medical case manager

ForzaCare

ABOUT US: Founded in 2022, ForzaCare is a purpose-driven organization that helps injured individuals recover faster and return to work safely through coordinated, clinically appropriate care. Our name reflects our mission - Forza means &quot;strength,&quot; representing the power of our team, and Care reflects our compassion for those we serve. ForzaCare is proud to be part of Ethos Risk Services, a leading national provider of investigative and risk mitigation solutions. Together, we're expanding our reach and strengthening our ability to deliver exceptional service across the workers' compensation industry. Learn more about ForzaCare and Ethos partnership here. JOB SUMMARY: As a Field Medical Case Manager at ForzaCare, you'll help injured workers navigate their recovery and return to work. You'll act as the central point of coordination, connecting the injured worker, medical providers, employers, and insurance carriers to ensure timely, transparent, and effective care management. This role is ideal for licensed nurses or certified rehabilitation counselors. While prior experience in workers' compensation is strongly preferred, those who have it will find their background especially valuable in this role. KEY RESPONSIBILITIES: Coordinate care between medical providers, employers, insurance carriers, and injured workers. Attend appointments with the injured workers, which may include visiting employers and injured workers at their place of employment. Develop, document, and monitor individualized recovery goals and return-to-work plans. Provide consistent communication and detailed progress reports to clients and stakeholders. Ensure all case management work meets or exceeds customer and compliance requirements. Build and maintain strong relationships with clients, providers, and internal team members. QUALIFICATIONS: Education &amp; Licensure: Active Registered Nurse (RN) or Certified Rehabilitation Counselor (CRC) license with associated college degree is required. Additional certifications such as CCM, CIRS, or other case management credentials are preferred. Must comply with all state-specific licensure and certification requirements. Prior experience in workers' compensation case management is strongly preferred. Valid driver's license, reliable transportation, and auto insurance with ability to travel to appointments. Skills &amp; Attributes: At ForzaCare, we look for professionals who embody our values and thrive in a collaborative, purpose-driven environment: Motivated &ndash;You take pride in exceeding goals and continuously improving. Organized &ndash; You can manage a fast-paced workload and multiple priorities with ease. Collaborative &ndash; You communicate clearly and work well with diverse teams and stakeholders. Committed &ndash; You uphold ForzaCare's mission to deliver high-quality, compassionate care and comply with all safety, ethical, and professional standards. ForzaCare is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.

Medical Case Manager - Workers' Compensation

Enlyte

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div> 
Be part of a team that makes a real difference.</div>
Job Description:
<div>
This is a full-time, hybrid position. The candidate must be located in the Washington, DC area due to regular local travel for in-person patient appointments.</div><div></div><div> 
Perks: Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div> 
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li>Education: Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li>
Experience: 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li>
Skills: Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.</li><li>
Certifications, Licenses, Registrations:
<ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li>
Travel: Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li>
Internet: Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $79,000 - $90,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div> 
</div>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
#LI-AC1<div></div><div> 
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

Medical Field Case Manager

Total Care Services, Inc.

<div><div>Now Hiring: Case Manager</div>
<div> 
$60,000 Base and potential to earn up to $5,000 (paid out quarterly based on performance</div>
<div></div><div>Adult Medical Day Care (AMDC) Program &ndash; Maryland</div>
<div></div><div>Total Care Services, Inc. (TCS) 
 
Be Part of Something Powerful. Be Part of Something New.</div>
<div> 
Total Care Services, Inc. (TCS) is excited to announce the expansion of our services in Maryland with the launch of our Adult Medical Day Care (AMDC) Program. The third TCS program serving the Maryland Region. This milestone reflects our continued commitment to providing high‑quality, person‑centered care to adults with complex medical and support needs across the state. 
 
The Case Manager plays a critical frontline role within the Adult Medical Day Care Program, delivering comprehensive, person‑centered case management services to adults enrolled in the Adult Medical Day Care Services Waiver. This role focuses on coordination of care, advocacy, compliance, and meaningful engagement with participants, families, providers, and community partners. 
 
This is more than a job, it&rsquo;s an opportunity to be part of a growing program, influence best practices, and directly improve quality of life for Maryland residents. 
 
