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

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

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

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 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

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

Care Coordinator RN

As a RN Care Coordinator, you will be a central figure in patient care, seamless...

Location

United States , Chattanooga

Salary:

30.76 - 45.76 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Graduate of an accredited school of nursing
Minimum two (2) years of acute hospital clinical experience, upon hire
Registered Nurse: TN, upon hire
Basic Life Support - CPR, within 90 Days

Job Responsibility

Completes and documents a discharge planning assessment on those patients identified by the designated screening process, or upon request
Reassess the patient as appropriate and update the plan accordingly
Facilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members, the patient and/or patient representative and post acute care providers
Oversees and evaluates the implementation of the discharge plan
Collaborates with the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria
Collaborates with the healthcare team and post-acute service providers to ensure timely and smooth transitions to the most appropriate type and setting of post-acute services
Identifies risk for readmission and implements interventions to mitigate those risks for at least a 30-day period

What we offer

medical
prescription drug
dental
vision plans
life insurance
paid time off
tuition reimbursement
retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings

Fulltime

New

Clinical Liaison

We are looking for a dynamic Clinical Liaison to lead our growth and partnership...

Location

United States , Brooklyn, NY

Salary:

100000.00 - 105000.00 USD / Year

Ready Responders

Expiration Date

Until further notice

Requirements

Current, unrestricted New York State license as a Registered Nurse (RN), Social Worker (LMSW/LCSW), or Paramedic
4+ years of clinical experience in an Inpatient or Emergency Room (ER) setting
Proficiency with Electronic Health Records (EHR) and Google Workspace (Docs, Sheets, Slides)
Excellent communication skills
Ability to work flexible shifts (e.g., 9a-5:30p or 11a-7:30p) based on business needs
Legally authorized to work in the United States without the need for employer sponsorship, now or in the future
Able to commute to a hospital setting in Brooklyn, NY daily

Job Responsibility

Build partnerships with hospital leadership, case managers, and discharge planners
Drive growth by identifying and developing new referral sources within the hospital system
Screen patients for eligibility and facilitate their enrollment
Collaborate with the team and hospital staff to ensure seamless operational integration
Use analytical skills to identify barriers to enrollment and implement solutions

What we offer

Unlimited Vacation (eligible after 90 days)
Choice of 6 Aetna Medical Plans (effective after 1 month)
Dental & Vision Coverage
401(k) Plan
Company-provided laptop & accessories
Performance Bonus

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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Job Description:

Job Responsibility:

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Job Posted:January 26, 2026

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Job Posted:
January 26, 2026