CrawlJobs Logo

Certified Case Manager

encompasshealth.com Logo

Encompass Health

Location Icon

Location:
United States , Overland Park

Category Icon
Category:

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

36.06 - 47.60 USD / Hour

Job Description:

Case Manager Career Opportunity. Recognized for your abilities as a Case Manager. Are you ready for a Case Management role that brings your career closer to home and heart? Join Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional care and the transformative impact on each patient's journey. As the leading provider of rehabilitation care in the nation, this opportunity allows you to leverage your clinical expertise while contributing to the well-being of individuals in your community. Manage resources, coordinate patient care from admission to post-discharge, and oversee interdisciplinary plan-of-care decisions. This is more than a career move; it's a chance to shape a future where care and compassion converge for truly meaningful outcomes.

Job Responsibility:

  • Work with interdisciplinary team, guiding treatment plans based on patient needs and preferences
  • Coordinate with interdisciplinary team to establish tentative discharge plan and contingency plans
  • Participate in planning for and the execution of patient discharge experience
  • Monitor patient experience: quality/timeliness/service appropriateness/payors/expectations
  • Facilitate team conferences weekly and coordinate all treatment plan modifications
  • Complete case management addendums and all required documentation
  • Maintain knowledge of regulations/standards, company policies/procedures, and department operations
  • Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions
  • Understand commercial contract levels, exclusions, payor requirements, and recertification needs
  • Attend Acute Care Transfer (ACT) meetings to identify trends and collaboratively reduce ACTs
  • Meet with patient/family per Patient Arrival and Initial Visit Standard within 24 hrs of admission
  • Perform assessment of goals and complete case management addendum within 48 hours of admission
  • Educate patient/family on rehabilitation and Case Manager role
  • establish communication plan
  • Schedule and facilitate family conferences as needed
  • Assist patient with timely procuring/planning of resources to avoid discharge delays or issues
  • Monitor compliance with regulations for orthotics and prosthetics ordering and payment
  • Make appropriate/timely referrals, including documentation to post discharge providers/physicians
  • Ensure accuracy of discharge and payor-related information in the patient record
  • Participate in utilization review process: data collection, trend review, and resolution actions
  • Participate in case management on-call schedule as needed

Requirements:

  • Must be qualified to independently complete an assessment within the scope of practice of his/her discipline (for example, RN, SW, OT, PT, ST, and Rehabilitation Counseling)
  • If licensure is required for one's discipline within the state, individual must hold an active license
  • Must meet eligibility requirements for CCM® or ACM™ certification upon entry into this position OR within two years of entry into the position
  • CCM® or ACM™ certification required OR must be obtained within two years of being placed in the Case Manager II position
  • For Nursing, must possess minimum of an Associate Degree in Nursing, RN licensure with BSN preferred. A diploma is acceptable only in those states whose minimum requirement for licensure or certification is a diploma rather than an Associate Degree
  • For all other eligible licensed or certified health care professionals, must possess a minimum of a bachelor's degree and graduate degree is preferred
  • 2 years of rehabilitation experience preferred
What we offer:
  • Affordable medical, dental, and vision plans for both full-time and part-time employees and their families
  • Generous paid time off that accrues over time
  • Opportunities for tuition reimbursement and continuous education
  • Company-matching 401(k) and employee stock purchase plans
  • Flexible spending and health savings accounts
  • A vibrant community of individuals passionate about the work they do

Additional Information:

Job Posted:
January 05, 2026

Employment Type:
Fulltime
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Certified Case Manager

Integrated Care Manager

Responsible for promoting continuity of care through a collaborative process tha...
Location
Location
United States , Phoenix
Salary
Salary:
Not provided
azblue.com Logo
Blue Cross Blue Shield of Arizona
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
  • Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
  • Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN.
  • Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications
  • Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC.)
  • Intermediate PC proficiency
  • Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
  • Intermediate skill in word processing, spreadsheet, and database software
  • Maintain confidentiality and privacy
  • Advanced and current clinical knowledge
Job Responsibility
Job Responsibility
  • Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan.
  • Answer a diverse and high volume of health insurance related customer calls on a daily basis.
  • Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc.
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests.
  • Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director.
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.
  • Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements.
  • Maintain complete and accurate records per department policy.
  • Demonstrate ability to apply plan policies and procedures effectively.
  • Fulltime
Read More
Arrow Right