What You&rsquo;ll Do</div>
<ul><li>Provide comprehensive, person‑centered case management to adults enrolled in the AMDC Program</li>
<li>Complete assessments, develop and maintain Plans of Service (POS), and conduct ongoing monitoring</li>
<li>Coordinate medical, behavioral health, and community‑based services</li>
<li>Ensure documentation and services meet CMS, Maryland Department of Health (MDH), OLTSS, and COMAR requirements</li>
<li>Collaborate with participants, families, providers, and internal program teams</li>
</ul><div>What We&rsquo;re Looking For</div>
<ul><li>Bachelor&rsquo;s degree in Social Work, Human Services, Nursing, or a related field</li>
<li>Case management or care coordination experience (waiver or Medicaid experience preferred)</li>
<li>Strong communication, organization, and documentation skills</li>
<li>Knowledge of Maryland community resources and long‑term services and supports is a plus</li>
</ul><div>Why Join TCS?</div>
<ul><li>Be part of a new and growing Adult Medical Day Care program</li>
<li>Make a meaningful impact on the lives of adults with complex medical needs</li>
<li>Supportive leadership, collaborative teams, and growth opportunities</li>
<li>Hybrid work environment (office, community, and participant settings as applicable)</li>
</ul><div>Total Care Services, Inc. is committed to equal employment opportunity and to compliance with federal, state, and local laws governing non-discrimination. Total Care Services, Inc. is proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class.</div></div>

Case Manager 1

Regal Medical Group

<div>Summary of position:

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.

Essential duties and responsibilities:

<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>
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.

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.

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

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.

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.

Full Time Position Benefits:

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.

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.

Health and Wellness:
<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>
Savings and Retirement:
<ul>
<li>401k Retirement Savings Plan</li>
<li>Income Protection Insurance</li>
</ul>
Other Benefits:
<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>
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.
Requirements:
Education and/or Experience:
<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> 
</ul>
 
Compensation: $38-50/hour</div>

Outpatient Case Manager

Consociate Health

<div>Job Description: 
Consociate Health, a leading Third-Party Administrator, offers an opportunity to grow and develop your career in an environment that provides a fulfilling workplace for employees, and creates continuous learning and embraces the ideas and diversity of others.
As part of our Mission to make Healthcare more accessible and affordable for our clients through innovation solutions and expert consultation, we value the inherent qualities that are foremost in our Mission, Vision, Values- Compassion, Humility and Impact, which allow us all to create authentic relationships with our team and our clients.
POSITION SUMMARY:
The Case Manager for Transplant and Dialysis provides comprehensive support for members with specialized health benefits, including travel and care coordination at top medical facilities for serious conditions. This role anticipates and resolves member issues, facilitates next steps, addresses financial barriers and ensures access to quality care. The Case Manager also manages clinical travel operations and participates in after-hours on-call rotations.
PRINCIPAL DUTIES AND RESPONSIBILITIES:<ul><li>
Case Management: Manage a caseload of 95+ members, acting as the primary point of contact.</li><li>
Hospital &amp; Transport Coordination: Arrange hospital transfers and emergency medical transport for transplants.</li><li>
Eligibility &amp; Education: Verify member eligibility and educate them on transplant and dialysis benefits.</li><li>
Member Support: Handle high-stress calls, resolve member inquiries and provide guidance on next steps.</li><li>
Referral &amp; Account Management: Process new referrals and proactively research member accounts.</li><li>
Documentation &amp; Communication: Record all interactions and coordinate with various stakeholders.</li><li>
Issue Resolution: Address billing issues, claim denials and travel-related inquiries.</li><li>
Member Education: Provide clear guidance on benefit parameters to ensure high member satisfaction.</li><li>
After-Hours Support: Work independently after hours to resolve urgent issues.</li><li>
Process Improvement: Identify workflow gaps and contribute to process enhancements.</li><li>
Performance &amp; Compliance: Meet established goals in efficiency, call quality and customer satisfaction.</li><li>
Travel Coordination: Execute travel reservations and manage travel-related expenses.</li><li>
Leadership &amp; Support: Cover for the supervisor when unavailable and act as a resource for team members.</li><li>
Training &amp; Development: Assist in developing training materials and onboarding new staff.</li><li>
Scheduling &amp; Coverage: Manage on-call schedules, queue coverage and caseload/referral assignments.</li><li>
Communication Management: Monitor and respond to emails in a timely manner.</li><li>
Policy &amp; Compliance: Review forms, policies, SPD language, scripts and job aids for accuracy.</li><li>
Reporting: Maintain and analyze reports as needed.</li></ul>
GENERAL EXPECTATIONS:<ul><li>
Present a positive image of Consociate Health at all times.</li><li>
Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual whether they are a customer or co-worker.</li><li>
Communicate in a clear and concise manner, while also demonstrating receptivity through active listening.</li><li>
Identify and perform work that has not been specifically assigned, as needed.</li><li>
Continuously seek opportunities for improvement and suggest ways in which procedures/systems may be modified to accomplish tasks/goal efficiently and effectively.</li><li>
Demonstrate a teamwork philosophy by working cooperatively with others.</li><li>
Attend required in-service and staff meetings.</li><li>
Seek other educational opportunities directly related to this position.</li><li>
Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups and individuals, employees and applicants.</li><li>
Adhere to established safety standards and utilizes proper techniques to avoid work-related injuries.</li></ul>
BENEFITS:<ul><li>
Paid time off</li><li>
Paid Holidays</li><li>
Medical, Dental and Vision Insurance</li><li>
Basic Group Life, Short Term and Long Term Disability</li><li>
Voluntary Life, Critical Illness and Accident Coverage</li><li>
401K Plan: Employees are immediately eligible with a 2% automatic enrollment. Consociate matches up to 4% of an employees' annual salary.</li></ul> 

