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case manager (10237)

case manager - hsprs

home care aide medtech

Angel Core Home of Care

<div><div><div><b>Benefits:</b></div>
<ul><li>401(k)</li>
<li>401(k) matching</li>
<li>Competitive salary</li>
<li>Flexible schedule</li>
</ul></div><div><div><b>Benefits/Perks</b></div>
<ul><li>Flexible Scheduling</li>
<li>Competitive Compensation</li>
<li>Careers Advancement</li>
</ul><div><b>Job Summary</b></div>
<div>We are looking for a <b>Home Care Aide/MEDTECH</b> to join our team! You will be directly working with residents, following a one-on-one care plan in an Assisted Living facility. You operate with a big heart, not only providing personalized and attentive care but by building genuine relationships with those you serve. You are detail-oriented, highly organized, and committed to creating a healthy environment that meets patient needs. Strong verbal and written communication skills are needed to succeed in this role. Prior Home Health or Hospice experience is a plus.</div><div><br>
</div>
<div><b>Responsibilities</b></div>
<ul><li>Assist residents with daily activities such as moving in and out of beds, baths, wheelchairs, or automobiles</li>
<li>Care for residents by changing bed linens, doing laundry, cleaning the home, or assisting with personal care</li>
<li>Maintain records of resident care, condition, progress, or problems to report and discuss observations with the supervisor</li>
<li>Build relationships with residents by conversing or reading aloud to help keep them mentally healthy and alert</li>
<li>Administer medications</li>
<li>Engage residents in exercises or other activities</li>
<li>Document all meds on MAR sheets</li>
</ul><div><b>Qualifications</b></div>
<ul><li>Graduated from an accredited Home Health Aide program</li>
<li>High School Diploma or GED</li>
<li>Two years prior professional experience</li>
<li>Driver&rsquo;s license required</li>
<li>CPR certification required</li>
<li>Certified as Medtech</li></ul></div></div>

