clinical case management

Sidra

<div>JOB SUMMARY
The Clinical Nurse Manager - Homecare and Case Management has 24-hour operational accountability for all clinical, operational and budget responsibility of the Case Management and homecare units incorporating the hospitals vision and strategic plan. The Clinical Nurse Manager - Case Management and Homecare directs and coordinates clinical planning activities for both services and is responsible for the recommendation, development and implementation of case management and homecare procedures, standards and guidelines, and for keeping the Director of Nursing informed of progress and potential problems. As a key member of the hospital&rsquo;s senior nursing management team the incumbent assumes accountability for the overall management and the delivery of quality Nursing Services to achieve optimal patient experience and outcomes for the service delivery area. S/he ensures that standards for case management and homecare are adhered to. The incumbent is fully responsible for the Case Management and Homecare unit budgets, patient experience and outcomes and staff performance and development. S/he works collaboratively to ensure that commissioning, recruitment, onboarding, orientation and service activation responsibilities are carried out in accordance with Sidra&rsquo;s plans and timelines. The Clinical Nurse Manager - Homecare and Case Management is professionally accountable to the Chief Nursing Officer.
QUALIFICATIONS, EXPERIENCE AND SKILLS &ndash; SELECTION CRITERIA
EDUCATION
Essential:
<ul><li>Bachelor Degree in Nursing (4 years)
</li><li>Master&rsquo;s degree in Nursing or health related field, or Masters in Business Administration
</li><li>Registered Nurse
</li></ul>Preferred:
<ul><li>Master&rsquo;s degree in Nursing or health related field, or Masters in Business Administration
</li><li>Post graduate specialty qualification/certification
</li></ul>EXPERIENCE
Essential:
<ul><li>7+ years of clinical experience including 5+ progressive management experience within the relevant specialty area in an acute care hospital Experience in an Academic Medical Center
</li></ul>Preferred:
<ul><li>Demonstrated experience with clinical Information systems
</li><li>Hospital Commissioning
</li><li>Previous accreditation experience
</li><li>Evidence of publications / presentations in the past 5 years
</li></ul>CERTIFICATION &amp; LICENSURE
Essential:
<ul><li>Valid professional nursing license in country of origin
</li><li>Case Manager Certification from an accredited national organization
</li><li>Meets licensing requirements of the State of Qatar
</li></ul>PROFESSIONAL MEMBERSHIP
Preferred:
Member of a professional nursing association 
<ul><li>
</li></ul>JOB SPECIFIC SKILLS &amp; ABILITIES 
Essential:
<ul><li>Proactive approach to planning
</li><li>Demonstrated ability to cope with rapid and sustained change, competing demands and tight deadlines
</li><li>Demonstrated ability to develop and maintain effective relationships with a range of stakeholders internally and externally
</li><li>Effective communication and presentation skills and demonstrated ability to present to large audiences.
</li><li>Empowering and enabling leadership style
</li><li>Effective coordination of resources to maintain safe patient care
</li><li>Proficiency with Microsoft Office suite
</li><li>Fluency in written and spoken English
</li></ul>Preferred:
<ul><li>Arabic speaking and/or bilingual in other languages
</li></ul>KEY ROLE ACCOUNTABILITIES
<ul><li>Formulates, communicates and oversees the implementation of the case management and national homecare strategy in collaboration with key stakeholders.
</li><li>Develops, directs and ensures continuous improvement to the implementation of operational plans for case management and homecare.
</li><li>Makes decisions on budget planning, clinical operation, resource allocation and staff performance for case management and homecare units.
</li><li>Ensures all nursing staff work within their scope of practice and within QCHP licensure of Qatar.
</li><li>Implements patient experience and quality plans for homecare and case management.
</li><li>Translates the pediatrics nursing strategy into plans for case management and homecare and drives their execution.
