disease case manager rn

Namaste Home Health + Hospice

<div><p><b>JOB SUMMARY</b></p><p>
The registered nurse plans, organizes and directs/coordinates home care services and is experienced in nursing, with emphasis on community health education/experience. The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individuals and families within their homes and communities.</p><p></p><p><b>
DUTIES &amp; RESPONSIBILITIES</b></p><ul><li>
Complies with accepted ethical conduct and Professional Standards of Nursing Practice as set forth by the American Nurses Association and the &ldquo;Nurse Practice Act&rdquo; of the State of Colorado.</li><li>
Practices and maintains patient safety and dignity by abiding by Federal, State, Local and (insert company name) policy &amp; procedures as pertains to patient protected health information and HIPAA (Health Information Portability and Accountability Act).</li><li>
Assess the physical, psychosocial, and environmental factors that affect a patient&rsquo;s health. In addition, they perform in-depth functional assessments and medication assessment.</li><li>
Performs physical assessments which may include but is not limited to interviewing patients and their caregivers about the patient&rsquo;s health history and diagnoses, and includes performing a complete physical assessment of all the patient&rsquo;s body systems and capabilities, along with a review of nutritional needs.</li><li>
Performs a psychosocial assessments which may include but is not limited to assessing the patient&rsquo;s cognitive, developmental, behavioral, and coping status and includes screening for anxiety, depression, and abuse or neglect. Furthermore, a psychosocial assessment discovers the patient&rsquo;s language preference, health literacy, learning style, and cultural needs and preferences. Special attention is paid to the multiple impacts the patient&rsquo;s illness and disease have on the family, the caregiver, and the patient&rsquo;s/family&rsquo;s finances.</li><li>
Performs environmental assessments which may include but is not limited to focusing on risks within the home and community to the patient&rsquo;s and home health clinician&rsquo;s personal health and safety. A home environmental assessment includes attention to obstacles within the home that may increase the risk for falls, presence of needed safety features, presence of smoke alarms, and safety practices that are required for home treatments, such as oxygen safety. Sanitation issues that may affect the risk of infection are also assessed.</li><li>
Performs comprehensive medication assessments which may include but is not limited to reconciling medications in the home to the prescriber&rsquo;s list and the patient&rsquo;s diagnoses; monitoring the medications for effectiveness, side effects or adverse effects, and interactions; assessing the ability of the patient and the caregiver to safely and consistently administer the medications; and identifying any barriers or issues related to medication adherence.</li><li>
Performs comprehensive functional assessments which may include but is not limited to determine the patient&rsquo;s risk for falls and ability to safely perform activities of daily living (ADLs) and independent activities of daily living (IADLs), including the ability of the patient and caregiver9s) to safely manage all medical/assistive devices and equipment.</li><li>
Assesses client&rsquo;s condition and needs, through the collection of health data, the recognition, interpretation and reporting of symptoms and psychological responses and re-evaluates the client nursing needs as required.</li><li>
Document diagnoses and identify problems from the assessment data.</li><li>
Partners with the patient, family, and other caregivers to identify specific, measurable, attainable, relevant, and time-defined (SMART) goals for the patient based on the patient&rsquo;s identified problems and diagnoses.</li><li>
Develops a plan of care in collaboration with the patient, family and other caregivers, and other healthcare providers.</li><li>
When the need for other services and supplies is identified, the home health nurse collaborates with the inter-professional home health team to further develop the most effective and economical plan.</li><li>
Develops and implements nursing plan of care with consideration for the dignity and desires of the client care, organizes and participates in direct client care, performs treatment and administers medications.</li><li>
Implements the plan of care and provides skilled nursing interventions to patients, as well as patients&rsquo; families and caregivers, including direct care, teaching, counseling, coaching, care management, and resource coordination.</li><li>
Implements care management which includes report communication to the NS or NM as instructed per (insert company name) protocol.</li><li>
Care management communication also includes frequency by discipline and other needs communicated to (insert company name) Scheduling as instructed per (insert company name) protocol.</li><li>
