Hospice RN Clinical Management Specialist Job at Aveanna Healthcare (Pelham)

Care Management Specialist II

Established in 1997, L.A. Care Health Plan is an independent public agency creat...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing for Registered Nurses
Master's Degree in Social Work for Licensed Clinical Social Workers
Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
Experience providing care management with complex/catastrophic conditions
Current knowledge of clinical standards of care and disease processes
Critical thinking skill
Excellent customer service skills
Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
Ability to triage immediate member health and safety risks
Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping

Job Responsibility

Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs
Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
reviewing member claims histories and identifies intervention opportunities through the professional standards of practice
contacting and interviewing members to conduct a baseline assessment, assess self-care ability, assess knowledge and adherence deficits
conducting comprehensive clinical assessments as indicated
developing a member centric plan of care. Maintains assigned care management caseload for with a focus on the most complex, highest-risk members particularly those with advanced chronic conditions, co-occurring mental and/or substance abuse and complex social issues (e.g. homelessness, domestic violence)
Collaborates with primary care physician and other treating professionals as appropriate. Authorizes initiation of care management services and specialized program services for members and specific populations, and develops interventions designed to meet member or population desired outcomes. Provides comprehensive education and resources to members about accessing services, in-network use, national guidelines for care, community resources, and self-management skills and strategies
Employs engagement techniques to build relationships with members and their authorized representatives. Encourages participants to participate in their health care decisions and assists member with researching treatment options in order to communicate effectively with providers and to make informed decisions
Notifies Care Coordinators and CHWs of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines
Performs field assessment and care coordination functions in community settings with members, such as at the L.A. Care Community Resource Centers, medical clinics, and member homes

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Care Management Specialist II, D-SNP Team

The Care Management Specialist II utilizes clinical skills and training to perfo...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing for Registered Nurses OR Master's Degree in Social Work for Licensed Clinical Social Workers
Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
Experience providing care management with complex/catastrophic conditions
Current knowledge of clinical standards of care and disease processes
Critical thinking skill
Excellent customer service skills
Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
Ability to triage immediate member health and safety risks
Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping
Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders

Job Responsibility

Utilizes clinical skills and training to perform essential functions of care management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines
Manages a specified caseload across the entire continuum of programmatic levels including those within National Committee for Quality Assurance (NCQA) scope or otherwise Complex/Catastrophic cases
Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating member access to care in a timely and cost-effective manner
Collaborates and communicates with member, family, and interdisciplinary health team to promote wellness and member empowerment, while ensuring access to appropriate services across the healthcare continuum and maximizing member benefit
Serves as clinical advocate for members, active interdisciplinary team member, liaison with other departments and external health care team
Provides direction and assistance to Care Coordinators and to Community Health Workers (CHW) of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines
Uses claims processing and care management software to look up member information, document contacts, and track member progress
Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs
Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
reviewing member claims histories and identifies intervention opportunities through the professional standards of practice

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Quality Specialist LPN/RN

Quality Specialist – Blue Ridge Care Your expertise helps ensure excellence, co...

Location

United States , Winchester

Salary:

29.00 - 36.50 USD / Hour

Blue Ridge Hospice

Expiration Date

Until further notice

Requirements

Current, unrestricted RN or LPN license in Virginia or compact multistate license eligible to practice in Virginia
Minimum of three (3) years of clinical nursing experience in hospice or palliative care
Strong knowledge of hospice principles, including pain and symptom management and end-of-life care
Familiarity with state and federal hospice regulations
Proficiency in EMR systems and documentation standards
Excellent verbal and written communication skills
Strong organizational, time-management, and critical-thinking skills
Valid driver's license and insured automobile
ability to travel throughout the service area

Job Responsibility

Conduct medical record chart reviews and focused compliance audits
provide written feedback to staff regarding deficiencies and required corrections
Analyze documentation trends and report high-risk or unfavorable findings to leadership to support education and performance improvement
Maintain up-to-date knowledge of federal, state, and accreditation standards and educate staff to ensure compliance
Attend Interdisciplinary Team (IDT) meetings to ensure regulatory and accreditation compliance
Participate in departmental and organizational quality assessment and improvement initiatives
Support management of the Hospice Outcomes and Patient Evaluation (HOPE) Tool, ensuring complete and accurate datasets prior to submission
Educate staff on HOPE requirements and proper EMR documentation
Ensure medical records are accurate, complete, secure, and HIPAA-compliant
Assist with scanning, indexing, discharge paperwork, letters, appeals, and medical record requests

