RN Case Manager, Inpatient Job at Boston Children's Hospital (Boston)

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

RN Case Manager

Rady Children’s nurses serve as local and global leaders in shaping how care is ...

Location

United States , San Diego

Salary:

58.87 - 101.33 USD / Hour

Rady Children's Hospital-San Diego

Expiration Date

Until further notice

Requirements

BLS for Health Providers (American Heart Association)
California RN License
Bachelor's Degree in Nursing
4 years nursing in an acute hospital or 2 years Case Management, Utilization Review, or Discharge Planning experience in an acute hospital

Job Responsibility

Function as liaisons between patients, their families, payors, and healthcare personnel to ensure appropriate movement along the continuum of care
Coordinate discharge needs, quality of care, and implement the utilization management process for acute inpatients
Perform concurrent review and denials management based on acute care guidelines with a focus on authorization and reimbursement, appropriateness of admission, length of stay, and avoidable delays in discharge
Collaborate with the family, the care team, third party payors, and outside providers to coordinate discharge needs including home health, durable medical equipment, and safe transitions of care

What we offer

Medical, Dental, Vision
403(b) Retirement Plan with 100% employer match up to 3% of your salary
Tuition Reimbursement up to $2,000 per year, paid time off for seminars
Life and Disability Insurance
Infertility Reimbursement
Annual merit increases, longevity increases, success sharing, paid leave cash-out program
Annual Team Rady event, milestone awards, CARES recognition

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

Rn transition coordinator

Weekend position. Saturday and Sunday 8a - 6p. Must also be able to join 30 minu...

Location

United States , Charlotte

Salary:

38.20 - 57.30 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Graduate of an accredited school of nursing required
BSN preferred
Current RN license or temporary license as a Registered Nurse Petitioner in the state in which you work and reside
Minimum of three years nursing experience preferred
Prefer two years in acute health care inpatient setting
home health, managed care, hospice, or case management
Current driver's license

Job Responsibility

Functions as a liaison for patient/family in navigating the continuum of care
Assesses, plans, coordinates, and evaluates services of patients with the goal of equipping and empowering individuals and their families to easily assess resources and adopt healthy lifestyles
Works closely with hospitals, clinics, health care facilities, and agency clinical and administrative personnel to ensure patient care is seamless, efficient, effective and appropriate
Interacts daily with patients, medical professionals, and the community to achieve continuity of care, coordination of medical services, and to document plans of care as related to home health care and hospice services
Makes on-site consultative, educational visits in the hospital to evaluate the appropriateness of the patient's admission to continuing care services
Completes accurate and appropriate documentation, logs, and/or patient forms and records to ensure compliance with regulations, agency policy, payer requirements, and standards of care

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

Parttime

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

Rn transition coordinator - transition services

Responsible for coordinating with the medical team, Clinical Care Managers, and ...

Location

United States , Charlotte

Salary:

38.20 - 57.30 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Graduate of an accredited school of nursing required
BSN preferred
Current RN license or temporary license as a Registered Nurse Petitioner in the state in which you work and reside
Minimum of three years nursing experience preferred
Prefer two years in acute health care inpatient setting
home health, managed care, hospice, or case management
Current driver's license

Job Responsibility

Functions as a liaison for patient/family in navigating the continuum of care
Assesses, plans, coordinates, and evaluates services of patients with the goal of equipping and empowering individuals and their families to easily assess resources and adopt healthy lifestyles that will increase their ability to remain healthy at home or in the least restrictive environment
Works closely with hospitals, clinics, health care facilities, and agency clinical and administrative personnel to ensure patient care is seamless, efficient, effective and appropriate to the individual
Interacts daily with patients, medical professionals, and the community to achieve continuity of care, coordination of medical services, and to document plans of care as related to home health care and hospice services
Makes on-site consultative, educational visits in the hospital to evaluate the appropriateness of the patient's admission to continuing care services
Able to complete needs assessment considering psychosocial, physical, economic, and health literacy factors
Uses interpersonal skills and excellent communication skills to establish a rapport with the patient and forecast and prioritize his/her needs
Receives referrals and orders from physicians, hospital, and other agencies
Acts as a resource for clinical personnel
Completes accurate and appropriate documentation, logs, and/or patient forms and records to ensure compliance with regulations, agency policy, payer requirements, and standards of care

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

Assistant Patient Care Manager (RN), Oncology

The Assistant Patient Care Manager is responsible for assisting the Patient Care...

Location

United States of America , Palo Alto

Salary:

83.98 - 111.27 USD / Hour

Stanford Health Care

Expiration Date

Until further notice

Requirements

Bachelor’s Degree in Nursing from an accredited college or university
Two (2) years of progressively responsible and directly related work experience
Oncology outpatient and inpatient experience preferred
California Registered Nurse (RN) license
American Heart Association Basic Life Support (BLS) certification
Ability to contribute to health care policy formulation when working in partnership with a multidisciplinary team of health care providers
Ability to delegate responsibly to others, activities according to ability, level of preparation, the standards of practice and regulatory guidelines
Ability to develop programs and lead process improvement projects
Ability to establish the strategic direction and business plans for a functional group
Ability to initiate and implement change conducive to the improvement of the quality and safety of patient care delivery

Job Responsibility

Assists in the performance of the operational aspects of a designated unit(s) while providing mentoring and leadership support to the unit(s) staff
supervises the provision of quality, therapeutic and cost-effective patient care in accordance with standards of practice, hospital protocols, policies and procedures, and desired patient outcomes
Assists Patient Care Manager in administrative/management functions and assumes the duties and responsibilities of the Patient Care Manager as delegated and/or in the case of absence
Coordinates and directs the unit(s) patient care operations for an assigned shift, acting on behalf of the Patient Care Manager
Facilitates orientation, training and ongoing staff development
assists in coaching, developing and corrective action of personnel as appropriate
participates in ongoing and annual evaluation of employee performance
Facilitates the effective delivery of competent, compassionate care by monitoring and evaluating patient care processes and outcomes to facilitate smooth workflow and desired outcomes on the patient care unit(s)
Interprets to staff the application and implementation of the philosophy, objectives, policies, and procedures of the unit(s), department, and organization
communicates expectations nd monitors staff performance

What we offer

Benefits eligible during term

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

RN Case Manager, Inpatient

Boston Children's Hospital

Location:
United States , Boston

Category:
Nursing

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 26, 2026

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