clinical case manager

Penn State Health

<p></p><div><div><p><b>Penn State Health</b> - <b>Hershey Medical Center</b></p>
<p><b>Location:</b> US:PA: Hershey
<br>
<b>Work Type:</b> Full Time
<br>
<b>FTE: </b>1.00
<br>
<b>Shift:</b> Day
<br>
<b>Hours:</b> 8hr / day 80hrs pay period
<br>
<b>Recruiter Contact:</b> Taryn Blydenburgh at tblydenburgh@pennstatehealth.psu.edu</p>
<p><b>SUMMARY OF POSITION:</b></p>
<p></p><p>Responsible to coordinate interdisciplinary professional care of a select patient population as determined by individualized plan of care, clinical pathways, managed care guidelines and contracts. Mobilizes resources and manages the systems to respond to concurrent and respective data analysis, identifying variances. Participates in developing programs to improve clinical quality and fiscal outcomes, maintains knowledge of and responds to clinical system and fiscal data related to specific patient populations.</p>
<p></p><p><b>MINIMUM QUALIFICATION(S):</b></p>
<p></p><ul><li>Bachelor's degree</li>
<li>Two (2) years nursing experience
</li><li>Currently licensed to practice as a Registered Nurse by state of employment or holds a multistate RN license through the interstate Nurse Licensure Compact.
</li><li>Certified Heart Failure Nurse or must be willing to obtain within one year</li>
<li>AHA BLS prior to end of orientation period</li>
</ul><p><b>PREFERRED QUALIFICATION(S):</b></p>
<p></p><ul><li>Experience as clinical case manager preferred.</li>
<li>Experience in general cardiology, heart failure, advance heart failure</li>
<li>Experience in outpatient operations.</li>
</ul><p></p><p><b>WHY PENN STATE HEALTH?</b></p>
<p>Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community.</p>
<p><b>Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below:</b></p>
<ul><li><b><i>Be Well </i></b>with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).</li>
<li><b><i>Be Balanced </i></b>with Generous Paid Time Off, Personal Time, and Paid Parental Leave.</li>
<li><b><i>Be Secured</i></b> with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.</li>
<li><b><i>Be Rewarded</i></b> with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.</li>
<li><b><i>Be Supported</i></b> by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.</li>
</ul><p></p><p><b>WHY PENN STATE HEALTH MILTON HERSHEY MEDICAL CENTER?</b></p>
<p>Penn State Hershey Medical Center is Central Pennsylvania&rsquo;s only Academic Medical Center, Level 1 Regional Adult and Pediatric Trauma Center, and Tertiary Care Provider. As a four-time Magnet-designated hospital, Hershey Medical Center values the hard work and dedication that our employees exhibit every day. Through our core values of Respect, Integrity, Teamwork, and Excellence, our employees are a team committed to compassionate care for our diverse patient population, our community and each other. As a valued team member, we promote continued professional development, specialty certification, continuing education, and career growth.</p>
<p><b>YOU TAKE CARE OF THEM. WE&rsquo;LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence &ndash; that&rsquo;s Penn State Health. But what makes our healthcare award-winning? That&rsquo;s all you.</b></p>
<p></p><p><i>This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract. </i><i>All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.</i></p>
<p><i>Penn State Health is an Equal Opportunity Employer and does not discriminate on the basis of any protected class including disability or veteran status. Penn State Health&rsquo;s policies and objectives are in direct compliance with all federal and state constitutional provisions, laws, regulations, guidelines, and executive orders that prohibit or outlaw discrimination.</i></p>
 <p></p><p><b>Union:</b> Non Bargained</p></div></div><div></div>