</li><li>Leads and coordinates collaborative multi-disciplinary partnerships working towards the achievements of constant improvement in quality patient care and patient experience.
</li><li>Assumes accountability and oversight for patient experience and clinical outcomes for the Case Management and Homecare units.
</li><li>Continually reviews nursing practice to ensure that the most effective research based and timely care is provided for patients and their families. Addresses any issues that negatively impact on patient care outcomes.
</li><li>Develops goals, KPIS and objectives for Case Management and Homecare in collaboration with the Director and other key stakeholders by embracing evidence and research to support transformational changes.
</li><li>Ensures that patient care is provided in accordance with established case management and standards of nursing care, accreditation, policies, guidelines and protocols of Sidra and the State of Qatar.
</li><li>Develops and implements processes to ensure authorization of appropriate services for continued stay and during discharge.
</li><li>Plans for resource allocation that meets patient population needs. Ensures staffing ratios and patient assignments are reflective of patient census, acuity, level of education, and capabilities of staff.
</li><li>Assumes financial responsibility through budget management for the unit to ensure that patient services are provided in a timely, efficient and effective manner. Balances financial responsibility against safe patient care.
</li><li>Manages ongoing individual performance appraisals, development plans and professional goals for case management and homecare staff members.
</li><li>Leads, plans, implements and evaluates the operational care delivery for case management and homecare.
</li><li>Achieves goals and objectives by embracing evidence and research to support transformational changes.
</li><li>Sets and monitors performance standards against patient outcomes.
</li><li>Monitors and implements the comprehensive unit based safety program takes corrective action as required.
</li><li>Establishes and analyzes areas of improvement through data to prepare necessary reports.
</li><li>Develops, reviews and revises unit procedures as required.
</li><li>Leads and participates in organization-wide performance improvement activities and committees as assigned.
</li><li>Provides support for Shared Governance for case management and homecare.
</li><li>Partners with clinical educators in planning, implementation and evaluation of patient and staff education requirements.
</li><li>Drives the implementation of patient experience principles, provides service recovery, and identifies and implements continuous improvement opportunities as required.
</li><li>Monitors and analyzes performance data to ensure that unit KPIs are achieved, identifies opportunities for improvement and implements solutions.
</li><li>Leads and manages the selection, development and retention of all staff within the unit
</li><li>Serves as a professional and clinical role model for staff and acts as an advocate for patients and their families
</li><li>Promotes positive staff morale by building and maintaining relationships.
</li><li>Ensures clinical practitioner competence and professional nursing credibility.
</li><li>Deputizes for the Director of Nursing as required.
</li><li>Adheres to Sidra&rsquo;s standards as they appear in the Code of Conduct and Conflict of Interest policies
</li><li>Adheres to and promotes Sidra&rsquo;s Values
</li></ul>In view of the evolving needs and opportunities within Sidra, this position may be required to perform other duties as assigned and reporting relationships may vary.</div>
 <div><div>About US</div>
<div><div>Sidra Medicine a healthy population is essential to a strong, prosperous society, and throughout 2020, Sidra continued to provide uninterrupted comprehensive specialist healthcare services for children and young people; and exceptional maternity, gynecology, and reproductive medical services for women, previously unavailable in Qatar and the region.&rdquo; &ndash; H.H Sheikha Moza bint Nasser, Chairperson of Qatar Foundation
</div><div>Sidra Medicine represents the vision of Her Highness Sheikha Moza bint Nasser who serves as its Chairperson. This high-tech facility is home to world-class patient care, scientific expertise, and educational resources.</div></div></div><div></div>