Integrated Care Manager - Adult

Responsible for promoting continuity of care through a collaborative process tha...
Location
Location
United States , Phoenix
Salary
Salary:
Not provided
azblue.com Logo
Blue Cross Blue Shield of Arizona
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
  • Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
  • Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
  • Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications
  • Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC)
  • Intermediate PC proficiency
  • Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
  • Intermediate skill in word processing, spreadsheet, and database software
  • Maintain confidentiality and privacy
  • Advanced and current clinical knowledge
Job Responsibility
Job Responsibility
  • Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan
  • Answer a diverse and high volume of health insurance related customer calls on a daily basis
  • Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests
  • Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
  • Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
  • Maintain complete and accurate records per department policy
  • Demonstrate ability to apply plan policies and procedures effectively
  • Fulltime
Read More
Arrow Right

Embedded Transitional Care Manager RN

Oak Street Health takes a team-based approach to providing outstanding patient c...
Location
Location
United States , Rockford
Salary
Salary:
66575.00 - 142576.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • An active RN license within the state of practice in good standing
  • Willingness to obtain cross-state licensure, as needed
  • Certified Case Manager (CCM) or equivalent case management certification required, or willingness to obtain within 12 months of hire
  • 2+ years’ experience in transitional nursing, discharge planning, nursing case management, or home health
  • Experience in utilization management preferred
  • Knowledge of Medicare/Medicaid and NCQA regulatory transitions of care criteria
  • Exceptional communication skills and customer service orientation
  • Innovative and independent problem solving skills
  • Ability to monitor and evaluate opportunities for cost-effective care options with high-quality outcomes
  • Spanish-speaking preferred but not required
Job Responsibility
Job Responsibility
  • Manage patients through transitions of care
  • Advocate for the patient throughout the care continuum
  • Identify opportunities for improved program workflows
  • Maintain real-time and accurate records of patient status
  • Adhere to CMS, state specific and NCQA compliance criteria
  • Evaluate patient status post-ED visit or observation stay
  • Triage to determine appropriate follow up care
  • Engage directly with inpatient physicians, case managers, medical directors, and hospitalists
  • Coordinate with the Utilization Management team
  • Conduct structured clinical assessment to identify post-discharge needs
What we offer
What we offer
  • Paid vacation, sick time, and investment/retirement 401K match options
  • Health insurance, vision, and dental benefits
  • Affordable medical plan options
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access
  • Fulltime
Read More
Arrow Right

Embedded Transitional Care Manager

The Embedded Transitional Care Manager - RN (TCM-RN) plays a critical role in en...
Location
Location
United States , Indianapolis
Salary
Salary:
54095.00 - 116760.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • An active RN license within the state of practice in good standing
  • willingness to obtain cross-state licensure, as needed
  • Certified Case Manager (CCM) or equivalent case management certification required, or willingness to obtain within 12 months of hire
  • 2+ years’ experience in transitional nursing, discharge planning, nursing case management, or home health
  • experience in utilization management preferred
  • knowledge of Medicare/Medicaid and NCQA regulatory transitions of care criteria
  • exceptional communication skills and customer service orientation
  • innovative and independent problem-solving skills
  • ability to monitor and evaluate opportunities for cost-effective care options with high-quality outcomes
  • Spanish-speaking preferred but not required
Job Responsibility
Job Responsibility
  • Manage patients through transitions of care, either face to face in the facility or telephonically
  • advocate for the patient throughout the care continuum
  • identify opportunities for workflow improvements and partnerships
  • maintain real-time records of patient transitions
  • engage with physicians, case managers, and hospitalists
  • coordinate follow-up care, medication reconciliation, and discharge planning
  • collaborate with internal stakeholders and regional leaders on transitions initiatives
  • participate in training, documentation, tracking, and quality assurance
What we offer
What we offer
  • Mission-focused career
  • paid vacation and sick time
  • investment/retirement 401K match options
  • health insurance, vision, and dental benefits
  • affordable medical plan options
  • no-cost programs for health and wellness
  • tuition assistance
  • flexible schedules
  • family leave
  • dependent care resources
  • Fulltime
Read More
Arrow Right