Clinical Case Manager - Heart and Vascular Institute Heart Failure Services

Youth Development, Inc

<div><div>Exempt : No
</div><div>Type : Regular Full-Time
</div><div>Department : EET
</div><div>Location : 120<br>
</div><div></div><br>
<div><div><b>CASE MANAGER II:</b>
</div><div>Under the direct supervision of the Program Manager and/or Clinical Manager. Will provide case management services for assigned target population in PIBH assigned programs.<br>
</div><div></div><br>
<div><b>MINIMUM QUALIFICATIONS:</b>
</div><div>&bull; Bachelor&rsquo;s degree in social work or related counseling field of study and two (2) years&rsquo; experience providing case management services to children and families; or six (6) years&rsquo; experience providing services to children, youth and families, and/or a combination of education and experience to equal eight (8) years.
</div><div>&bull; Extensive knowledge of community resources and ability to work efficiently with public and private agency professionals
</div><div>&bull; Ability to complete assessment, service planning and service coordination with high-risk clients
</div><div>&bull; Ability to establish an effective professional manner in all dealings with clients and the public
</div><div>&bull; Ability to exhibit emotional maturity and good judgement, to include high standards of morals and speech.
</div><div>&bull; Must be dependable and flexible with regard to working hours
</div><div>&bull; Ability to follow and carry out written and oral instructions, quickly and accurately.
</div><div>&bull; Must possess basic computer skills.
</div><div>&bull; Must be able to use discretion in all facets of work-related situations.
</div><div>&bull; Ability to perform all work rapidly and accurately, meeting all deadlines when applicable.
</div><div>&bull; Must keep abreast of modern techniques and methods used in individual and group sessions.<br>
</div><div></div><br>
<div><b>DUTIES &amp; RESPONSIBILITIES (Not Inclusive):</b>
</div><div>&bull; Will accept assigned referrals and complete case management needs assessment.
</div><div>&bull; Will develop a crisis/safety plan with all clients
</div><div>&bull; Will develop a service plan to identify all the areas of services to be provided including goals and objectives for each service
</div><div>&bull; Will participate in weekly supervision with identified Clinical Manager or Supervisor
</div><div>&bull; Will participate in monthly group supervision
</div><div>&bull; Will facilitate access to services for clients in the area of medical, social, educational, vocational, legal and therapeutic care
</div><div>&bull; Will work cooperatively and collaboratively with the assigned Clinical Therapist (if applicable).
</div><div>&bull; Will monitor and evaluate the provision of client services on an ongoing basis.
</div><div>&bull; Will provide advocacy and referral services on behalf of clients
</div><div>&bull; Will provide family support referrals
</div><div>&bull; Will provide safety and risk assessment services to clients
</div><div>&bull; Will provide substance abuse treatment referral services.
</div><div>&bull; Will get certified in any identified curricula specified by supervisor or funder
</div><div>&bull; Will be proficient in the Tiered Level Case Management system
</div><div>&bull; Will provide crisis intervention services
</div><div>&bull; Will provide life skills, parenting, and conflict management training
</div><div>&bull; Will provide follow up services for all clients discharged from the program
</div><div>&bull; Will maintain comprehensive client records and generate reports as required.
</div><div>&bull; Other duties as assigned<br>
</div><div></div><br>
<div><b>JOB CHARACTERISTICS/PHYSICAL DEMANDS:</b>
</div><div>This is a professional position which requires organizational and communication skills, as well as judgment, tact and diplomacy in contacts with Youth Development, Inc. employees, community residents, parents and local government agencies. Strict adherence is required to all regulations concerning confidentiality. Project management experience preferred.<br>
</div><div></div><br>
<div>Good general health. Physical will be required at time of hire. Background investigation to include fingerprinting will be required. Frequent travel is required. Valid driver&rsquo;s license and proof of satisfactory car insurance are required. Must be able to perform essential job duties with or without reasonable accommodation.<br>
</div><div></div><br>
<div>Youth Development, Inc. is an at-will employer. Employment is by mutual consent of the company and employee, and either may terminate the relationship at any time with or without cause or advance notice. This job is contingent upon funding; however, availability of funding is not a guarantee of continued employment, nor does it imply any specific term of employment.<br>
</div><div></div><br>
<div><b>SUPERVISION RECEIVED:</b>
</div><div>Under direct supervision of the Program Manager or Clinical Manager</div></div></div>

