Case Manager Nurse-RN Job at Personify Health

Case Manager Nurse-RN

We are seeking Case Manager Nurse, RN, to join our team part-time. As a Case Man...

Location

United States

Salary:

36.00 - 38.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

Graduation from an accredited Registered Nursing (RN) program
Possession of a current California RN license
a multi-state license will also be required
Minimum of five (5) years medical/surgical or acute care experience, including two years’ experience in case management, or an equivalent combination of education and experience
Prior case management experience, emergency room, critical care background or other relevant clinical care experience pertinent to case management
Knowledge of medical claims and ICD-10, CPT, HCPCS coding
Ability to critically evaluate claims data and determine treatment plan, discharge planning experience
Ability to work independently making decisions and problem solving
Knowledge of community resources and alternate funding programs
Computer proficiency or working knowledge of Microsoft Office Suite

Job Responsibility

Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs
Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs
Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals
Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner
report measurable outcomes that record effectiveness of interventions
Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care
Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs
provide patient/family with emotional support and guidance
Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis
Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports

What we offer

Part-time schedule designed around your availability and life priorities
Access to learning and development opportunities alongside full-time colleagues
Mentorship and skill-building that translates to career advancement
Competitive hourly compensation that values your expertise
Technology and equipment support to set you up for success

Parttime

Case Manager Nurse-RN

As a Case Manager RN, you will provide telephonic case management between provid...

Location

United States

Salary:

36.00 - 38.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

Graduation from an accredited Registered Nursing (RN) program
Possession of a current California RN license
a multi-state license will also be required
Minimum of five (5) years medical/surgical or acute care experience, including two years’ experience in case management, or an equivalent combination of education and experience
Prior case management experience, emergency room, critical care background or other relevant clinical care experience pertinent to case management
Knowledge of medical claims and ICD-10, CPT, HCPCS coding
Ability to critically evaluate claims data and determine treatment plan, discharge planning experience
Ability to work independently making decisions and problem solving
Knowledge of community resources and alternate funding programs
Computer proficiency or working knowledge of Microsoft Office Suite

Job Responsibility

Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs
Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health and identify for participation in appropriate programs
Develop treatment plan for standard and catastrophic cases in collaboration with the patient, caregivers or family, community resources and multi-disciplinary healthcare providers that include obtainable short- and long-term goals
Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner
report measurable outcomes that record effectiveness of interventions
Initiate and maintain contact with the patient/family, provider, employer, and multidisciplinary team as needed throughout the continuum of care
Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs
provide patient/family with emotional support and guidance
Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis
Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions
Paid Time Off
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

Utilization Review Nurse-RN

The Utilization Review Nurse will provide professional assessments and review fo...

Location

United States

Salary:

30.00 - 38.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

Current RN license in the United States or U.S. territory
Associate’s degree or diploma (Nursing program) required
1+ year clinical experience required
Ability to perform the essential job functions safely and successfully with or without reasonable accommodation, including meeting qualitative and/or quantitative productivity standards
Ability to maintain regular, punctual attendance
Ability to sit for 6-8 hours
Constant use of computer keyboard and mouse
repetitive use of both hands
Occasional to frequent twisting of neck
occasional bending of neck and at waist

Job Responsibility

Provide professional assessment and review for the medical necessity of treatment requests and plans
Provide first level review for all outpatient and ancillary pre-certification requests for medical appropriateness
inpatient hospital stay including mental health, substance abuse, skilled nursing, and rehabilitation for medical necessity
and post claim or post service reviews
Work to the top of the RN license and ensure proper referral to medical director for denial authorizations through independent review organizations (IRO)
Work with hospital staff to prepare patients for discharge and ensure a smooth transition to the next level of care
Refer requests that fall outside of established guidelines to advance review or senior care consultants
Process appeals for non-certification of services, complete non-certification letters when appropriate
Review plan document for benefit determinations
attempt to redirect providers and patients to PPO providers

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions
Paid Time Off
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

Utilization Review Nurse-RN

The Utilization Review Nurse will provide professional assessments and review fo...

Location

United States

Salary:

30.00 - 38.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

Current RN license in the United States or U.S. territory
Associate’s degree or diploma (Nursing program) required
1+ year clinical experience required
Ability to perform the essential job functions safely and successfully with or without reasonable accommodation, including meeting qualitative and/or quantitative productivity standards
Ability to maintain regular, punctual attendance
Ability to sit for 6-8 hours
Constant use of computer keyboard and mouse
repetitive use of both hands
Occasional to frequent twisting of neck
occasional bending of neck and at waist

Job Responsibility

Provide professional assessment and review for the medical necessity of treatment requests and plans
Provide first level review for all outpatient and ancillary pre-certification requests for medical appropriateness
inpatient hospital stay including mental health, substance abuse, skilled nursing, and rehabilitation for medical necessity
and post claim or post service reviews
Work to the top of the RN license and ensure proper referral to medical director for denial authorizations through independent review organizations (IRO)
Work with hospital staff to prepare patients for discharge and ensure a smooth transition to the next level of care
Refer requests that fall outside of established guidelines to advance review or senior care consultants
Process appeals for non-certification of services, complete non-certification letters when appropriate
Review plan document for benefit determinations
attempt to redirect providers and patients to PPO providers

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions
Paid Time Off
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets

Fulltime

New

Ai Engineer

We are recruiting an AI Engineer for a direct contract with a company based in t...

