Manager, Inpatient Case Management Job at Baptist Health (Florida) (Jacksonville)

Embedded Transitional Care Manager RN

Oak Street Health takes a team-based approach to providing outstanding patient c...

Location

United States , Rockford

Salary:

66575.00 - 142576.00 USD / Year

CVS Health

Expiration Date

Until further notice

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

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

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

Emergency Department Rn Case Manager

At Boston Children’s Hospital, the quality of our care – and our inclusive hospi...

Location

United States , Boston

Salary:

93537.60 - 149656.00 USD / Year

Boston Children's Hospital

Expiration Date

Until further notice

Requirements

A Bachelor's degree in nursing
Master's in a related Healthcare field preferred
A minimum of 5 years nursing experience required
pediatrics preferred
Experience as a nurse Case Manager (Discharge Planning) preferred
Current Massachusetts license as a Registered Nurse (RN)
A certification as a Certified Case Manager is preferred, if not willingness to obtain within the first two years of employment

Job Responsibility

Assessing, planning, organizing and overseeing daily clinical operations of care coordination and transitions to address the comprehensive and complex health needs of the patient and family
Possessing knowledge of community health services, payer systems and post-acute care needs for inpatient patients and families
Collaborative work with inpatient nursing teams and inpatient case managers
Demonstrating the ability to integrate regulatory requirements, length of stay, resource allocation, funding sources, and capacity management to optimize delivery of appropriate services
Actively participating, as required, in hospital, departmental and multidisciplinary programs, committees and special projects
Working 40 hours per week, Monday through Friday, 12:00pm – 8:30pm with rotating holidays and weekends as needed

What we offer

flexible schedules
affordable health, vision and dental insurance
child care and student loan subsidies
generous levels of time off
403(b) Retirement Savings plan
Pension
Tuition and certain License and Certification Reimbursement
cell phone plan discounts
discounted rates on T-passes

Fulltime

RN Case Manager, Inpatient

The inpatient and outpatient RN Case Managers at Boston Children’s function as t...

Location

United States , Boston

Salary:

93537.60 - 149656.00 USD / Year

Boston Children's Hospital

Expiration Date

Until further notice

Requirements

A Bachelor’s degree in nursing
A minimum of 5 years nursing experience required
Current Massachusetts license as a Registered Nurse (RN)

Job Responsibility

Assessing, planning, organizing and overseeing daily clinical operations of care coordination and transitions to address the comprehensive and complex health needs of the patient and family
Possessing knowledge of community health services, payer systems and post-acute care needs for inpatient patients and families
Collaborative work with inpatient nursing teams and inpatient case managers
Demonstrating the ability to integrate regulatory requirements, length of stay, resource allocation, funding sources, and capacity management to optimize delivery of appropriate services
Actively participating, as required, in hospital, departmental and multidisciplinary programs, committees and special projects
Working 40 hours per week, Monday through Friday, operational hours 8:00 am to 4:30 pm with rotating holidays and weekends

What we offer

flexible schedules
affordable health, vision and dental insurance
child care and student loan subsidies
generous levels of time off
403(b) Retirement Savings plan
Pension
Tuition and certain License and Certification Reimbursement
cell phone plan discounts
discounted rates on T-passes

Fulltime

Case Manager Registered Nurse - Inpatient Respiratory Unit

This position is accountable for assessing, planning, implementing, coordinating...

Location

United States , Madera

Salary:

53.00 - 82.00 USD / Hour

Valley Children's Healthcare

Expiration Date

Until further notice

Requirements

College Degree - 2 year Nursing (required)
College Degree - 4 year Nursing or in a field that supports the Case Management's process (preferred)
RN - Registered Nurse License - CA-BRN - California Board of Registered Nursing (required)
Minimum two (2) years Nursing experience (required)
Pediatric experience and Case Management/Utilization Management experience desirable (preferred)
Bilingual Skills Preferred

Job Responsibility

Assessing, planning, implementing, coordinating, monitoring, and evaluating options and services available to meet a patient's health needs
Coordinating services provided to a specified group of patients, ensuring care in an appropriate setting and that severity of illness and intensity of service is consistent with patient's clinical condition
Collaborating with the health care team to ensure care meets desired patient outcomes with appropriate utilization of resources within expected time-frames across the continuum of care

Fulltime

Director of care management services inpatient

UNM Health provides the highest quality of care for more than 200,000 New Mexica...