Clinical Nurse Manager - Homecare and Case Management

Enlyte

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div> 
Be part of a team that makes a real difference.</div>
Job Description:
<div>
This is a full-time, hybrid position. The candidate must be located in the Albuquerque, New Mexico area due to regular local travel for in-person patient appointments.</div><div>
Bilingual (English/Spanish) Required.</div><div></div><div> 
Perks: Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div> 
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li>Education: Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li>
Experience: 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li>
Skills: Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.</li><li>
Certifications, Licenses, Registrations:
<ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li>
Travel: Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li>
Internet: Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $73,000 - $83,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div> 
</div>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
#LI-AC1<div></div><div> 
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Bilingual Field Case Manager

The Camden Center

<div>Within the chain of command, the mentor&rsquo;s and companion&rsquo;s direct supervisor is the client&rsquo;s respective Case Manager. The mentor/companion reports to the case manager for all aspects of client care. It is then the case manager&rsquo;s responsibility to report directly to the client&rsquo;s family members, financial guarantors and treatment providers. This set-up serves to protect and nurture the mentor/client and companion/client relationship, ensuring that mentors/companions can focus their time and energies on their client, building rapport and a foundation of trust. The case manager will additionally communicate with the client, hour dependent, to further support their process in the case management program, making changes as needed.
RESPONSIBILITIES Core duties and responsibilities include but are not limited to the following:<ul><li>Have weekly, bi-weekly, or monthly sessions with the client in efforts to further support their experience within the case management program, making changes as needed. (frequency of sessions is service dependent)</li><li>Responsible for consistent communication with all appropriate members of a client&rsquo;s team, including the client, the respective mentor/companion, family members, clinical providers, non-clinical providers and financial guarantors.</li><li>Develop and revise client reintegration plans as needed.</li><li>Provide phone support for clients.</li><li>Case managers protect and nurture the mentor/client and companion/client relationship by communicating with all outside parties.</li><li>Devote time to respective mentors/companions, collaborating alongside them and offering phone support and supervisory communication.</li><li>Provide pre-approval for reimbursement as related to any out-of-pocket expenses incurred by mentors and companions on behalf of Camden Case Management business.</li><li>Document all interactions or discussions with any member of the team, including the client, and/or mentor/companion.</li><li>Manage all information relating to toxicology screens (via urine samples).</li><li>Manage all medication management in conjunction with the mentors/companions.</li></ul> 
MUST have a valid driver's license and be willing to transport clients if/when needed 
 
This is a W-2 position.
 
 
This is an on-call/ as -needed position.
zs11EaSHCN</div>

Case Manager- San Francisco

UC Davis Rehabilitation Hospital

<div>Clinical Liaison Position Summary
Builds and maintains referral relationships to drive appropriate admissions to the hospital. Coordinates the intake and pre-admission screening process, conducts on-site clinical assessments to determine suitability for acute rehabilitation, educates patients/families on services and participation requirements, and serves as the primary external contact for case managers, discharge planners, physicians, and payors.
Essential Functions
<ul><li>Assist and coordinate the intake and pre-admission screening process.</li>
<li>Perform on-site clinical assessments (typically at referring facilities) to determine appropriateness for admission.</li>
<li>Educate patients and families on rehabilitation options, level of care, and expectations for participation.</li>
<li>Serve as the initial contact for external case management, discharge planners, payors, and hospital partners.</li>
<li>Conduct face-to-face, in-service educational visits with physicians, case managers, and other professionals.</li>
<li>Inform and educate community decision-makers about the hospital and acute rehabilitation services to develop census through direct outreach.</li>
<li>Document screenings, decisions, and communications accurately and timely in EMR and tracking systems.</li>
<li>Perform other duties as assigned.</li>
</ul>Additional Information
Role involves routine travel to referring facilities and community partners; valid driver&rsquo;s license and clean driving record required. Success measures include timeliness of screenings, conversion rates, and quality of referral relationships. Works closely with admissions, nursing, therapy, and case management to ensure smooth transitions and payer authorization compliance.
Knowledge, Skills &amp; Abilities
Education: Bachelor&rsquo;s degree preferred.
Licensure/Certification: Current clinical licensure required (e.g., RN, PT, OT, SLP, MSW) per state requirements.
Experience: Prior marketing/sales experience preferred; prior clinical experience with demonstrated assessment skills and EMR proficiency preferred; formal sales training preferred.
Skills: Excellent oral and written communication, strong interpersonal and presentation skills, customer relationship building, sound clinical judgment, organization/time-management, and basic computer/data-entry proficiency.</div>

Clinical Liaison (CL) PRN, Inpatient Rehabilitation

Banner Rehabilitation Hospital

<div>Overview:

Hospital Name: Banner Rehabilitation Hospital - Tucson 
In Partnership with Select Medical 
Position: Case Manager 
Schedule: Per Diem - Weekdays &amp; Weekends available 
Our Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate care to best address the medical, physical, emotional, and vocational challenges for individuals with brain injuries, spinal cord injuries, neurological disorders, orthopedic issues, amputation, and multiple traumas. 
Why Join Us:<ul><li>
Start Strong: Extensive orientation program to ensure a smooth transition into our setting.</li><li>
Opportunity for Advancement: Demonstrate your skills and dedication which could lead to potential full-time opportunities</li><li>
Foster Well-being: We offer benefits which support the financial, work/life and emotional well-being of you and your family members. Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their first anniversary or subsequent calendar year.</li><li>
Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care</li></ul>
Responsibilities:
<div>
The Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans. The Case Manager assesses the psychosocial needs of the patient and provides intervention as part of the discharge planning process.</div><ul><li>
The primary job functions in Case Management include:</li><li>
Clinical Interventions/Discharge Planning</li><li>
Care Planning Management</li><li>
Fiscal Management</li><li>
Payer/Referral Management</li></ul>
Qualifications:

