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

Director of Revenue Strategy - The St. Regis Jakarta

Responsible for balancing the financial objectives of different lodging products...

Location

Indonesia , Jakarta

Salary:

Not provided

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

2-year degree from an accredited university in Business Administration, Finance and Accounting, Economics, Hotel and Restaurant Management, or related major
1 year experience in the revenue management, sales and marketing, or related professional area
4-year bachelor's degree from an accredited university in Business Administration, Finance and Accounting, Economics, Hotel and Restaurant Management, or related major
no work experience required

Job Responsibility

Analyzes information, identifies current and potential problems and proposes solutions
Analyzes period end and other available systems data to identify trends, future need periods and obstacles to achieving goals
Generates updates on transient segment each period and continually analyzes transient booking patterns
Assists with account diagnostics process and validates conclusions
Maintains accurate reservation system information
Checks distribution channels regularly for hotel positioning, information accuracy and competitor positioning
Identifies the underlying principles, reasons, or facts of information by breaking down information or data into separate parts
Generates and provides accurate and timely results in the form of reports, presentations, etc.
Observes, receives, and otherwise obtains information from all relevant sources
Submits reports in a timely manner, ensuring delivery deadlines

Fulltime

New

Administrative Coordinator

Do you like office work? Do you like the diversity of tasks? We have the job you...

Location

Canada , Drummondville

Salary:

22.00 CAD / Hour

Randstad

Expiration Date

August 07, 2026

Requirements

6 months to 1 year of work experience in an administrative position
Good command of computer software
Resourceful and autonomous
Comfortable to communicate in French and English on an intermediate level : English is required because it is a Canadian company, and internal communication with clients and internal employees can be in English
Having the flexibility to work any schedule is a strong asset

Job Responsibility

Confirm and remind clients of their upcoming appointments through calls, emails
Provide excellent service to clients by answering inquiries and addressing concerns in a professional and courteous manner
Resolve appointment-related issues or conflicts effectively and promptly
Assist with other administrative tasks related to appointments and scheduling
Enter and update appointment details accurately in the company’s scheduling system
Track and report on appointment statistics and trends as needed

What we offer

Weekly Pays
Weekends off
Beautiful dynamic working environment
Diversity of tasks

New

Staff Pharmacist

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Edgewater

Salary:

65.00 - 81.00 USD / Hour

CVS Health

Expiration Date

August 15, 2026

Requirements

Active Pharmacy License in the state in which you are employed
Not on the DEA Excluded Parties List
Immunization Certification through an accredited organization (e.g., APhA)
No pending felony charges or convictions for criminal offenses involving controlled substances

Job Responsibility

Support the Pharmacy Manager in leading and directing Pharmacy Technician Support Staff
Support the management, oversight and operation of all aspects within your pharmacy including Patient Safety, Pharmacy Professional Practice, Regulatory Requirements, Quality Assurance, Customer Service, Personnel Management, Inventory Management, Financial Profitability, Loss Prevention, Workflow Management
Keep customers and patients healthy through adoption and management of patient care programs
Lead with Heart – display empathy and compassion for patients, customers, caregivers and colleagues
Motivate, inspire and develop Pharmacy Support Staff
Identify critical business opportunities and contribute to the development of meaningful solutions
Successfully implement solutions by leading the team to achieve specified goals
Adapt to change and adjust plans in a dynamic community healthcare setting
Seek new ways to grow, collaborate with others and deliver better outcomes
Align others around purpose to gain support and commitment

What we offer

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
CVS Health bonus, commission or short-term incentive program

Fulltime

New

Pharmacy Technician

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Somersworth

Salary:

17.00 - 27.00 USD / Hour

CVS Health

Expiration Date

August 01, 2026

Requirements

Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
State-level licensure and national certification requirements vary by state
Regular and predictable attendance, including nights and weekends
Ability to complete required training within designated timeframe
Attention and Focus: Ability to concentrate on a task over a period of time
Ability to pivot quickly from one task to another to meet patient and business needs
Ability to confirm prescription information and label accuracy, ensuring patient safety
Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner

Job Responsibility

Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
keeping patients healthy by offering immunizations and other services at the register and over the phone
and demonstrating compassionate care by solving or escalating patient problems
Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
voluntarily traveling to stores in the market to work shifts as needed by the business

What we offer

dental
vision
wellness resources
employee discounts
access to certain voluntary benefits
other programs

Parttime

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Case Manager Nurse-RN

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