Home Care Aide/MEDTECH

Touching Angels Healthcare

<p><b>Touching Angels Healthcare, Inc.</b></p><p><b>Areas: Baltimore City</b></p><p><b>Compensation &amp; Benefits</b></p><ul><li><b>Hourly Rate:</b> $80.00/hour</li><li><b>Mileage Reimbursement:</b> Full compensation for mileage and tolls</li><li><b>Schedule:</b> Part-time, Per Diem with flexible scheduling</li><li><b>Start Date:</b> April 2026</li></ul><p><b>CRITICAL POSITION REQUIREMENT - EXTENSIVE TRAVEL</b></p><p><b>This assignment is a field-based position requiring approximately 90% travel time.</b> You will travel from client residence to client residence throughout Baltimore City to conduct comprehensive nursing assessments. Traveling from your home to client locations typically ranges from <b>30 to 45 minutes one way</b>. If you are unable to commit to extensive daily travel, please do not apply.</p><p><b>About Touching Angels Healthcare</b></p><p>Since 2006, Touching Angels Healthcare has been a trusted provider of comprehensive non-medical home care services throughout Maryland. We are licensed under Maryland's LTSS/ISAS Medicaid program and accredited by the Joint Commission. Our mission extends beyond profit&mdash;we are committed to providing dignified care, enriching communities, and making a meaningful difference in the lives we serve, one patient at a time.</p><p><b>Position Summary</b></p><p>The Home Health Registered Nurse Case Manager is responsible for conducting comprehensive in-home assessments, developing individualized Plans of Care, and ensuring that caregivers provide appropriate, consistent, and safe personal care assistance services. This role requires independent judgment, excellent time management, and the ability to work autonomously while traveling throughout the service area.</p><p><b>Essential Duties and Responsibilities</b></p><p><b>Assessment &amp; Care Planning:</b></p><ul><li>Conduct comprehensive in-home nursing assessments at client residences throughout Baltimore City, MD.</li><li>Complete a thorough OASIS assessment and all required supporting documentation per COMAR rules and regulations.</li><li>Create, implement, and maintain individualized Plans of Care (POC) for each assigned client</li><li>Perform ongoing re-evaluations and make necessary adjustments to care plans based on client needs</li><li>Document all assessments, interventions, and changes accurately and in a timely manner.</li></ul><p><b>Care Coordination &amp; Supervision:</b></p><ul><li>Supervise and provide clinical oversight to LPNs, CNAs, GNAs, and Home Health Aides per Maryland regulations</li><li>Educate and instruct patients, family members, and direct care staff on proper care techniques and procedures</li><li>Coordinate all services provided and consult interdisciplinary team members and other health professionals</li><li>Monitor caregiver performance and ensure compliance with established care plans</li></ul><p><b>Communication &amp; Collaboration:</b></p><ul><li>Notify physicians and the appropriate staff of significant changes in patient conditions in a timely manner.</li><li>Maintain professional communication with patients, families, caregivers, and healthcare team members</li><li>Collaborate with Care Coordinators and office staff to ensure continuity of care</li><li>Participate in case conferences and team meetings as required</li></ul><p><b>Professional Practice:</b></p><ul><li>Plan, organize, and prioritize a daily schedule to maximize efficiency across multiple client locations.</li><li>Work independently with minimal supervision while adhering to agency policies and regulatory standards</li><li>Maintain knowledge of patient rights and responsibilities</li><li>Comply with all organizational policies, procedures, and quality assurance standards</li><li>Ensure all nursing care reflects awareness of legal responsibilities and consequences of nursing actions</li></ul><p><b>Required Qualifications</b></p><p><b>Education:</b></p><ul><li>Graduate of an accredited School of Nursing (BSN preferred)</li></ul><p><b>Licensure &amp; Certifications:</b></p><ul><li>A current, active, and unrestricted Registered Nurse (RN) license in Maryland or a valid Compact State license</li><li>Current Basic Life Support (BLS) certification</li><li>Current First Aid certification</li><li>Must maintain all certifications throughout employment</li></ul><p><b>Background Checks&mdash;MANDATORY:</b> Candidates must have a <b>clean background</b> from all of the following:</p><ul><li><b>Maryland Board of Nursing (MBON)</b>&mdash;No disciplinary actions</li><li><b>Criminal Justice Information System (CJIS)</b>&mdash;Clear criminal background verification</li><li><b>Office of Inspector General (OIG)</b>&mdash;Not excluded from federal healthcare programs</li></ul><p><b>Health Requirements:</b></p><ul><li>Current COVID-19 vaccination (required)</li><li>TB test clearance</li><li>Health screening is required by agency policy.