Location

United States , Albuquerque

Salary:

53.29 - 82.51 USD / Hour

UNM Hospitals

Expiration Date

Until further notice

Requirements

Master's Degree in Health Related Discipline
4 years directly related experience
New Mexico RN or Social Work license

Job Responsibility

Coordinate the planning, implementation and evaluation of the inpatient care management and case management programs
Responsible for the ongoing development of care management implementation strategies
monitoring and evaluation of project outcomes
effectively communicating and integrating the mission, values and strategic initiatives of the hospitals and the Health Sciences Center
Ensure adherence to Hospitals and departmental policies and procedures
Patient care assignment may include neonate, pediatric, adolescent, adult, and geriatric age groups
Adhere to and promote the core expectations of the Patient Centered Medical Home or Patient Centered Specialty Practice as applicable
Participate in the assessment, development, implementation, evaluation, and attendance of educational needs for personnel based on quality assurance indicators
Assist in the development of a care delivery system consistent with changes in patient needs, medical technology and the professions involved with specific case types
Maintain awareness of ongoing Quality Assurance studies within the unit

What we offer

Relocation Assistance Available

Fulltime

Inpatient DRG Nursing Auditor

Join our team in Manila as Inpatient DRG Nursing Auditor. If you’re a registered...

Location

Philippines , Taguig City

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Good Comprehension skills
Strong attention to detail and communication skills
Curious and willing to ask relevant questions
Ability to understand client guidelines related to insurance advantage claims
Must be Philippine Registered Nurse with Active license
Must have an experience in clinical and audit in IP DRG

Job Responsibility

Conduct initial audit reviews to validate billed diagnoses and DRG code are supported by medical records
Record audit results and document finding notes based on policies using professional clinical resources
Perform provider appeals reviews and render decision to either uphold or overturn original finding
Review questionable encoder results, complex cases, and appeal reviews to facilitate referrals to clinical department as needed
Propose new audit concepts supported by your research and analysis
Define new audit concept criteria and test and validate new concepts developed by analytics team
Escalate facility issues per client guidance

Case Mgr II - Inpatient Pediatrics

The Case Management and Social Work team at UVM Medical Center is seeking a Case...

Location

United States , Burlington

Salary:

35.78 - 53.67 USD / Hour

The University of Vermont Health Network

Expiration Date

Until further notice

Requirements

Master's in social work from an accredited school of social work. LICSW preferred
OR Current RN licensure or compact licensure recognized by the State of Vermont is required
OR Master's degree from an accredited institution in a Health or Human Services field, this can include a Master's degree in Counseling. Licensure preferred
OR Bachelor’s of Science or higher degree from an Accredited Occupational Therapy Program. Licensed or eligible to be licensed to practice occupational therapy in the State of Vermont
OR Bachelor’s of Science or higher degree from an Accredited Physical Therapy program. Licensed or eligible to be licensed to practice physical therapy in the State of Vermont
Case management accreditation required by a nationally recognized accrediting body for case management (examples: CCM, ACM or ANCC certifications) preferred
Minimum of (3) years experience in a clinical setting, including (2) years in a medical setting, preferably a hospital
(2) years case management experience or a similar role preferred

Job Responsibility

Coordinates the care and services of selected patient populations across the continuum of illness
Promotes effective utilization and monitoring of health care resources
Assumes a critical role with an interdisciplinary team to achieve optimal patient-centered, clinical, and resource outcomes
Proactively identifies and intervenes to address barriers to treatment, health outcomes, and discharge planning, including biopsychosocial and other high-risk factors
Acts as an essential link between the patient, the healthcare team, the payer, and the community
Apply evidence-based case management practices
Conduct comprehensive assessments including medical, psychosocial, and environmental factors
Formulate and implement individualized care plans in collaboration with patients, families, and care teams
Demonstrate strong verbal and written communication skills
Build honest, respectful relationships with patients, families, and interdisciplinary teams

What we offer

Comprehensive, total compensation package that includes salary, health and wellness benefits, paid time off, and more

Fulltime

Complex Inpatient Medical Social Worker

Provides care management/social work services to Complex patients, families, and...

Location

United States

Salary:

33.05 - 49.60 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

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

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

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

Manager, Inpatient Case Management

Baptist Health (Florida)

Location:
United States , Jacksonville

Category:
Nursing

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
May 03, 2026

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