Formulates, notifies, and carries out client care plan which identifies nursing actions toward achievable goals according to client needs.</li><li>
Maintains a safe, therapeutic environment for the client.</li><li>
Initiates and maintains care coordination while participating in the development of the Plan of Care which includes but is not limited to: obtains physician&rsquo;s orders; clarifies those orders obtaining necessary revisions as needed; informs the physician of changes in the clients condition which may include but in not limited to laboratory and diagnostic reports; provides written summary reports to the physician; and completes all required patient documentation.</li><li>
Participates in patient education, health counseling and teaching with the patient, caregiver and family members as designated per specific patient HIPAA releases.</li><li>
Provides ongoing assessment and evaluation of the patient&rsquo;s progress toward expected outcomes and thus determines the effectiveness of the plan of care providing any necessary modification as needed.</li><li>
Maintains detailed records of nursing actions, client progress, and response to therapy and teaching so that the Plan of Care can be documented and evaluated.</li><li>
Provides ongoing assessment and supervision of care given by ancillary personnel (LPN and C.N.A./C.H.H.A.) to ensure the plan of care is being followed to thereby obtain the best possible outcomes of care provided.</li><li>
Initiates preventative and rehabilitative nursing procedures.</li><li>
Coordinates discharge planning and prepares discharge summaries and instructions.</li><li>
Initiates cardio-pulmonary resuscitation and institutes other emergency procedures when necessary.</li><li>
Communicates information effectively to appropriate personnel to facilitate continuity of care.</li><li>
Motivate patients, families, and caregivers in health promotion and disease management by applying change theory, learning principles, and teaching skills.</li><li>
Accepts accountability for own practice.</li><li>
Maintains competency by participating in in-service, mandatory meetings or education or in-services, and continuing educational programs.</li><li>
Participates in Monthly, Quarterly, Annual trainings as well as other meetings required by Namaste Home Health and Hospice.</li><li>
Coordinates care of all agency disciplines which may include, but not be limited to, Nursing, Certified Home Health Aide, Physical Therapy, Occupational Therapy, Speech Therapy, Medical Social Worker, and other services delivered to clients of the agency.</li><li>
Complies with agency policies, protocols, and standard procedures.</li><li>
Provides consultation to NS, NM, DCS, and HR for proper placement of qualified personnel</li><li>
Completes all required documentation within 24 hours of the patient visit.</li><li>
Completes within 24 hours all documentation sent back for correction.</li><li>
Other duties and tasks as assigned by the Namaste Home Health and Hospice Home Care Emergency Command Center communication tree in the event of a local, regional or national emergency and/or disaster.</li><li>
Employee responds, as required, to support emergency response plan activation.</li><li>
Employee participates in exercises and drills for emergency preparedness, as required.</li><li>
Employee completes emergency preparedness training as identified as appropriate for this employee level.</li><li>
Other duties and tasks as assigned.</li><li>
Other duties / responsibilities that support the agency&rsquo;s core values of Commitment, Advocacy, Respect, and Excellence.</li></ul><p></p><p><b>
JOB REQUIREMENTS (Education, Experience, Knowledge, Skills &amp; Abilities)</b></p><ul><li>
Must have graduated from an approved school of nursing and be licensed in the state where practicing.</li><li>
Minimum of two years of experience, at least one of which is in the area of public health or home care nursing is preferred.</li><li>
Maintains a current CPR certification.</li><li>
Must be a licensed driver with an automobile that is insured in accordance with state or organization requirements and is in good working order.</li><li>
Self-directed and able to work with minimal supervision.</li><li>
Demonstrates excellent observation, problem solving, verbal and written communication skills; nursing skills per competency checklist.</li><li>
Shows ability to organize and prioritize workload independently.</li><li>
Management experience not required. Responsible for supervising home health aides.</li><li>
Prolonged or considerable walking or standing. Able to lift, position, or transfer patients. Able to lift supplies and equipment. Considerable reaching, stooping, bending, kneeling, or crouching. Visual acuity and hearing to perform required nursing skills.</li></ul><p></p><p>
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by the employee of this job. The employee may be requested to perform job-related tasks other than those stated in this description.</p><p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p>
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.</p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>