</li></ul><p><b>Transportation:</b></p><ul><li>Valid driver's license and reliable personal vehicle (required)</li><li>Current auto insurance meets Maryland state requirements.</li><li>Willingness and ability to travel 90% of work time between client residences.</li></ul><p><b>Physical Demands &amp; Work Environment</b></p><ul><li>Ability to lift, move, and transfer up to 50 pounds</li><li>Frequent stooping, bending, squatting, kneeling, standing, and walking</li><li>Normal or correctable vision and hearing</li><li>Ability to accurately discern colors is necessary for patient assessment.</li><li>Work performed primarily in clients' homes with varying environmental conditions</li><li>Extensive driving in various weather conditions throughout Baltimore and surrounding areas</li><li>May require climbing stairs in homes without elevators</li></ul><p><b>Preferred Qualifications</b></p><ul><li>2+ years of home health or community health nursing experience</li><li>Experience with OASIS documentation and Medicare/Medicaid regulations</li><li>Familiarity with Maryland LTSS/ISAS waiver programs</li><li>Bilingual capabilities (Spanish, Korean, or Arabic)</li><li>Strong clinical assessment and critical thinking skills</li><li>Excellent time management and organizational abilities</li><li>Proficiency with electronic health records and mobile documentation systems</li></ul><p><b>Why Join Touching Angels Healthcare?</b></p><ul><li><b>Competitive Compensation:</b> $80/hour plus full mileage and toll reimbursement</li><li><b>Flexibility:</b> Enjoy per diem scheduling that aligns with your availability.</li><li><b>Professional Autonomy:</b> Work independently with supportive team backup</li><li><b>Meaningful Work:</b> Make a direct impact on clients' quality of life</li><li><b>Established Agency:</b> Nearly 20 years of service excellence in Maryland</li><li><b>Career Growth:</b> Opportunities for professional development and advancement</li></ul><p><b>Application Process</b></p><p><b>SERIOUS CANDIDATES ONLY</b></p><p>This position requires a significant commitment to travel and independent fieldwork. Please only apply if you:</p><ul><li>Have reliable transportation and are willing to travel 90% of your work time.</li><li>You are capable of committing to 30-to-45-minute commutes to client locations.</li><li>Candidates must have or be able to obtain clear background checks from MBON, CJIS, and OIG.</li><li>Meet all licensure and certification requirements</li></ul><p><b>To Apply:</b></p><ul><li>Submit your application through our website: <b>www.touchingangels.com</b></li><li>Include your current resume highlighting home health experience.</li><li>Attach copies of your RN license and current BLS certification.</li><li>Provide three professional references</li></ul><p><b>Equal Opportunity Employer</b></p><p>Touching Angels Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.</p><p><b>For immediate consideration, apply at www.touchingangels.com.</b></p><p><i>Only candidates who meet all requirements will be contacted for an interview.</i></p><p>Job Type: Part-time</p><p>Pay: $80.00 per hour</p><p>Benefits:</p><ul><li>Flexible schedule</li></ul><p>Application Question(s):</p><ul><li>Are you willing to undergo and pass all required background checks (MBON, CJIS, OIG)?</li><li>Are you comfortable working in clients&rsquo; homes with varying conditions (pets, smoking, stairs, etc.)</li><li>Do you have a valid driver&rsquo;s license, reliable personal vehicle, and current auto insurance that meets Maryland state requirements?</li><li>Can you commit to per diem scheduling with flexibility (including occasional same-day assignments)?</li><li>Do you have experience conducting in-home nursing assessments and creating individualized Plans of Care?</li><li>Do you have at least 2 years of home health or community health nursing experience?</li><li>Are you familiar with OASIS documentation and Medicare/Medicaid regulations?</li><li>Do you speak any additional languages (Spanish, Korean, Arabic)?</li><li>Are you willing and able to travel approximately 90% of your work time to client homes throughout Baltimore City?</li></ul><p>Work Location: On the road</p>