What we offer

Competitive Pay
PTO & Paid Volunteer Time
Comprehensive Health Benefits
Tuition Reimbursement & Scholarships
Peer Support & Mentorship
30% Thrift Shop Discount
Career Growth

Fulltime

Np provider hospice & palliative care (pediatric)

The Pediatric NP Provider Hospice/Palliative Care has two primary responsibiliti...

Location

United States , Brooklyn

Salary:

115104.83 - 143881.04 USD / Year

MJHS

Expiration Date

Until further notice

Requirements

Master’s degree in nursing and graduate of an approved Nurse Practitioner Program required
License/Certification: NYS Certified Nurse Practitioner (NP)
Minimum of 1-year clinical experience as a NP provider preferred
Pediatric RN or NP experience strongly preferred
Prior experience working as a member of a specialist-level palliative care team or working in a hospice environment preferred.
CPR-BLS
Valid NYS Driver's license
Hospice & Palliative Care certification strongly encouraged by year 2 of hire
Microsoft Word and Excel
Ability to work flexible hours to meet the needs of the position

Job Responsibility

Provide NP-appropriate service to patients enrolled in hospice
Assist in staffing pediatric palliative care consultation services
Work in a community, long-term care environment, or hospital
Provide in-person visits or telehealth visits, as appropriate
Provide face-to-face evaluations for hospice eligibility
Assess and manage hospice patients in need of exigent medical care
Contribute to the training of the hospice team
Provide support for the interdisciplinary team, as needed
Help build a teaching curriculum on pediatric aspects of hospice care
Use an evidence-based approach to management and to the use of materials and policies/procedures

What we offer

Sign-on Bonuses OR Student Loan Assistance for clinical staff
FREE Online RN to BSN and MSN degree programs
Tuition Reimbursement for all full and part-time staff
Dependent Tuition Reimbursement for clinical staff
Generous paid time off, including your birthday
Affordable and comprehensive medical, dental and vision coverage for employee and family members
Two retirement plans! 403(b) AND Employer Paid Pension
Flexible spending

Fulltime

Case Manager - Registered Nurse - Southeast Region

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

Location

United States , Work at Home

Salary:

60522.00 - 129615.00 USD / Year

CVS Health

Expiration Date

May 27, 2026

Requirements

Candidates must live in the Southeast Region (States Include- FL, GA, AL, MS, NC, SC, TN, AR, LA)
Candidate must have active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence
3+ years clinical practical experience with preference in the following areas: diabetes, Congestive Heart Failure (CHF), Chronic Kidney Disease (CKD), post-acute care, hospice, palliative care, cardiac, home health with Medicare members
2+ years case management, discharge planning and/or home health care coordination experience
2+ years of experience with Microsoft Word, Excel, and Outlook
Associate's Degree in Nursing or Nursing Diploma (REQUIRED)

Job Responsibility

Acts as a liaison with member/client/family, employer, provider(s), insurance companies, and healthcare personnel as appropriate
Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care
Interacts with members/clients telephonically or in person
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status
Develops a plan of care to facilitate the member/client's appropriate condition management
Communicates with member/client and other stakeholders as appropriate
Prepares all required documentation of case work activities as appropriate
Interacts and consults with internal multidisciplinary team as indicated
May make outreach to treating physician or specialists concerning course of care and treatment
Provides educational and prevention information for best medical outcomes

What we offer

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

Fulltime

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Registered Nurse – Hospice Admission

This is a community-based role and will require regular travel in local and rura...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

