties as assigned.

• Conduct research to support legal proceedings
• Assist with the pre litigation process and reviewing of legal documents
• Investigate facts to help in the negotiation of legal disputes
• Monitor and ensure compliance with state and federal regulations
• Record and store client information

• Previous experience as a case manager or other legal field
• Familiarity with legal research
• Ability to prioritize and multitask
• Excellent written and verbal communication skills
• Deadline and detail-oriented

• Conduct research to support legal proceedings
• Assist with the drafting and reviewing of legal documents
• Investigate facts to help in the negotiation of legal disputes
• Monitor and ensure compliance with state and federal regulations
• Record and store client information

• Previous experience as a paralegal or other legal field
• Familiarity with legal research
• Ability to prioritize and multitask
• Excellent written and verbal communication skills
• Deadline and detail-oriented

• Conduct research to support legal proceedings
• Assist with the pre litigation process and reviewing of legal documents
• Investigate facts to help in the negotiation of legal disputes
• Monitor and ensure compliance with state and federal regulations
• Record and store client information

• Previous experience as a case manager or other legal field
• Familiarity with legal research
• Ability to prioritize and multitask
• Excellent written and verbal communication skills
• Deadline and detail-oriented

Job Type

Full-time

Description

Case Managers I, II, III, IV PER DIEM OPPORTUNITIES

Conifer Park is seeking Per Diem Case Managers to join our clinical team in Glenville, NY. In this role, the employee assumes full charge of patient case management, delivering individual and group mental health and chemical dependency services including assessment, discharge planning, managed care, and relevant communication, formulation and implementation of treatment plans, and performing specified duties.

Requirements

• Case Manager I Requirements: High School Diploma or GED with a minimum of 1 year of Case Management experience or applicable internship and a CASAC-T certification. Chemical dependency and/or mental health experience preferred and group counseling, didactic skills.
• Case Manager II Requirements: High School Diploma or GED with 1 year of Case Management experience or applicable internship and posses a current CASAC Certification.
• Case Manager III Requirements: Bachelor's Degree and current CASAC certification OR Master's licensable degree and a minimum of 1 year relevant experience or applicable internship
• Case Manager VI Requirements: Master's Licensed Degree with LMHC, LMSW or LCSW