Registered Nurse Case Manager (Per Diem) - Field Position

Gentiva

<div>Overview:
<div><b>
Deliver Compassion. Elevate Care. Empower Lives.</b></div><div></div><div><br>
We are seeking a compassionate and skilled Palliative Care Nurse Practitioner to join our interdisciplinary team. In this role, you will provide advanced palliative care to patients in their homes, helping them achieve the highest quality of life possible while managing complex medical needs. You will work autonomously in collaboration with the Palliative Medical Director, delivering exceptional care and guiding patients and families through every stage of treatment.</div><div></div><div><b><br>
Responsibilities:</b></div><ul><li><div>
Collaborate with the Palliative Medical Director and care team to deliver comprehensive, patient-centered palliative care.</div></li><li><div>
Perform in-depth patient assessments, including physical, emotional, and psychosocial evaluations.</div></li><li><div>
Develop and implement individualized care plans in partnership with patients and families.</div></li><li><div>
Manage and adjust treatment plans based on patient needs and progress.</div></li><li><div>
Prescribe medications (including controlled substances) and order diagnostic tests as permitted by state law.</div></li><li><div>
Maintain timely, accurate clinical documentation in compliance with professional standards.</div></li><li><div>
Communicate effectively with physicians, caregivers, and other healthcare professionals.</div></li><li><div>
Participate in evening/weekend call rotation as needed.</div></li><li><div>
Facilitate referrals for additional care services when appropriate.</div></li></ul>
About You:
<div><b>
Specialized Knowledge/Skills:</b></div><ul><li><div>
Excellent leadership, interpersonal, written, and verbal communication skills.</div></li><li><div>
Strong independent decision-making abilities and self-motivation.</div></li><li><div>
Understanding of palliative medicine principles, home health, hospice care eligibility, and Medicare/Medicaid regulations.</div></li><li><div>
Familiarity with the interdisciplinary care process.</div></li><li><div>
Meets mandatory continuing education requirements for Gentiva and licensing boards.</div></li><li><div>
Proficient in point-of-care software and technology.</div></li></ul><div><b>
Education/Experience:</b></div><ul><li><div>
Master of Science in Nursing from an accredited school of nursing (or equivalent per state law).</div></li><li><div>
Minimum two years&rsquo; Nurse Practitioner experience.</div></li><li><div>
Specialty in Family or Adult Medicine preferred.</div></li><li><div>
Experience with Part B billing.</div></li><li><div>
Ability to work autonomously in an advanced practice role.</div></li></ul><div><b>
Licenses/Certifications/Agreements:</b></div><ul><li><div>
Current RN license and Nurse Practitioner certification/license as required by state law.</div></li><li><div>
Collaborative agreement with supervising physician (or willingness to establish).</div></li><li><div>
Part B Provider certification.</div></li><li><div>
Federal DEA license and state DEA license (if required).</div></li><li><div>
ACHPN certification in Hospice and Palliative Care preferred.</div></li><li><div>
Valid driver&rsquo;s license and current automobile insurance.</div></li></ul>
We Offer:
<div>
Compensation may vary within the salary range provided based on several factors including but not limited to a candidate&rsquo;s location, experience, education, skills, licensure, certifications and department equity. Gentiva provides associates with a comprehensive benefits and total rewards package, of which base pay is just one piece.</div><div></div><div><br>
Salary Range &ndash; $106,540 to $133,170</div><div></div><div><br>
Full Time Employee Benefits:</div><ul><li>
Medical, Dental, Vision</li><li>
Wellness Program and Resources</li><li>
401k match</li><li>
PTO</li><li>
FMLA, ADA and other federal and state required leaves</li><li>
Short/Long Term Disability</li><li>
HSA Contribution</li><li>
Mileage or Fleet Car Program</li><li>
Cell Phone Reimbursement (for eligible roles)</li><li>
Short Term Incentive (for eligible roles)</li><li>
Tuition Reimbursement</li></ul><div></div><div><b><br>
Benefits for All Associates (Full-Time, Part-Time &amp; Per Diem):</b></div><ul><li>
Competitive Pay</li><li>
401(k) with Company Match</li><li>
Career Advancement Opportunities</li><li>
National &amp; Local Recognition Programs</li><li>
Teammate Assistance Fund</li></ul><div></div><div><b><br>
Additional Full-Time Benefits:</b></div><ul><li>
Medical, Dental, Vision Insurance</li><li>
Mileage Reimbursement or Fleet Vehicle Program</li><li>
Generous Paid Time Off + 7 Paid Holidays</li><li>
Wellness Programs (Telemedicine, Diabetes Management, Joint &amp; Spine Concierge Care)</li><li>
Education Support &amp; Tuition Assistance (ASN to BSN, BSN to MSN)</li><li>
Free Continuing Education Units (CEUs)</li><li>
Company-paid Life &amp; Long-Term Disability Insurance</li><li>
Voluntary Benefits (Pet, Critical Illness, Accident, LTC)</li></ul><div></div><div><b><br>
Apply now to be part of a team that values expertise, compassion, and excellence in care.
</b></div>Legalese:
<ul><li>This is a safety-sensitive position</li><li>
Employee must meet minimum requirements to be eligible for benefits</li><li>
Where applicable, employee must meet state specific requirements</li><li>
We are proud to be an EEO employer</li><li>
We maintain a drug-free workplace</li></ul>
Location: Empatia Our Company:<p></p><div><br>
At Empatia, part of Gentiva, it is our privilege to offer compassionate care in the comfort of wherever our patients call home. We are a national leader in hospice care, palliative care, home health care, and advanced illness management, with nearly 600 locations and thousands of dedicated clinicians across 38 states.</div><div></div><div><br>
Our place is by the side of those who need us &ndash; from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis.</div><div></div><div><br>
Our nationwide reach is powered by a family of trusted brands that include:</div><ul><li><b>
Hospice care:</b> Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon</li><li><b>
Palliative care:</b> Empatia Palliative Care, Emerald Coast Palliative Care</li><li><b>
Home health care:</b> Heartland Home Health</li><li><b>
Advanced illness management:</b> Illumia Health</li></ul><div></div><div><br>
With corporate headquarters in Atlanta, Georgia, and providers delivering care across the U.S., we are proud to offer rewarding careers in a collaborative environment where inspiring achievements are recognized &ndash; and kindness is celebrated.</div></div>