Case Manager II

Henry Ford Health

<div><div><p>GENERAL SUMMARY:</p><p>
The Case Manager is a member of the hospital or specialty-based patient-centered care team or treatment team responsible for the collaborative practices of identification, assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual's and family's health care needs. The goals of the case manager are to promote patient safety, quality of care and cost-effective outcomes. The case manager provides effective discharge planning services that support a safe transition to the next level of care and addresses the needs of patients who have experienced a critical event or diagnosis that requires management strategies to optimize health outcomes along the care continuum.</p>
<div><p>EDUCATION/EXPERIENCE REQUIRED:</p><ul><li>
Bachelor's degree in nursing or a Master's degree of Social Work</li><li>
Minimum (3) three years of clinical experience</li><li>
Excellent verbal communication and written documentation skills</li><li>
Excellent customer service and interpersonal skills including the ability to interact with internal and external customers and all levels of the organization</li><li>
Strong problem-solving, analytical, and decision-making skills</li><li>
Strong computer skills and knowledge</li><li>
Experience in discharge planning, home health care, rehabilitative medicine, or managed care preferred</li><li>
Knowledge of preventive service guidelines, clinical practice guidelines, behavior change theory</li><li>
Medicare and Medicaid regulations and case management principles</li><li>
Knowledge of medical ethics and legal implications related to case management</li><li>
Understanding of social determinants of health and their impact on a patient's wellbeing</li><li>
Well versed in facilitating community resources to meet the needs of diverse populations</li><li>
Strong organizational, planning and implementation skills with the ability to handle multiple complex patient needs simultaneously</li><li>
Strong sense of compassion with the ability to successfully advocate for patients and their families</li></ul><p>
 CERTIFICATIONS/LICENSURES REQUIRED:</p><ul><li>
Registered Nurse (RN) or a Licensed Social Worker (LMSW) with a valid, unrestricted State of Michigan license</li><li>
Certification in Case Management (CCM) by the Commission for Case Management Certification (CCMC) or Accredited Case Manager (ACM) by the American Case Management Association preferred</li></ul>
 </div></div><div><div><div><div><h4 class="jobSectionHeader"><b>Additional Details</b></h4>
<div><p>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Overview</b></h4>
<div><p>
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services &ndash; from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford&rsquo;s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation&rsquo;s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Benefits</b></h4><div><p><br>
</p><p>The health and overall well-being of our team members is our priority. That&rsquo;s why we offer support in the various components of our team&rsquo;s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
</p></div></div></div></div><div><div><div><h4 class="jobSectionHeader"><b>Equal Employment Opportunity/Affirmative Action Employer</b></h4>
<div><p>
 Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is</p>
<p>
 committed to the hiring, advancement and fair treatment of all individuals without regard to</p>
<p>
 race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,</p>
<p>
 weight, marital status, family status, gender identity, sexual orientation, and genetic information,</p>
<p>
 or any other protected status in accordance with applicable federal and state laws.</p></div></div></div></div></div></div>

Case Manager - Contingent - Days - West Bloomfield

Bond Health

<div><p><b>Case Managers Needed Positions available in Manhattan - Bronx &amp; Brooklyn.</b></p><p><br>
<b>
Full time position</b><br>
<br>
<b>Responsibilities:</b><b>
</b></p><ul><li>Provide direct case management services (on-site and in the field). Case management services will include but not limited to mental health and substance use assessments, developing and updating service plans, assistance with obtaining public assistance, Social Security benefits/entitlements and other publicly available resources that may be beneficial to the tenant.</li>
<li>Using a person centered approach, provide case management services and assessments rooted in evidence based models such as Motivational Interviewing, Critical Time Intervention and Harm Reduction.</li>
<li>Utilize electronic health record. Maintain accurate and up-to-date tenant files/charts.</li>
<li>Coordinate and document clinical case management and psychosocial services while also documenting the overall effectiveness of the case management services provided. Case Managers will develop an Individual Service Plan and review the plan periodically to document process toward goals.</li>
<li>Serve as a liaison between tenant and community providers.</li>
<li>Facilitate groups with a focus on life skills, education and support, relapse prevention and mental health counseling.</li>
<li>Complete referrals to medical, mental health, and other outside providers.</li>
<li>Collaborate with Workforce Opportunities Staff to assist tenant in developing employment related goals, where applicable.</li>
<li>Ensure overall compliance with organizational and funder regulations. Adhere to documentation requirements as assigned by leadership and funder regulation/standard.</li>
<li>Coordinate aftercare services and follow-up contacts for post-discharge updates. &Oslash; Conduct outreach and engagement including apartment visits and inspections.</li>
<li>Participate in community development efforts such as Community Meetings and supporting the residence in establishing partnerships with other providers in the community.</li>
<li>Work with</li>
<li>Property Management staff to assist tenant to meet terms of their lease including timely payment of rent and avoidance of any nuisance behaviors.Mediate landlord-tenant disputes that threaten housing stability.</li>
<li>Utilize trauma informed interventions and culturally responsive engagement techniques to assist tenants with overcoming barriers to housing stability.</li>
<li>Participate in community initiatives to fulfil our mission to end homelessness</li>
<li>Provide crisis intervention as needed.</li>
<li>Provide all services in a manner that respects cultural differences amongst tenants.</li>
<li>Carry out other duties as assigned by leadership.</li>
<li><ul><li><b>Scatter Site Programs Only: Field work can account for 85% of your time</b></li></ul></li>
<li><b>Requirements:</b><b>
</b></li><li>A Bachelor's degree in human services or related field.</li>
<li>Must possess strong organizational, writing, communication, and computer skills.</li>
<li>Some relevant experience working with low-income or homeless populations.</li>
<li>Fluent in Spanish is strongly preferred.</li>
<li>Candidates must be self-starters with the skills and energy to work within the community.</li>
<li>Case Manager is regularly required to, type, use hands and fingers, reach with hands and arm. The Case Manager is regularly required to walk, stoop, and kneel. The Case Manager is often required to spend up to six (6) hours sitting at a desk during a normal eight (8) hour shift. Occasionally the Case Manager is required to lift items less than 5 pounds. The Case Manager is regularly required to move throughout the facility while carrying out job duties.</li></ul><br>
<p><br>
<b>For more information and to apply, please contact :
</b><br>
<b>Howard Newman</b><br>
<i>Account Manager, Bond Health Staffing
</i><br>
5824 12th Avenue<br>
Brooklyn, NY, 11219<br>
Office: 1-718-302-0040 ext. 204<br>
Fax: 1-718-302-0070<br>
Howard@bondhealthstaffing.com</p></div><p></p>