Experience and Skills:
SERVICE EXPECTATIONS:<ul><li>
Greet all people in a prompt and courteous manner. Communicate in a warm and courteous manner, making eye contact and speaking in a tone of voice that matches words.</li><li>
Ask customers what they need and strive to exceed their expectations. Offer and provide assistance whether or not the request falls within your specific job duties.</li><li>
Respond to customer requests in a timely manner consistent with Consociate Health's standards and best practices, return calls promptly and keep them informed of delays before they ask.</li><li>
Make decisions based on customer needs, opinions, complaints or suggestions.</li><li>
Take appropriate steps to resolve problems to the customer's satisfaction.</li><li>
Ask customers for their opinions, accepting criticism as an opportunity to improve service.</li><li>
Seek opportunities, provide value-added services, and eliminate tasks that do not serve our customer.</li><li>
Remain aware of products and services provided by Consociate Health.</li><li>
Project a positive, professional image when working.</li></ul>
KNOWLEDGE, SKILLS AND ABILITY REQUIREMENTS:<ul><li>
High school diploma, GED, or equivalent.</li><li>
1-3 years of experience in customer service, travel, healthcare or a related field.</li><li>
Ability to work independently and manage information flow.</li><li>
Ability to telecommute or reside in Central Arkansas.</li><li>
Proficiency in Office 365, Adobe and Excel.</li><li>
Must be certified and maintain Medical Travel Professional certification</li><li>
College degree in healthcare, psychology, social work or a related field preferred.</li><li>
5+ years of experience in customer service, travel, healthcare or a related field.</li><li>
Knowledge of medical terminology.</li><li>
Experience working with transplant patients.</li><li>
Ability to perform in high-stress, time-sensitive environments.</li></ul> 
From: Consociate Health</div>