Nurse Practitioner Palliative Care

Chase Brexton Health Care

<div>
 JOB SUMMARY: The Nurse Care Coordinator delivers and oversees care management services for medically and/or socioeconomically complex patients in accordance with patient-defined goals, multi-disciplinary plan of care, and established policies and procedures. Drawing on best practices in motivational interviewing and care management, the Nurse Care Coordinator collaborates with clients and multi-disciplinary teams to develop and implement flexible, patient-centered, and cost-effective strategies that support clients to achieve health-related goals. The Nurse Care Coordinator will collect and analyze patient-level data, assist with development and maintenance of care plans, and evaluate outcomes of interventions. The Nurse Care Coordinator also serves as a role model and mentor to CBHC staff on best practices in care coordination, motivational interviewing and addressing social determinants of health. Assures compliance with regulatory body standards (including Joint Commission, HRSA, PCMH, and grant funding sources). This is a hybrid position, and the staff member is expected to be licensed and based in Maryland.
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  Major Duties And Responsibilities
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 Analytical and Critical Thinking
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 Work to develop systems and processes to engage patients in self-management and care navigation.
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   Ensure that appropriate community resources, home care and ancillary services are in place and being delivered.
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   Identify high and rising-risk, high-need, and potentially high-cost patients within the assigned panel of Chase Brexton Health Care patients
  </li>
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   Identify patients at risk for poor outcomes and those who may require more intensive services; provide additional outreach and frequent follow up (by phone and in-person) to this population.
  </li>
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   Provide complex case management, including chronic disease case management, care coordination, transition care management, high risk clinical tracking, and complex medication management to appropriate patients.
  </li>
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   Access appropriate resources inside and outside the organization to meet the needs of the patient.
  </li>
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   Provide referrals to appropriate community resources; facilitate access and communication when multiple services are involved; monitor activities to ensure that services are actually being delivered and meet the needs of the patient, coordinate services to avoid duplication. Teamwork
  </li>
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   Role model and mentor others, including RN Care Managers, to assess and address the physical, functional, social, psychological, environmental, learning and financial needs of patients.
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  </li>
 </ul>
 Communication
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   Deliver, and assist others to also provide, appropriate interventions which demonstrate knowledge of, and sensitivity toward, cultural diversity and religious, developmental, health literacy, and educational backgrounds of the population served. Utilize interpreter services per policy.
  </li>
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   Facilitate disease prevention and health promotion with nursing staff, patients and families. Patient Focus
  </li>
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   Provide education, information, and support related to care goals of patients.
  </li>
  <li>
   Act as a patient advocate and assist with problem solving and addressing any barriers to care or compliance with care plan. Checking, Examining, and Recording
  </li>
  <li>
   Maintain accurate patient records and patient confidentiality. Willingness to Learn
  </li>
  <li>
   Engage in professional development activities to keep abreast of care management practices and patient engagement strategies.
  </li>
  <li>
   Attend training sessions and staff meetings as assigned.
   <br/>
   <br/>
  </li>
 </ul>
 SKILLS AND ABILITIES:
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  <br/>
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 Able to prioritize competing responsibilities and manage complex caseloads.
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  <li>
   Motivational interviewing skills.
  </li>
  <li>
   Supportive coaching and mentorship to colleagues at clinic sites, including RN Care Managers, around care coordination and addressing social determinants of health.
  </li>
  <li>
   Experience with documentation in an Electronic Medical Record
  </li>
  <li>
   Ability to work with computers in word processing, and database applications preferred.
  </li>
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   CPR certified by scheduled start date.
  </li>
  <li>
   Must be flexible and adapt to a changing environment.
   <br/>
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  </li>
 </ul>
 EDUCATION AND/OR EXPERIENCE:
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 Graduate from an Accredited School of Nursing; Current Maryland Nursing License
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   At least five years of related nursing experience serving vulnerable clients in a community-based, home-based, or ambulatory care setting.
  </li>
  <li>
   Chronic disease management experience
  </li>
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   Encouraged to maintain membership in professional organizations such as the AAACN, ANAC, etc.
  </li>
 </ul>
 <li>
  <br/>
  <br/>
 </li>
 Preferred: Case Management Certification
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 WORKING CONDITIONS/PHYSICAL DEMANDS:
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  <li>
   Work is typically performed in an office environment. Depending on client/population needs, may also include clinical and community and/or home-based activities, as appropriate to program. The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
   <br/>
   <br/>
  </li>
 </ul>
 My signature below indicates that I have reviewed this job description. I understand the specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
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 <br/>
 ___________________________________________________ _________________
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 Employee Signature
</div>


Population Health RN Care Coordinator

The Chimes, Inc.

