29 registered nurse case management jobs found

Registered Nurse, RN Care Transitions Manager – PRN Bring your passion to Texas Health so we are Better + Together Work location:  Texas Health Denton 3000 N I-35 Denton, TX 76201 (Onsite) Work hours: PRN (As Needed), schedule can vary depending on the unit; Monday-Friday, 8:30am-5:00pm or 10:00am-10:30pm and Saturday & Sunday, 8:30am-5:00pm. This position requires 2 weekend days/month minimum and 1 critical holiday staffing. Highlights: At Texas Health Denton we take seriously our mission to improve the health of those in our community. We are a 255-bed, full-service hospital serving our community since 1987. Our central location provides convenient care to people in the DFW Metroplex and across North Texas and Oklahoma. With more than 1,000 employees and 450+ physicians on our medical staff we are one of Denton County’s largest employers. Texas Health Denton is a Joint Commission-accredited Primary Stroke Center and Chest Pain Center...

Registered Nurse Outpatient Care Manager - PRN Bring your passion to Texas Health so we are Better + Together   Work location: Remote (Local DFW candidates only) Work hours: PRN - must be available to work Monday - Friday   Care Management highlights: New and innovative Care Management Collaborative community impact  

GENERAL PURPOSE OF JOB: The neonatal nurse practitioner (NNP) is a professional registered nurse with clinical experience in neonatal nursing who has received formal education with supervised clinical experience in the management of sick neonates. The NNP exercises independent judgment in assessment, diagnosis, initiation of delegated medical procedures, and evaluation which is consistent with state nurse practice laws, institutional guidelines, and the NNP s education and experience. The NICU nurse practitioner operates within the framework of Driscoll Children's Hospital Mission Statement and Core Vales. E SSENTIAL D UTIES AND B EHAVIORAL E XPECTATIONS : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential...

Become a part of our caring community As a Clinical Manager at CenterWell Home Health, reporting to the Branch Director, you will lead and support a team of dedicated clinicians who deliver compassionate, high quality care in the home setting. By guiding clinical practice, coordinating patient services, and ensuring excellence in every step of the care journey, you'll empower patients to achieve their highest level of independence while helping your team thrive in their roles. As a Registered Nurse Clinical Manager , you will: Oversee clinical operations for the location, including patient care delivery, staff management, documentation quality, and regulatory compliance, working onsite in-office. Review referrals, determine admission appropriateness, assign clinicians, and ensure Plans of Care meet patient needs and agency standards. Guide, support, and educate clinicians; help goal set, care planning, and clinical decision making; and remain available during operating...

Interventional Radiology Technologist - Interventional Radiology Bring your passion to Texas Health so we are Better + Together *** Sign-on Bonus (Eligible New Hires) ***   Work location:  Texas Health Ft. Worth, 1301 Pennsylvania Ave., Ft. Worth, TX  76104                            Work hours:   Monday-Friday 7:30-1800p; rotating days off; this provides a four (4) day weekend every five (5) weeks.  On-call is required but it is self-scheduled. You must be within thirty (30) minutes of the hospital.  On call requirements include two (2) primary weeks and two (2) backup weeks within a thirteen (13) week cycle. Department highlights: Our experienced and compassionate team in Interventional Radiology care for patients with Cardiac, Peripheral Vascular or Electrophysiology related disease.  For our clinical staff, we require a 30-minute call response time which includes STEMI call.  We are a Magnet...

Become a part of our caring community As a Clinical Manager at CenterWell Home Health, reporting to the Branch Director, you will lead and support a team of dedicated clinicians who deliver compassionate, high quality care in the home setting. By guiding clinical practice, coordinating patient services, and ensuring excellence in every step of the care journey, you'll empower patients to achieve their highest level of independence while helping your team thrive in their roles. As a Registered Nurse Clinical Manager , you will: Oversee clinical operations for the location, including patient care delivery, staff management, documentation quality, and regulatory compliance, working onsite in-office. Review referrals, determine admission appropriateness, assign clinicians, and ensure Plans of Care meet patient needs and agency standards. Guide, support, and educate clinicians; help goal set, care planning, and clinical decision making; and remain available during operating...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to: overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE RN is required. BSN or Master's degree is preferred. Minimum four (4) years nursing, acute care, quality management or managed care experience is required. Knowledge of InterQual screening criteria and coding resources (DRG, ICD and...