Case Manager

MedStar Health

<div>About this Job:
<p><b>
General Summary of Position</b></p><p></p><div><p><br>
MedStar Health is currently seeking an Inpatient Case Manager to join our team at MedStar Georgetown University Hospital. This position facilitates the delivery of quality, cost effective, patient-centered care from pre-admission through post-discharge timeframe.</p></div><p></p><div><p><br>
As a member of the Case Management team, you will monitor the care and services delivered to selected patient populations during the acute hospital stay, promoting effective case management and utilization of resources facilitating the continuum of care to achieve optimal clinical outcomes. Additionally, you will collaborate with multidisciplinary health care teams to develop and coordinate plans of care designed to meet individualized patient outcomes.</p></div><p></p><div><p><br>
MedStar Health is a great place to work and grow your career. We provide a supportive and inclusive work environment, comprehensive health and wellness benefits, generous PTO, tuition assistance, retirement plans, and many other benefits focused on your wellbeing. Apply today and learn how MedStar Health can be your next great career move!</p></div><p></p><div><p><br>
Primary Duties:</p></div><div><ul><li><p>
Demonstrate the ability to develop a plan of care that addresses needs across the continuum; develop long and short-term goals with specific time frames for resolution; identify specific services to be provided in the care plan; include the family/caregiver in the plan of care; and show life planning contingencies such as power of attorney and/or advance directives.</p></li></ul></div><div><ul><li><p>
Collaborate with and complete referrals to appropriate community agencies for assistance based on patient need. Initiate referrals in a timely manner. Utilize resources to help patient resume life in the community and/or to adjust to lifestyle changes.</p></li></ul></div><div><ul><li><p>
Facilitate communication between the patient and family and the healthcare team. Assess and communicate the patient's social, cultural, emotional, and economic problems to medical staff and other healthcare providers as needed. Participate in multidisciplinary rounds and collaborate with internal and external healthcare providers, patient and family to develop a comprehensive discharge plan, as necessary.</p></li></ul></div><div><ul><li><p>
Complete psychosocial history or socioeconomic assessment in a timely manner per policy standards when referred by healthcare team or as determined by high-risk indicators.</p></li></ul></div><div><ul><li><p>
Develop and maintain information on community resources and referral requirements based on patient population as identified in the unit scope of practice.</p></li></ul></div><p></p><div><p><br>
Qualifications:</p></div><div><ul><li><p>
Master&rsquo;s degree in social work from a school accredited by the Council on Social Work education</p></li></ul></div><div><ul><li><p>
1 &ndash; 2 years&rsquo; experience in social work, preferable in a hospital setting</p></li></ul></div><div><ul><li><p>
1 &ndash; 2 years&rsquo; experience in care/case management preferred</p></li></ul></div><div><ul><li><p>
LCSW-C - Licensed Certified Social Worker &ndash; Clinical License in the District of Columbia or the State of Maryland depending on work location OR LICSW - Licensed Independent Clinical Social Worker License in the District of Columbia or the State of Maryland depending on the work location</p></li></ul></div><div><ul><li><p>
CCM &ndash; Certified Case Manager preferred</p></li></ul></div>
This position has a hiring range of : USD $74,214.00 - USD $134,596.00 /Yr.</div>