<div><p><b>Community Support Manager/Individual Support Services</b><br>
<b>Compensation: $53,207/Annually
</b></p><p><b>Position Summary</b></p>
<p>
Chimes is seeking a dedicated and compassionate <b>Community Support Manager</b> to lead residential services that support adults with intellectual and developmental disabilities in a community living environment. This role is responsible for the overall operation of an assigned home, including staff leadership, program implementation, quality care, compliance, communication, and resource management. The Community Support Manager plays a key role in helping individuals achieve their personal goals while ensuring a safe, supportive, and person-centered home environment.</p>
<p><b>
What You&rsquo;ll Do</b></p>
<p>
As a Community Support Manager, you will:</p>
<ul>
<li>Lead and supervise direct support staff in the daily operation of an assigned residential home</li>
<li>Support adults with intellectual and developmental disabilities in achieving greater independence and quality of life</li>
<li>Implement and monitor individual support plans, behavior plans, and related program documentation</li>
<li>Train, coach, and evaluate staff to ensure high-quality, person-centered care</li>
<li>Coordinate communication among families, guardians, internal teams, outside agencies, and other stakeholders</li>
<li>Oversee medication administration, medication records, and related compliance processes</li>
<li>Maintain accurate program files, house records, and required postings in accordance with agency policy and regulations</li>
<li>Ensure the home environment is safe, clean, personalized, and compliant with applicable standards</li>
<li>Coordinate appointments, transportation, activities, and daily supports for individuals served</li>
<li>Participate in staff hiring, onboarding, training, scheduling, and retention efforts</li>
<li>Review time records, manage household resources, and help maintain budget accountability</li>
<li>Respond appropriately in emergencies and use crisis intervention techniques when needed</li>
<li>Work collaboratively with others while promoting professionalism, teamwork, and service excellence</li>
</ul>
<p><b>Qualifications</b></p>
<p>
To be successful in this role, candidates should have:</p>
<ul>
<li>An <b>Associate degree</b> in education, psychology, social sciences, or a related field</li>
<li>At least <b>2 years of experience</b> working directly with people who have co-occurring diagnoses</li>
<li>At least <b>1 year of supervisory experience</b></li>
<li>A <b>valid driver&rsquo;s license</b>, reliable vehicle, and an acceptable driving record in accordance with agency requirements</li>
</ul>
<p>Additional related education and/or experience may be considered in place of stated requirements, at the discretion of Human Resources.</p>
<p><b>
Schedule Expectations</b></p>
<p>
This role requires flexibility and may include:</p>
<ul>
<li>Evening hours</li>
<li>Weekend hours</li>
<li>On-call responsibilities, as assigned</li>
</ul>
<p><b>Benefits You&rsquo;ll Love</b></p>
<ul>
<li>Medical plans starting as low as <b>$6.90/month</b> beginning <b>Day 1</b></li>
<li>Dental &amp; vision coverage</li>
<li>Life &amp; disability insurance</li>
<li>Generous PTO</li>
<li><b>403(b) retirement plan</b> with employer match</li>
<li>Paid training + tuition assistance</li>
<li>Referral bonuses &amp; recognition programs</li>
</ul>
<p>✨ <b>Join the Chimes Community Support Team</b> and experience the fulfillment of making a difference&mdash;every single day.</p>
<p>
To learn more and apply, visit <b>chimes.org/Careers</b>.</p>
<p>
#CMD410</p></div>

