Registered Nurse Inpatient Case Manager Job at Advocate Health Care (Kenosha)

RN Case Manager, Brain Tumor Clinic

The outpatient RN Case Manager in the Brain Tumor Clinic at Boston Children’s fu...

Location

United States , Boston

Salary:

93538.00 - 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, 8:00pm – 4:30 pm

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

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

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

Utilization Management Nurse Specialist RN II

The Utilization Management Nurse Specialist RN II facilitates, coordinates, and ...

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
At least 5 years of varied RN clinical experience in an acute hospital setting
At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting
Registered Nurse (RN) - Active, current and unrestricted California License
Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint
Provision of excellent customer service required
Excellent time management and priority-setting skills
Maintains strict member confidentiality and complies with all HIPAA requirements
Strong verbal and written communication skills

Job Responsibility

Facilitates, coordinates, and approves medically necessary referrals that meet established criteria
Assures timely and accurate determination and notification of referrals and reconsiderations
Generates approval, modification and denial communications
Actively monitors for admissions in any inpatient setting
Performs telephonic and/or onsite admission and concurrent review
Collaborates with onsite staff, physicians, providers, member/family to develop and implement a successful discharge plan
Works with the UM Manager and Physician Advisor on case reviews
Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers
Acts as a department resource for medical service requests /referral management and processes
Receives incoming calls from providers, professionally handles complex calls

What we offer

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

Fulltime

Utilization Management Nurse Specialist RN II

The Utilization Management Nurse Specialist RN II facilitates, coordinates, and ...

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
At least 5 years of varied RN clinical experience in an acute hospital setting
At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting
Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint
Provision of excellent customer service required
Excellent time management and priority-setting skills
Maintains strict member confidentiality and complies with all HIPAA requirements
Strong verbal and written communication skills
Registered Nurse (RN) - Active, current and unrestricted California License

Job Responsibility

Facilitates, coordinates, and approves medically necessary referrals that meet established criteria
Assures timely and accurate determination and notification of referrals and reconsiderations
Generates approval, modification and denial communications
Actively monitors for admissions in any inpatient setting
Performs telephonic and/or onsite admission and concurrent review
Collaborates with onsite staff, physicians, providers, member/family to develop and implement a successful discharge plan
Works with the UM Manager and Physician Advisor on case reviews
Monitors and oversees the collection and transfer of data and referral requests by Providers
Acts as a department resource for medical service requests /referral management and processes
Receives incoming calls from providers, professionally handles complex calls

What we offer

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

Fulltime

RN Care Manager

Inpatient Care Managers are Registered Nurses who independently assure patients ...

Location

United States , Salem

Salary:

52.52 - 80.11 USD / Year

Kaiser Permanente

Expiration Date

Until further notice

Requirements

Minimum of two years combine RN experience in the following areas: Med/Surg (hospital acute care)
ICU (hospital acute care)
Emergency Department
Home Health
Skilled Nursing Facilities
Hospice
Long Term Acute Care
Inpatient Rehab
Utilization Management
Successful completion of an RN program by date of hire

Job Responsibility

Independently assure patients are admitted to the correct level of care for accurate billing and reimbursement
Provide quality, cost effective clinical coordination/care management in acute care and emergency care settings
Manage patients with routine and complex transition planning needs by: independently assessing needs, developing and implementing plans of care for transitions across care settings
Serve as expert consultants and educators for physicians and other health care team members for discharge and transitional care, coordination of internal and community resources
Support the evaluation and improvement of systems of care to support the optimal utilization of health care resources, while maintaining quality of patient care
Assume primary accountability for anticipating, assessing, developing, implementing, documenting, advising, and communicating a safe transition plan of care for patients with complex care needs
Coordinates post-discharge patient care needs to assure the timely and effective discharge of routine and complex patients from the hospital setting
Independently and proactively completes and documents patient assessments which are thorough, timely, age appropriate, and reflect psychosocial support systems, care needs, health plan benefits, level of care determinations for hospitalized patients
Coordinates and communicates with patients, families, and the health care team to develop mutually agreeable plans of care that optimize the use of resources to support the particular needs of individual patients
Facilitates resolution of issues which present barriers to safe transfers through the use of patient/team care conferences to assure the efficient transition to a lower level of care and to assure the patient/family receives the right care at the right time so that quality and utilization of resources are simultaneously enhanced

What we offer

Medical, Vision & Dental
Retirement Plans
Tuition Reimbursement
Supportive Teams & Resources
Career Growth & Development

Parttime

Patient Nurse Navigator (RN)

As a skilled and compassionate RN, you will play a pivotal role in providing and...

Location

United States , Grafton

Salary:

41.10 - 61.65 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Completion of an accredited or approved program in nursing
Registered Nurse license issued by the state in which the teammate practices
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association
Similar experience with additional skills in case management or social work, preferred
RN license with dual-state licensure preferred (IL/WI for regional coverage), or willingness to get dual-state licensure
Strong communication and technology skills for virtual care delivery

Job Responsibility

Identify eligible patients from ED or inpatient units based on inclusion/exclusion criteria
Coordinate referrals and documentation with Utilization Management and HAH team
Provide and coordinate comprehensive patient care through the nursing process to deliver safe, therapeutic care in accordance with established standards, policies, and procedures
Using evidence-based practice, clinical decision making, compassion, and skills communication while leading efforts to create the safest patient environment and the best patient experience across the continuum

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
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions

Fulltime

Patient Nurse Navigator

As a skilled and compassionate RN, you will play a pivotal role in providing and...

Location

United States , Grafton

Salary:

41.10 - 61.65 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Completion of an accredited or approved program in nursing
Registered Nurse license issued by the state in which the teammate practices
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association

Job Responsibility

Identify eligible patients from ED or inpatient units based on inclusion/exclusion criteria
Coordinate referrals and documentation with Utilization Management and HAH team
Provide and coordinate comprehensive patient care through the nursing process to deliver safe, therapeutic care in accordance with established standards, policies, and procedures
Using evidence-based practice, clinical decision making, compassion, and skills communication while leading efforts to create the safest patient environment and the best patient experience across the continuum

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

Registered Nurse Inpatient Case Manager

Advocate Health Care

Location:
United States , Kenosha

Category:
Nursing

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 20, 2026

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Job Posted:February 20, 2026

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