LCSW-C/LICSW Inpatient Case Manager

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p><b>
*Must reside in Illinois and possess IL RN License**</b></p><p>
Program Overview</p><p>
Help us elevate our patient care to a whole new level! Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members&rsquo; health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.</p><p>
Our Case Managers use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual&rsquo;s and family&rsquo;s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.</p><p>
Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member&rsquo;s overall wellness.</p><div><ul><li><br>
Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member&rsquo;s overall wellness.</li><li>Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.</li><li>Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.</li><li>Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.</li><li>Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.</li><li>Collaborates with supervisor and other key stakeholders in the member&rsquo;s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences</li><li>Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation
</li></ul></div><p></p><p><b>A Brief Overview</b><br>
Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as advocate for patients, ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being.</p><p><b>
What you will do</b></p><ul><li>
Administers the care coordination plan to assess patient needs and ensure seamless transitions between different care settings.</li><li>
Analyzes complex patient data from medical history, diagnostic test results, and treatment plans, to understand the current health status of the patient.</li><li>
Applies in-depth knowledge of case management to organize patient files in an orderly manner for easy retrieval.</li><li>
Communicates through internal platforms to securely exchange messages, conduct video conferences, share files, and collaborate on patient care plans.</li><li>
Conducts routine utilization reviews to ensure patients have access to appropriate cost-effective care.</li><li>
Configures the case management system to organize cases dealing with disease management and utilization review; tracks patient progress and manages specific conditions.</li><li>
Coordinates analytics projects to enable case managers to analyze data and generate reports on key performance health indicators.</li><li>
Designs complex processes to coordinate discharge planning in a safe and timely transition from the hospital to home.</li><li>
Develops resource management to help case managers optimize healthcare with community resources.</li></ul><p><b><br>
Required Qualifications</b></p><ul><li>3-5 years of direct clinical practice experience e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility</li><li>Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually</li><li>Excellent analytical and problem-solving skills</li><li>Effective communications, organizational, and interpersonal skills</li><li>Ability to work independently</li><li>Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.</li><li>Efficient and Effective computer skills including navigating multiple systems and keyboarding</li></ul><p></p><p><b><br>
Preferred Qualifications</b></p><ul><li>Case management and discharge planning experience
</li><li>Managed care/utilization review experience
</li><li>Crisis intervention skills
</li><li>Certified Case Manager
</li><li>Bilingual</li></ul><p></p><p><b>
Education and Certification </b><b>Requirements</b></p><ul><li>
Associate's Required
</li><li>Active and Unencumbered Registered Nurse License in Illinois</li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$66,575.00 - $142,576.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
We anticipate the application window for this opening will close on: 06/17/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Case Manager Registered Nurse (Illinois)