Community Support Manager/Individual Support Services

CareFirst BlueCross BlueShield

<div>
 <strong>
  Resp &amp; Qualifications
  <br/>
  <br/>
 </strong>
 <strong>
  PURPOSE:
  <br/>
  <br/>
 </strong>
 The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience and skills in both care management and utilization management, the Clinical Navigator will leverage proficiency in established MCG, in addition to administrative/regulatory considerations, to determine medical necessity, appropriate level(s) of care, and case management to engage members/enrollees, their families and other support systems in discharge planning. The role will function as a liaison working telephonically with the hospital care team including case managers, social workers and discharge planners to ensure CareFirst members/enrollees receive the appropriate level of care and partner to address any potential barriers to discharge. The candidate may be required to come to the CareFirst office location periodically for meetings, training, or other business-related activities. The candidate's primary residence must be within the
 <strong>
  greater Baltimore metropolitan area
 </strong>
 . Bilingual - fluent in Spanish a big plus!
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 <strong>
  Essential Functions
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Utilize clinical expertise and critical thinking skills to analyze available clinical information, Electronic Medical Records (EMRs), benefit contracts, mandates, medical policy, evidence based published research, national accreditation and regulatory requirements to aid in determination of appropriateness and authorization of inpatient clinical services. Engages telephonically with member, family and providers to identify key strategic interventions, discharge planning and coordination to address members medical, behavioral and/or social determinant of health needs to promote a safe transition to the appropriate level of care and/or home.
  </li>
  <li>
   Collaborates with CareFirst medical directors and participates in internal case rounds/discussions to determine appropriate course of action and level of care. Applies sound clinical knowledge and judgment throughout the review process. Follows member benefit contracts to assist with benefit determination.
  </li>
  <li>
   Makes referrals to other care management programs as appropriate for chronic, long-term care coordination.
  </li>
  <li>
   Works collaboratively with hospital teams to develop positive working relationships to decrease provider abrasion and improve the member experience.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Qualifications
  <br/>
  <br/>
 </strong>
 <strong>
  Education Level:
 </strong>
 Bachelor's Degree in Nursing OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
 <br/>
 <br/>
 <strong>
  Licenses/Certifications Upon Hire Required
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   RN - Registered Nurse - State Licensure And/or Compact State Licensure: RN - Registered Nurse in MD, VA or Washington, DC
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Experience:
 </strong>
 5 years clinically related experience working in Care Management, Home Health, Discharge Coordination and/or Utilization Review.
 <br/>
 <br/>
 <strong>
  Preferred Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Knowledge and experience with MCG
  </li>
  <li>
   Experience working with Commercial and Medicare/Medicaid enrollees and benefits contracts
  </li>
  <li>
   CCM certification
  </li>
  <li>
   MCG certification
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Knowledge, Skills And Abilities (KSAs)
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Strong interpersonal skills and the ability to engage in a member facing environment telephonically while at the same time building relationships and partnerships with hospital care team and alternative care delivery partners to meeting member/enrollee needs.
  </li>
  <li>
   Strong clinical documentation skills along with the ability to type on a computer keyboard with ease and speed.
  </li>
  <li>
   Proficient in the use of web-based technology and Microsoft Office applications such as Word, Excel and Power Point.
  </li>
  <li>
   Strong analytical and problem-solving skills to judge appropriateness of member services and treatments on a case-by-case basis.
  </li>
  <li>
   Knowledge of clinical standards of care and disease process and national, evidence based clinical guidelines and hospital operations.
  </li>
  <li>
   Knowledge of available community resources and programs.
  </li>
  <li>
   Basic understanding of the strategic and financial goals of a health care system, payer organization, health plan and/or health insurance operations (e.g. networks, eligibility, benefits).
  </li>
  <li>
   Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Salary Range:
 </strong>
 $72,216 - $143,429
 <br/>
 <br/>
 <strong>
  Salary Range Disclaimer
  <br/>
  <br/>
 </strong>
 The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
 <br/>
 <br/>
 <strong>
  Department
  <br/>
  <br/>
 </strong>
 Maryland Inpatient Telephonic
 <br/>
 <br/>
 <strong>
  Equal Employment Opportunity
  <br/>
  <br/>
 </strong>
 CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
 <br/>
 <br/>
 <strong>
  Where To Apply
  <br/>
  <br/>
 </strong>
 Please visit our website to apply: www.carefirst.com/careers
 <br/>
 <br/>
 <strong>
  Federal Disc/Physical Demand
  <br/>
  <br/>
 </strong>
 Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
 <br/>
 <br/>
 <strong>
  Physical Demands
  <br/>
  <br/>
 </strong>
 The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
 <br/>
 <br/>
 <strong>
  Sponsorship in US
  <br/>
  <br/>
 </strong>
 Must be eligible to work in the U.S. without Sponsorship
 <br/>
 <br/>
</div>


Clinical Navigator (Remote)