Minimum Qualifications<ul><li>
Current Licensure per state guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline.</li></ul>
Preferred Qualifications<ul><li>
Previous experience in Case Management and Discharge Planning preferred.</li><li>
CCM Certification Preferred.</li></ul>
Additional Data:

Equal Opportunity Employer/including Disabled/Veterans</div>

Case Manager- Per Diem

Hill Physicians Medical Group

<div>We&rsquo;re delighted you&rsquo;re considering joining us!
At Hill Physicians Medical Group, we&rsquo;re shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.
Join Our Team!
Hill Physicians has much to offer prospective employees. We&rsquo;re regularly recognized as one of the &ldquo;Best Places to Work in the Bay Area&rdquo; and have been recognized as one of the &ldquo;Healthiest Places to Work in the Bay Area.&rdquo; When you join our team, you&rsquo;re making a great choice for your professional career and your personal satisfaction.
DE&amp;I Statement:
At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are.
We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right!
Job Description:
Responsible for carrying out case management activities for IPA members referred to the case management program across all levels of care. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet the client&rsquo;s health and human service needs. It is characterized by advocacy, communication and resource management and promotes quality and cost-effective interventions and outcomes. Case management activities are based on nationally recognized case management standards and concepts and principles. All contacts are telephonic with an option for on-site case conferences as needed.
Job Responsibilities<ul><li>
Identification of members appropriate for case management, based on identification of health-related problems.</li><li>
Assessing members&rsquo; physical and psychosocial needs/barriers.</li><li>
Developing the case management care plan.</li><li>
Developing and implementing the interventions needed to resolve barriers and coordinate care, allowing members to accomplish their goals with physician guidance and supervision.</li><li>
Documenting assessments, care plans, interventions, and all other activity related to coordinating the care of case-managed members.</li></ul>
Additional Responsibilities<ul><li>
Maintain client privacy, safety, confidentiality, and advocacy while adhering to ethical, legal, regulatory and accreditation standards.</li><li>
Maintain department procedure/policy standards with regard to turnaround time, etc.</li><li>
Support the interdisciplinary team approach to ensure effective resource utilization, as well as quality and cost-effective outcomes.</li><li>
Coordinate internal and external resources for the individual member.</li><li>
Maintain and update a community resource database.</li><li>
Document all case management activities in the HPMG case management online system.</li><li>
Utilize existing reports and systems to identify and monitor utilization resource patterns and facilitate needed care coordination in order to support Quality Improvement.</li><li>
Refer to various departments for supportive interventions, i.e., Health Education, Quality Management, Contracting, Provider Services, Client Data Management, TPL, COB, etc.</li><li>
Issue letters of explanation in accordance with department policy.</li><li>
Support Medical Management Team, Authorization Review, Clinical Initiatives, and Provider Education.</li><li>
Attend and participate in in service programs and conferences that support practice of case management.</li><li>
Perform other duties as assigned.</li></ul>
Required Experience<ul><li>
Minimum 3 &ndash; 5 years of experience required</li><li>
Minimum three years clinical nursing experience in an area such as medical surgical, critical care, home health or skilled nursing, and;</li><li>
Two years of experience in case management, utilization management, discharge planning and or quality improvement in a managed care setting</li><li>
Experience with managed care delivery including IPA networks and Medicare.</li><li>
Optimum organizational skills with ability to meet both expected and unexpected time frames.</li><li>
Excellent verbal and written communication skills.</li><li>
Ability to coordinate effectively with a variety of customers including members, providers, office staff, health plans, internal department, community resources, and peers.</li><li>
Ability to work independently with self-initiative and discipline.</li><li>
Knowledge of ICD-10 and or CPT coding.</li><li>
Working knowledge of personal computers.</li></ul>
Required Education<ul><li>
A.S. degree</li><li>
Unrestricted California Registered Nurse licensure; certification in case management preferred.</li></ul>
Additional Information
Salary: $100,000 - $123,000 Annual
Hill Physicians is an Equal Opportunity Employer</div>

Case Manager - 26-44

Case Manager - 26-43

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