POSITION SUMMARY/RESPONSIBILITIES Provides strategic leadership for Utilization Management programs and initiatives. Responsible for accreditation readiness, regulatory compliance oversight, performance improvement planning, delegated oversight, operational governance, and implementation of organizational UM strategies. Serves as a liaison between operational leadership, Medical Directors, executive leadership, regulatory agencies, and accreditation organizations. Provides leadership, oversight, direction, and performance management for Utilization Management staff, including clinical reviewers, denial and appeals staff, and administrative personnel. Oversees utilization review operations, prior authorization activities, concurrent review, retrospective review, appeals support, and regulatory compliance activities. Ensures consistent application of medical necessity criteria, regulatory requirements, accreditation standards, and organizational policies. Leads quality...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to: overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE RN is required. BSN or Master's degree is preferred. Minimum four (4) years nursing, acute care, quality management or managed care experience is required. Knowledge of InterQual screening criteria and coding resources (DRG, ICD and...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to: overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE RN is required. BSN or Master's degree is preferred. Minimum four (4) years nursing, acute care, quality management or managed care experience is required. Knowledge of InterQual screening criteria and coding resources (DRG, ICD and...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to: overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE RN is required. BSN or Master's degree is preferred. Minimum four (4) years nursing, acute care, quality management or managed care experience is required. Knowledge of InterQual screening criteria and coding resources (DRG, ICD and...

POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The SC-RN provides a holistic evaluation of the Member's individual dynamics, needs and preferences while providing education and health-related information to the Member, the Member's Legal Authorized Representative (LAR), and the Member's Support Network. Responsible for the coordination of STAR Kids members' covered and non-covered services, including both acute and long term services and supports (LTSS), while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with University Health System's and CFHP's policies, procedures and protocols for establishing and maintaining good working...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master's degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of...

POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The SC-RN provides a holistic evaluation of the Member's individual dynamics, needs and preferences while providing education and health-related information to the Member, the Member's Legal Authorized Representative (LAR), and the Member's Support Network. Responsible for the coordination of STAR Kids members' covered and non-covered services, including both acute and long term services and supports (LTSS), while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with University Health System's and CFHP's policies, procedures and protocols for establishing and maintaining good working...

POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The SC-RN provides a holistic evaluation of the Member's individual dynamics, needs and preferences while providing education and health-related information to the Member, the Member's Legal Authorized Representative (LAR), and the Member's Support Network. Responsible for the coordination of STAR Kids members' covered and non-covered services, including both acute and long term services and supports (LTSS), while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with University Health System's and CFHP's policies, procedures and protocols for establishing and maintaining good working...

POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The SC-RN provides a holistic evaluation of the Member's individual dynamics, needs and preferences while providing education and health-related information to the Member, the Member's Legal Authorized Representative (LAR), and the Member's Support Network. Responsible for the coordination of STAR Kids members' covered and non-covered services, including both acute and long term services and supports (LTSS), while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with University Health System's and CFHP's policies, procedures and protocols for establishing and maintaining good working...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master's degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master's degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of...

POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The SC-RN provides a holistic evaluation of the Member's individual dynamics, needs and preferences while providing education and health-related information to the Member, the Member's Legal Authorized Representative (LAR), and the Member's Support Network. Responsible for the coordination of STAR Kids members' covered and non-covered services, including both acute and long term services and supports (LTSS), while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with University Health System's and CFHP's policies, procedures and protocols for establishing and maintaining good working...

POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members. EDUCATION/EXPERIENCE Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master's degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of...