Location

Portugal , Porto

Salary:

Not provided

Precise

Expiration Date

Until further notice

Requirements

2+ years experience working within a software development team as an engineer
Comfortable writing and debugging code in Python. You understand the importance of readable code and are eager to learn best practices.
Familiarity with frameworks like FastAPI, Flask, or Django, with experience developing and exposing/consuming APIs.
Understanding of containerization and exposure to Docker.
Comfortable using Git for team collaboration (Gitlab pipelines exposure is a plus).
Machine Learning Fundamentals: Foundational knowledge of ML concepts and practical experience (academic or personal projects) deploying a simple model using libraries like scikit-learn, PyTorch, or TensorFlow.
Experience manipulating and analyzing data using libraries such as Pandas and NumPy.
A strong desire to learn MLOps principles, cloud infrastructure, and deployment practices (Kubernetes exposure is a plus).
BSc in Computer Science or a related technical field.

Job Responsibility

Implementing solutions for building and deploying AI models in production, with a focus on fault tolerance, scalability, maintainability and automation.
Leveraging modern LLM’s to include/enhance parsing capabilities for CVs/job adverts for existing supported languages and new additional languages.
Collaborating with the team to design, implement and optimise data processing pipelines and evaluation tools.

Fulltime

New

Branch Manager

Come and join us as a results driven Branch Manager to deliver sales and exceed ...

Location

United Kingdom , Lymington

Salary:

Not provided

City Plumbing

Expiration Date

Until further notice

Requirements

A great positive attitude
Enjoy customer interaction
Management Experience
Safe Practices
Forward Thinking
Tenacity and resilience
A pro-active approach to sales, with a strong desire and ability to win and grow new business
Experience of customer relationship management and developing a true partnership approach
Excellent communication skills
Self confident and self motivated, with the ability to work on own initiative or as part of a wider team

Job Responsibility

Effective management of the team and resource
Setting the standard of a sales orientated culture
Delivering against sales and customer demands while maximising profitability
Maximising margin and net profit
Keeping everyone safe
Build and maintain relationships with new and existing trade and retail customers
Ability to interpret and analyse financial and statistical information

What we offer

Bonus
Discounts, savings and cash back at numerous retailers
Life assurance
Extended family policy including maternity, paternity, additional annual leave and more
Mental Health First Aiders and Employee Assistance Programme, we look out for each other
Complete induction and a company that lets you grow and encourages development
Financial education and loans
Flexible working options
A business striving to create an environment of inclusion so everyone can be their true self

Fulltime

New

Guest Environment Expert

Our jobs aren’t just about giving guests a clean room and a freshly made bed. In...

Location

United States , Poughkeepsie

Salary:

18.00 USD / Hour

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

Ensuring a safe work place
following company policies and procedures
maintaining confidentiality
upholding quality standards
ensuring professional uniform, personal appearance, and communications
ability to stand, sit, or walk for an extended time
ability to move, lift, carry, push, pull, and place objects weighing less than or equal to 50 pounds without assistance

Job Responsibility

Delivering guest requests
stocking carts
cleaning rooms and public spaces
maintaining the appearance and cleanliness of the whole hotel

Parttime

New

Project Engineer

Our client is seeking a motivated and experienced Project Engineer to join their...

Location

United Kingdom , Dartford

Salary:

30000.00 GBP / Year

Office Angels

Expiration Date

Until further notice

Requirements

Proven construction based industry experience, (ideally within Smoke Ventilation/Fire Alarm Systems but not essential)
Computer literate with strong reporting and organisational skills
Excellent interpersonal and communication skills
Ability to multitask and manage cross-disciplinary projects
Strong time management and decision-making abilities
Professional, presentable, and self-motivated
Team-oriented with a commitment to exceeding client and colleague expectations
Full UK Driving License required, ideally with your own transport

Job Responsibility

Assist in the development and delivery of Risk and Method Statements
Compile detailed project reports covering quality, progress, and issues
Measuring up for install jobs and conducting Coordinate on-site deliveries to ensure smooth logistics
Support the accounts team with project-related financials and debt collection
Monitor project costs and provide financial updates, including profit/loss analysis
Communicate effectively with subcontractors and ensure alignment with project goals
Manage resources according to the client's program and track project progress
Ensure all documentation and certification is accurate, complete, and submitted on time

What we offer

23 days annual leave plus bank holidays, rising to 25 days annual leave at 2 years service
Company mobile phone
uniform and PPE
Life Insurance
Private Health Care
Pension Scheme

Fulltime

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Case Manager Nurse-RN

Job Description

Job Responsibility

Requirements

What we offer

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