Cayuga Centers

Cayuga Centers is hiring immediately for Case Manager
<br><br>
<b>Earn:</b> $64,500 annually
<br><br>
<b>Location:</b> Baltimore, Maryland
<br><br>
Join our team and make a difference in the lives of children, youth, and families in our community!
<br>About Cayuga Centers
<br>Cayuga Centers is an accredited non-profit, human services agency dedicated to family support and preservation, trauma-informed care, and serving vulnerable populations with the most unique needs. Founded in 1852 in Auburn, NY, we have a long history of delivering high-quality and innovative services to individuals, children, youth and families. We have program offices across 8 states and serve over 10,000 individuals and families annually. Join us!
<br><br>
At Cayuga Centers, we embrace diversity, equity, inclusion, and belonging. We do this by taking a firm stance against hatred, inequality, bias, and injustice. We do this by providing our staff with the training, coaching, and resources necessary to grow and serve with cultural humility, acceptance, and understanding. We are responsive to the diverse needs of those we serve and staff, and are committed to ensuring that everyone feels respected, valued, and a sense of belonging.
<br><br>
Cayuga Centers is an equal opportunity employer and does not discriminate against any employee, prospective employee, or applicant based on race, color, creed, hair style/texture, religion, national origin, citizenship status, sex, sexual orientation, age, disability, military or veteran status, genetic information, or any other classification protected by applicable federal, state, and/or local laws.
<br><br>
<b>About the Program and Case Manager Position:</b><br>
Our Home Study and Post Release Services (HS/PRS) program is dedicated to making a significant impact on the lives of unaccompanied children (UC) aged 0- 17 ½. Referred through shelters or trusted foster care providers, these children rely on our continuous support throughout their journey from the Office of Refugee Resettlement (ORR) to their parents or sponsors. We can guide and empower these children and sponsors through an unfamiliar system, which makes a great difference.
<br><br>
One of the responsibilities of the Case Manager is to conduct home studies. These studies involve assessing the safety of the home and the suitability of the sponsor before the child is unified with them. This assessment ensures that the child will be placed in a secure and appropriate environment. The case manager will employ child welfare principles and best practices during this process to ensure the child's well-being.
<br><br>
Furthermore, the Case Manager's role extends beyond the initial placement. They also provide post-release services to assess the child and the sponsor's areas of need. This ensures that the child and the sponsor are doing well and are connected within the community. They act as advocates for the child, helping them navigate the unfamiliar system and connecting them with resources that meet their specific needs. This could include medical care, education, mental health services, and any other support required for their well-being. The Case Manager will continue to monitor the placement on an ongoing basis, ensuring that the child's safety and well-being are maintained.
<br>How you get to use your skills as a Case Manager…
<br><ul>
<li>Ensure safety for all youth on caseload</li>
<li>Manage a high turnover caseload</li>
<li>Comply with agency and regulatory policies and procedures</li>
<li>Coordinate initial intake for each youth</li>
<li>Conduct home studies</li>
<li>Coordinator and handle an estimated caseload of 40 youth at any given time (HS and PRS cases)</li>
<li>Contact each child and sponsor within 24 hours of case assignment</li>
<li>Conduct safety screenings and mental health assessments</li>
<li>Coordinator, schedule, and confirm necessary services for each youth in their location</li>
<li>Communicate regularly with the youth and sponsor to address any needs and/or concerns</li>
<li>Ensure all assessments, reports, and team case notes are current in the hardcopy file and electronic file</li>
<li>Ensure each youth is enrolled and attending school</li>
<li>Respond to client emergencies within or outside work hours</li>
<li>Travel throughout the region, and potentially outside of the assigned region, to complete home studies and in-person case contacts. Case Managers may be required to travel up to 3 hours for home visits in their personal vehicle</li>
</ul>
<b>Required Experience as a Case Manager:</b><br>
<ul>
<li>Bachelor's degree in a relevant behavioral/social science field required</li>
<li>Experience conducing home studies according to state requirements - required</li>
<li>Strong professional writing, particularly for assessment reports - required</li>
<li>Knowledge of local community social services - required</li>
<li>Experience working with immigrant populations - required</li>
<li>One to three years of progressive experience in case management - preferred</li>
<li>Child welfare experience - preferred</li>
<li>Ability to work in a fast-paced environment</li>
<li>Strong skills in Microsoft Office</li>
<li>Ability to work well with people from many cultures, non-English speakers, and LGBTQ children</li>
<li>Bilingual - English/Spanish required. All agency documents and records are in English, therefore English writing proficiency is required. The position itself requires Spanish speaking, writing, and reading proficiency</li>
<li>Valid driver's license in a state located within the assigned region and personal, reliable vehicle to conduct home visits - required</li>
<li>Ability to travel extensively, both via ground and air - required</li>
<li>Reliable vehicle required to travel to clients locations up to 3 hours away</li>
</ul>
<b>Physical Requirements of a Case Manager:</b><br>
<ul>
<li>Computer work requires sitting at a desk for long periods of time</li>
<li>Must be able to lift up to 30 pounds</li>
<li>Time driving and/or taking public transportation to conduct client and family services</li>
</ul>
<b>Schedule:</b> Exempt
<br><ul>
<li>Regular hours entail Monday-Friday 9am-5pm, business hours. Must be flexible to meet program needs</li>
<li>Must be available to work afternoons, evenings, and weekends - required</li>
</ul>
Why Cayuga Centers?
<br><ul>
<li>Certified Great Place to Work ®</li>
<li>Council on Accreditation (COA) Accredited</li>
<li>Implement best practices and evidence-based interventions</li>
<li>Committed to employee professional development and advancement</li>
<li>We embrace change, innovation and opportunities</li>
<li>Our diverse workforce acts and leads with human sensitivity and respect</li>
<li>Large and growing national footprint</li>
</ul>
<b>Benefits:</b><br>
<ul>
<li>120 hours of vacation time; 12 Sick Days per year</li>
<li>10 Holidays, 3 Personal Days, Medical Appointment Time</li>
<li>Medical, dental, and vision insurance</li>
<li>Pet and Legal insurance</li>
<li>Employee Assistance Program</li>
<li>FSA, Transit, and Parking savings accounts</li>
<li>Supplemental life insurance, critical illness, enhanced short-term disability benefits</li>
<li>401(k) available</li>
<li>Corporate Discounts Program</li>
<li>Sick Leave Pool</li>
<li>Identity Protection</li>
</ul>


Case Manager - HSPRS

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