Home Health RN Case Manager - Central/West Denver Metro

Alignment Healthcare

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
Location: Fully Remote (Must be licensed in California)<br>
Schedule: Monday&ndash;Friday, 8:00 AM &ndash; 5:00 PM PT<br>
Language: Bilingual candidates strongly preferred (Spanish and Vietnamese)<br>
<br>
Join the Team That&rsquo;s Redefining Healthcare!<br>
<br>
Are you a compassionate Registered Nurse with a passion for improving the lives of seniors and complex care patients? Join Alignment Health as a Telephonic RN Case Manager for our Special Needs Plan (SNP) members &mdash; all from the comfort of your home!<br>
<br>
This is a fully remote, phone-based position where you'll play a vital role in helping members navigate their care journeys, close gaps in care, and overcome barriers to better health. (HIPAA compliant work space)<p></p><div><div><b>
What You'll Do</b></div><div>
As an <b>RN Case Manager (SNP)</b>, you will:</div><ul><li><div>
Provide telephonic case management to <b>medically complex and chronically ill members</b></div></li><li><div>
Conduct <b>comprehensive health assessments</b> and create individualized care plans</div></li><li><div>
Coordinate care with internal and external partners, including physicians and specialists</div></li><li><div>
Educate members and caregivers on disease management and preventive care</div></li><li><div>
Monitor member progress and advocate for timely, appropriate interventions</div></li><li><div>
Identify and help resolve service or access issues impacting care quality</div></li></ul><div></div><div><b>
Requirements</b></div><div><b>
Must-Haves:</b></div><ul><li><div><b>
Active, unrestricted RN license in California</b> (Non-Compact)</div></li><li><div><b>
Minimum 2 years of clinical nursing experience</b></div></li><li><div><b>
At least 1 year of case management</b> experience</div></li><li>
Proficiency with Microsoft Office (Word, Excel, Outlook)</li></ul><div></div><div><b>
Nice-to-Haves:</b></div><ul><li><div>
Bilingual (Spanish, Korean, Mandarin, etc.)</div></li><li><div>
Previous <b>health plan</b> or <b>IPA</b> experience</div></li><li><div>
Bachelor's Degree in Nursing (BSN)</div></li></ul><div></div><div><b>
Licensure Requirement Upon Hire:</b></div><ul><li><b>
Active, unrestricted RN license in California</b> (Non-Compact)</li><li><div>
Must be willing to obtain RN licensure in <b>Nevada</b>, <b>Arizona</b>, <b>North Carolina</b>, and <b>Texas</b> (company reimburses costs)</div></li></ul><div></div><div><b>
Work Environment</b></div><ul><li><div><b>
Fully remote</b> &mdash; work from anywhere in the U.S., but must work <b>Pacific Time hours</b></div></li><li><div>
All communication is conducted via phone, email and Teams.</div></li><li><div>
Company-provided equipment and IT support included</div></li></ul><div></div><div><b>
Why Join Alignment Health?</b></div><div>
At Alignment, we&rsquo;re changing the way healthcare is delivered for the most vulnerable populations. We're committed to innovation, compassion, and delivering meaningful outcomes &mdash; and we want <b>you</b> to be a part of that journey.</div><div></div><div><b>
Benefits &amp; Perks</b></div><ul><li><div>
Competitive compensation</div></li><li><div>
Full suite of health benefits (medical, dental, vision)</div></li><li><div>
401(k) with employer match</div></li><li><div>
Generous PTO and paid holidays</div></li><li><div>
Career growth and continuing education support</div></li><li><div>
Rewarding referral bonuses for successful hires</div></li></ul><div></div><div><b>
Apply Today</b></div><div>
Be part of something bigger. Bring your skills and compassion to a team that values connection, service, and innovation.</div><div></div><div>
Apply now or refer a colleague who would thrive in this role:</div><div>
https://careers.alignmenthealth.com</div><div></div><div><b>
Note:</b> This position is not open to LVNs. California RN license is required.</div></div><div></div><div><div><div><div><p>
Essential Physical Functions:</p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><ul><li>
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.</li><li>
The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</li></ul></div></div></div></div>
Pay Range: $77,905.00 - $116,858.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

Remote Bilingual Spanish Telephonic RN Nurse Case Manager (California RN Required)

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></p><p><b>
This is a remote work from home role anywhere in the US with virtual training.</b></p><p></p><p>
American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.</p><p></p><p><b>
Key Responsibilities</b></p><ul><li><p>
This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients.</p></li><li><p>
Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing benefits and/or member&rsquo;s needs to ensure appropriate administration of benefits.</p></li><li><p>
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.</p></li><li><p>
Assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.</p></li><li><p>
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.</p></li><li><p>
Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives.</p></li><li><p>
Utilizes case management processes in compliance with regulatory and company policies and procedures.</p></li><li><p>
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversations.</p></li><li><p>
Identifies and escalates member&rsquo;s needs appropriately following set guidelines and protocols.</p></li><li><p>
Need to actively reach out to members to collaborate/guide their care.</p></li><li><p>
Perform medical necessity reviews.</p></li></ul><p><b><br>
Required Qualifications</b></p><ul><li><p>
5+ years&rsquo; experience as a Registered Nurse, including at least 1 year in a hospital setting.</p></li><li><p>
The AHH RN Case manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support</p></li><li><p>
1+ years&rsquo; experience documenting electronically using a keyboard.</p></li><li><p>
1+ years&rsquo; current or previous experience in Oncology.</p></li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li><p>
1+ years&rsquo; Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience as well as experience with transferring patients to lower levels of care.</p></li><li><p>
1+ years' experience in Utilization Review.</p></li><li><p>
CCM and/or other URAC recognized accreditation preferred.</p></li><li><p>
1+ years&rsquo; experience with MCG, NCCN and/or Lexicomp.</p></li><li><p>
Bilingual in Spanish preferred.</p></li><li><p>
Bachelors Degree</p></li></ul><p><b><br>
Education</b></p><ul><li><p>
Diploma or Associates Degree in Nursing required.</p></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>
$54,095.00 - $155,538.00<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.</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>
This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.<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 (Oncology experience required)

Search 6210+ Disease case manager rn jobs near you this June. New roles added regularly across leading industries. Apply today.

6210 disease case manager rn jobs Near Me

Home Health RN Case Manager - Central/West Denver Metro

Remote Bilingual Spanish Telephonic RN Nurse Case Manager (California RN Required)

Case Manager, Registered Nurse (Oncology experience required)

Case Manager, Registered Nurse (Oncology experience required)

Case Manager, Registered Nurse (Oncology experience required)

Case Manager, Registered Nurse (Oncology experience required)

Case Manager, Registered Nurse (Oncology experience required)