Associate Manager, RN Care Management

We’re building a world of health around every individual — shaping a more connec...
Location
Location
United States , Chicago
Salary
Salary:
88374.00 - 190344.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
April 30, 2026
Flip Icon
Requirements
Requirements
  • Bachelor’s in Nursing strongly preferred
  • Active RN license within one or more OSH states
  • Certified Case Manager (CCM) or equivalent case management certification required, or willingness to obtain within 12 months of hire
  • Willingness to obtain cross-state licensure, as needed
  • 2+ years direct supervisory experience required
  • 4+ years in care management, case management, and/or transitional care, strongly preferred
  • Proficient with Microsoft Office, Google Suite, and healthcare EMRs
  • Knowledge of Medicare/Medicaid and NCQA requirements
  • Strong clinical and assessment skills
  • Outstanding verbal and written communication skills
Job Responsibility
Job Responsibility
  • Supervise RN-CMs in assigned markets, including clinical oversight of daily operations and metrics
  • Performance management: Provide guidance and oversight to the RN-CM team
  • Collaboration and communication with internal stakeholders
  • Tracking, reporting and training: Monitor and evaluate care management activities
  • Hire and train RN Care Managers in assigned regions
  • Assist with the implementation of new care management activities and programming
  • Provide feedback to Care Management leaders regarding team performance and process improvements
  • Provide support for process and quality improvement to RN-CMs
  • Create an engaging culture that inspires commitment and encourages excellence and strives for equity and inclusion
  • Monitor OSH program related data
What we offer
What we offer
  • Mission-focused career
  • Paid vacation, sick time, and investment/retirement 401K match options
  • Health insurance, vision, and dental benefits
  • Opportunities for leadership development and continuing education stipends
  • New centers and flexible work environments
  • Opportunities for high levels of responsibility and rapid advancement
  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access
  • Fulltime
Read More
Arrow Right

RN Case Manager

Under the general supervision of the Case Management Manager acts as a patient a...
Location
Location
United States , Weymouth
Salary
Salary:
117707.20 - 170768.00 USD / Year
southshorehealth.org Logo
South Shore Health
Expiration Date
May 04, 2026
Flip Icon
Requirements
Requirements
  • Registered Nurse, Bachelors prepared strongly preferred
  • 3-5 years acute care hospital experience preferred
  • Critical Care or Emergency Department experience highly desirable
  • RN - Registered Nurse license
  • ACM - Accredited Case Manager or CCM - Certified Case Manager within two years of hire
  • Demonstrated skills in: negotiation, communication (verbal and written), conflict, interdisciplinary collaboration, management, creative problem solving, and critical thinking, time management and ability to multitask in high stress environment
  • Knowledge of: healthcare financing, community and organizational resources, patient care processes, and data analysis
  • Knowledge of utilization management as it relates to third party payers
  • Knowledge of post-acute care community resources
  • Experience with Managed Care preferred
Job Responsibility
Job Responsibility
  • Acts as a patient advocate/Case Manager
  • Coordinates, negotiates, procures services and resources for, and manages the care of complex patients
  • Applies review criteria to determine medical necessity for admission and continued stay
  • Provides clinically-based case management, discharge planning and care coordination
  • Works collaboratively with interdisciplinary staff
  • Participates in quality improvement and evaluation processes
  • Works a weekend rotation and occasional holiday
  • Review medical records for appropriate utilization
  • Assist physician in determining medical necessity
  • Identify cases failing criteria
  • Fulltime
Read More
Arrow Right