Regal Medical Group

<div><p><b>Summary of position:</b></p>
<p>
</p><p>The Case Manager Outpatient RN is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members. The Case Manager Outpatient RN will assess and develop a care plan in collaboration with the admitting, attending and consulting physician, the member and other health care practitioners. The goal of the Case Manager Outpatient RN is to effectively manage members on an outpatient basis to assure the appropriate level-of-care is provided, to prevent in patient admission and re-admissions, and ensure that the members' medical, environmental, and psychosocial needs are met over the continuum of care.</p>
<p>
</p><p><b>Essential duties and responsibilities:</b></p>
<p>
</p><ul><li>Keeps member/family members or other customers informed and requests if necessary, further assistance when needed.</li>
<li>Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner.</li>
<li>Functions as liaison between administration, members, physicians and other healthcare providers.</li>
<li>Interacts professionally with member/family/physicians and involves member/family/physicians in formation of the plan of care.</li>
<li>Performs a Clinical Assessment/Questionnaire of the member and determines an acuity score for necessary scheduled follow-up.</li>
<li>Develops an outcome-based plan of care, based on the member's input and assessed member needs. Implements and evaluates the plan of care as often as needed as evidenced by documentation in the member's case file.</li>
<li>Documents member assessment and reassessment, member care plans, and other pertinent information completed in the member's medical record in accordance with the FOCUS Charting methodology, nursing standards, and company policies and procedures.</li>
<li>Initiates community visits (hospital, home visits) as needed to assess patient progress and meet with appropriate members of the patient care team.</li>
<li>Identifies planned and unplanned transitions of care from Requests for Services or daily inpatient and SNF census.</li>
<li>Educates the member/caregiver on the transition process and how to reduce unplanned transitions of care.</li>
<li>Manages transition of care from the sending to receiving settings ensuring that the Plan of Care moves with the member and updates/modifies the care plan as the member's health care status changes.</li>
<li>Communicates appropriately and clearly with physicians, in patient case managers and Prior-Authorization nurses</li>
<li>Identifies and addresses psychosocial needs of the members and family and facilitates consultations with Social Worker, as necessary.</li>
<li>Identifies and addresses pharmacological needs of the members and facilitates consultations with the pharmacy department, as necessary.</li>
<li>Identifies community resources to address needs not covered by the member's benefit plan, and coordinates member benefits as needed, with the health plan.</li>
<li>Participates in the efficient, effective and responsible use of resources such as medical supplies and equipment.</li>
<li>Responsible for the coordination and facilitation of member and family conferences as determined by assessment of member's needs.</li>
<li>Identifies the appropriate members to participate in the interdisciplinary case round process. Prepares the necessary summary information to present to the team.</li>
<li>Responsible for the coordination of clinic appointments, medication reconciliation, PCP and SPC visits.</li>
<li>Ability to collaborate and communicate with all members of the healthcare team (concurrent review, pre-authorization, PCP/SPC, Social Services, and Pharmacy) to coordinate the continuum of care of developing plans for management of each case.</li>
<li>Responsible for the identifying members that are appropriate for hospice conversion or Palliative care.</li>
<li>Meet with members/caregiver face to face in different locations (clinic, home, hospital, and community) in order to build a rapport with member so that the case manager can better support member/caregiver with care coordination and the plan of care.</li>
<li>Other duties as assigned by management.</li>
</ul>
<p></p><p>The pay range for this position at commencement of employment is expected to be between $45.00 to $50.00 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.</p>
<p>
</p><p>The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.</p>
<p>
</p><p>Details of participation in these benefit plans will be provided if an employee receives an offer of employment.</p>
<p>
</p><p>If hired, employee will be in an &ldquo;at-will position&rdquo; and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.</p>
<p>
</p><p></p><p>As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare &amp; Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.</p>
<p>
</p><p><b>Full Time Position Benefits:</b></p>
<p>
</p><p>The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.</p>
<p>
</p><p>Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.</p>
<p>
</p><p><b>Health and Wellness:</b></p>
<ul>
<li>Employer-paid comprehensive medical, pharmacy, and dental for employees</li>
<li>Vision insurance</li>
<li>Zero co-payments for employed physician office visits</li>
<li>Flexible Spending Account (FSA)</li>
<li>Employer-Paid Life Insurance</li>
<li>Employee Assistance Program (EAP)</li>
<li>Behavioral Health Services</li>
</ul>
<p><b>Savings and Retirement:</b></p>
<ul>
<li>401k Retirement Savings Plan</li>
<li>Income Protection Insurance</li>
</ul>
<p><b>Other Benefits:</b></p>
<ul>
<li>Vacation Time</li>
<li>Company celebrations</li>
<li>Employee Assistance Program</li>
<li>Employee Referral Bonus</li>
<li>Tuition Reimbursement</li>
<li>License Renewal CEU Cost Reimbursement Program</li>
<li>Business-casual working environment</li>
<li>Sick days</li>
<li>Paid holidays</li>
<li>Mileage</li>
</ul>
<p></p><p>Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.</p>
Requirements:
<p><b>Education and/or Experience:</b></p>
<ul>
<li>Graduate from an accredited Registered Nursing Program.</li>
<li>Current CA RN license, current CPR certification, valid CA Driver's license.</li>
<li>3 years acute care experience preferred.</li>
<li>2-3 years of utilization or HMO experience preferred.</li>
<li>Must have valid CA DL and provide proof of vehicle insurance.</li>
<li>Knowledge of computers, faxes, printers and all other office equipment.</li>
<li>Typing 30 WPM with accuracy.</li>
<li>Proficient in MS Office Programs (i.e., Word, Excel, Outlook, Access and PowerPoint).</li>
<li>Current and maintains an active California Nursing License in good standing</li>
<li>Minimum 3-5 years of clinical experience.</li>
<li>Required at least 2-3 years of case management experience or managed healthcare experience.</li><br>
</ul>
<br>
Compensation: $38-50/hour</div>

Outpatient Case Manager

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