Graduation from a qualified, nationally-accredited nursing program
One (1) year of nursing experience in an acute care setting
Current RN licensure permitting work in the State of Arizona
Basic Life Support (BLS) certification required
For Outpatient Hospice & Pediatrics areas, valid Arizona Fingerprint Clearance Card within 6 months of hire
Must have access to a vehicle, a valid driver's license, and current insurance
Knowledge of direct patient care and critical care procedures and techniques
Knowledge of the death/dying and bereavement process
Skill in communicating in a clear and concise manner
Ability to read and interpret documents such as safety rules and procedure manuals

Job Responsibility

Provides patient assessments in various settings to facilitate a well-coordinated, smooth transition to TMC Hospice services
Obtains initial medical orders from the referring providers
Assists Intake Department with referral, computer input as needed
Supports the death/dying process
Promotes TMC Hospice services and programs and exceptional customer service to physicians, facility staff, patients, and families
Develops and maintains positive relationships with referral sources
Explains hospice services and benefits to patients, family members, and caregivers
Develops and maintains therapeutic connections and relationships
Performs a comprehensive nursing assessment
Directs and efficiently coordinates the initiation of hospice services, and any other equipment, supplies, external services for hospice clients

Parttime

Registered Nurse – Hospice Admission

This is a community-based role and will require regular travel in local and rura...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

Graduation from a qualified, nationally-accredited nursing program
One (1) year of nursing experience in an acute care setting
Current RN licensure permitting work in the State of Arizona
Basic Life Support (BLS) certification required
For Outpatient Hospice & Pediatrics areas, valid Arizona Fingerprint Clearance Card within 6 months of hire
Must have access to a vehicle, a valid driver's license, and current insurance
Knowledge of direct patient care and critical care procedures and techniques
Knowledge of the death/dying and bereavement process
Skill in communicating in a clear and concise manner
Ability to read and interpret documents such as safety rules

Job Responsibility

Provides patient assessments in various settings to facilitate a well-coordinated, smooth transition to TMC Hospice services
Obtains initial medical orders from the referring providers
Assists Intake Department with referral, computer input as needed
Supports the death/dying process
Promotes TMC Hospice services and programs and exceptional customer service to physicians, facility staff, patients, and families
Develops and maintains positive relationships with referral sources
Supports programs, organizational, and departmental policies, goals, and objectives
Explains hospice services and benefits to patients, family members, and caregivers
Develops and maintains therapeutic connections and relationships
Performs a comprehensive nursing assessment

Fulltime

Complex Oncology Nurse Navigator

As a Complex Oncology Nurse Navigator, you will be on the frontlines serving our...

Location

United States

Salary:

45.67 USD / Hour

Thyme Care

Expiration Date

Until further notice

Requirements

Bachelor of Science Degree in Nursing (BSN)
Compact unrestricted Registered Nurse (RN) license
Willingness to obtain additional state licenses as needed
At least 5 years of nursing experience
3 years of high-acuity, adult oncology experience
Certification as an Oncology Certified Nurse (OCN), Advanced Oncology Certified Nurse (AOCN), Advanced Oncology Certified Nurse Specialist (AOCNS), or Certified Case Manager (CCM)
OCN certification required at time of hire or commitment to obtain within 2 years
Experience with working remotely
Willingness to learn new technology
Must be located within the lower 48 United States

Job Responsibility

Conduct clinical assessments
Monitor for changes in health
Coordinate care, including transitions
Educate members and caregivers about their diagnosis and treatment over the phone
Support higher-acuity members through the oncology care continuum
Communicate member and provider feedback to clinical leadership
Assist with administrative projects as needed
Conduct telephonic assessments, including pain assessments and medication reconciliation
Ensure members have access to medications and appointments
Perform virtual home safety evaluations

What we offer

Choice of great medical, dental, and vision insurance plans
Generous vacation policy for full-time employees
Holiday work compensated at 1x hourly rate and a 2.5x holiday rate (up to 2 holidays per year)

Fulltime

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Hospice RN Clinical Management Specialist

Aveanna Healthcare

Location:
United States , Pelham

Category:
Nursing

Contract Type:
Employment contract

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
May 04, 2026

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Hospice RN Clinical Management Specialist

Aveanna Healthcare

Location:United States , Pelham

Category:Nursing

Contract Type:Employment contract

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:May 04, 2026

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