Director Care Coordination

As our Director of Care Coordination, you will be responsible for leading, facil...
Location
Location
United States , Gilbert
Salary
Salary:
57.37 - 85.33 USD / Hour
americannursingcare.com Logo
American Nursing Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum Bachelors of Nursing required or Master's in Social Work
  • Seven years administrative and health care system experience
  • Seven years of clinical and care management experience
  • Five years of leadership experience
  • Registered Nurse: AZ
  • Certified Case Manager upon hire
  • Accredited Case Manager upon hire
Job Responsibility
Job Responsibility
  • Lead, facilitate, and implement strategies to optimize patient care coordination and outcomes
  • Oversee the comprehensive care coordination functions, ensuring seamless transitions, efficient resource utilization, and patient-centered approaches
  • Work closely with interdisciplinary teams, physicians, and leadership to enhance clinical effectiveness, patient satisfaction, and alignment with system goals
  • Drive continuous improvement initiatives, analyze performance metrics, and ensure adherence to best practices and regulatory standards
  • Oversee the daily operations of the Care Coordination program, ensuring accountability, effectiveness, efficiency, and compliance with regulatory and accreditation agencies
  • Accept multiple management tasks to handle financial, operations, managed care & staffing issues within the Care Management departments
  • Serve as clinical advisor to care management across the continuum of care for all programs
  • Analyze data and develop strategies and action plans to address opportunities for improvement
  • Develop department and division strategies to ensure efficient operations and goal achievement
  • Maintain relationships with medical staff members, CNO, nurse VPs, Directors/managers, department managers and technical Directors
What we offer
What we offer
  • Medical
  • Prescription drug
  • Dental
  • Vision plans
  • Life insurance
  • Paid time off (minimum of 14 days including holidays annually for full-time benefit eligible team members)
  • Tuition reimbursement
  • Retirement plan benefit(s) including 401(k), 403(b), and other defined benefits offerings
  • Fulltime
Read More
Arrow Right

Complex Inpatient Medical Social Worker

Provides care management/social work services to Complex patients, families, and...
Location
Location
United States
Salary
Salary:
33.05 - 49.60 USD / Hour
advocatehealth.com Logo
Advocate Health Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Master’s Degree in Social Work
  • LSW license issued by the State in which the team member practices (WI & IL Divisions)
  • Accredited Case Manger SW (ACM-SW) certification issued by the American Case Management Association (ACM) needs to be obtained within 2 years, or Certified Case Manager (CCM) issued by the Commission for Case Manager Certification (CCMC) needs to be obtained within 2 years, or Certified Social Worker in Health Care (C-SWHC) issued by National Association of Social Workers to be obtained within 2 years
  • 3 years of hospital care management experience
  • Ability to prioritize and organize work
  • Effective communication skills
  • Utilization of critical thinking and timely decision making
  • Ability to navigate the electronic health record
  • Basic utilization of MS Office products
  • Knowledge of Medicare A and B guidelines
Job Responsibility
Job Responsibility
  • Provides care management/social work services to Complex patients, families, and individuals including perming thorough patient psychosocial assessments, screening, determination of needs evaluation, appropriate interventions and follow up, and discharge planning
  • Implements targeted interventions and patient-family centered care plans to achieve optimal health outcomes
  • Collaborates and negotiates effectively with socially complex patients, family and the clinical team while striving to achieve patient and organizational goals regarding care needs, choices, and satisfaction during discharge planning and care transitions
  • Provide continuity of care and discharge planning services for socially complex patients compliant with regulatory standards
  • Provides advanced care management guidance and mentorship to frontline care management team members fostering a culture of excellence and continuous improvement
  • Initiates internal and external referrals to ensure timely progression of care and transitions for socially complex patients
  • Documents discharge planning interventions and utilization review activity according to department and organization standards in a timely manner
  • Advocates for patients and their families to ensure their voices are heard and their needs are met within the healthcare system while optimizing the utilization of hospital resources ensuring cost-effective care delivery and adherence to regulatory guidelines
  • Communicates effectively with the healthcare team regarding socially complex patients
  • Serves as a leader of the multidisciplinary rounds and work closely with clinical team members, hospital departments and ancillary services to identify and resolve barriers to discharge, expedite care delivery to avoid delays in timely service provision, and implement and report on care coordination and discharge planning
What we offer
What we offer
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program
  • Fulltime
Read More
Arrow Right