Case Manager Transplant

Banner Health

<div>Primary City/State:
Payson, Arizona
Department Name:
Work Shift:
Varied
Job Category:
Clinical Care<div><div><div><div><div><div><div><div><div>
We are currently looking for a Case Management Representative at Banner Payson to work PRN as needed. This role will cover shifts to provide coverage as needed for sick time and PTO. Holidays and weekends required.
Banner Staffing Services offers a world of opportunities to make an impact on one of the country&rsquo;s leading health systems. If you&rsquo;re looking to leverage your abilities to make a difference &ndash; you belong at Banner Staffing Services.
As the internal staffing (registry) provider for Banner Health, Banner Staffing Services (BSS) provides opportunities within one of the country&rsquo;s leading health systems. The BSS team is dedicated to providing personal attention and professional support for its employees. Registry opportunities are a great way to market your skills within Banner Health. As a BSS employee, you are eligible to apply (at any time) as an internal applicant to any regular full-time or part-time opportunities within Banner Health.
In addition, registry employment through BSS offers:<ul><li>Competitive wages</li><li>Paid orientation</li><li>Flexible Schedules (select positions)</li><li>Fewer Shifts Cancelled</li><li>Weekly pay</li><li>403(b) Pre-tax retirement plan</li><li>Employee Assistance Program</li><li>Employee wellness program</li><li>Discount Entertainment tickets</li><li>Restaurant/Shopping discounts</li><li>Auto Purchase Plan</li></ul>
BSS Registry positions do not have guaranteed hours and no medical benefits package is offered. BSS requires: Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education)</div></div></div></div></div></div></div></div></div>
POSITION SUMMARY 
This position coordinates care of Occupational Health cases across the continuum of care to achieve optimal clinical and financial resource outcomes. As a resource to facilitate that care, this position will use the company&rsquo;s occupational health protocols and act as a liaison between providers, ancillary referral services (physical therapy, radiology, laboratory, specialty referrals), contract employers, worker&rsquo;s compensation insurance carriers and outside service providers. The purpose of this position is to promote quality and cost effective patient care through integrated data management and communication with all affected parties. 
 
CORE FUNCTIONS 
1. Communicates continually with patients, other departments (clinic managers, providers, worker&rsquo;s compensation, risk mgmt, human resources), contract employers, referral network providers and worker&rsquo;s compensation carrier case managers to ensure that appropriate plans and protocols are being followed and that the patient is discharged from care with a timely and appropriate return to work status. 
 
2. Maintains current open and discharged case files in internal computer database. 
 
3. Monitors and tracks all referral activities within the company&rsquo;s ancillary and specialist referral network. 
 
4. Reports drug screen results to employers and records results in database. 
 
5. Works under general supervision. Confers with supervisor on any unusual situations. Positions are facility based with no budgetary responsibility. Internal customers: All levels of nursing management and staff, human resources, medical staff, and all other members of the interdisciplinary health care team. External Customers: Designated contacts of external employers, insurance providers, county and governmental agencies, case managers, medical care providers, ancillary care providers, and medical supply companies. 
 
MINIMUM QUALIFICATIONS 
High school diploma/GED or equivalent working knowledge. 
 
The position requires a proficiency level typically achieved with 3 years experience in healthcare as a Nursing Asst, Medical Asst, Health Unit Coordinator, Patient Care Tech, Patient Billing, etc. 
 
Requires an understanding of medical terminology. Must demonstrate effective communication skills, human relations skills, strong organizational and time management skills and flexibility in responding to multiple demands. 
 
PREFERRED QUALIFICATIONS 
Additional related education and/or experience preferred.
EEO Statement:
EEO/Disabled/Veterans
Our organization supports a drug-free work environment.
Privacy Policy:
Privacy Policy</div>

Per Diem Case Management Representative

Penn State Health

<div><div>Penn State Health - Hershey Medical Center
Location: US:PA: Hershey
 
Work Type: Full Time
 
FTE: 1.00
 
Shift: Day
 
Hours: 8hr / day 80hrs pay period
 
Recruiter Contact: Taryn Blydenburgh at tblydenburgh@pennstatehealth.psu.edu
SUMMARY OF POSITION:
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.
MINIMUM QUALIFICATION(S):
<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>PREFERRED QUALIFICATION(S):
<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>WHY PENN STATE HEALTH?
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.
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:
<ul><li>Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton).</li>
<li>Be Balanced with Generous Paid Time Off, Personal Time, and Paid Parental Leave.</li>
<li>Be Secured with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection.</li>
<li>Be Rewarded with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program.</li>
<li>Be Supported by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling.</li>
</ul>WHY PENN STATE HEALTH MILTON HERSHEY MEDICAL CENTER?
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.
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.
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. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities.
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.
 Union: Non Bargained</div></div><div></div>

Clinical Case Manager - Heart and Vascular Institute Heart Failure Services

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