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This position serves as a hospital-wide, service-line leader for psychosocial related issues, complex discharge planning activities, and population disease management. Serves as a hospital/post acute-based leader for comprehensive case management activities including assessing high-risk patients and leading team to identify at-risk patients, participating in daily Care Coordination rounds, and identifying and leading resolution to barriers of efficient patient throughput.
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Performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians.
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As needed, supervise other nurse or community health worker team members, and train them in case management. The position utilizes the nursing care process to provide and plan case management and overall care, i.e. assessment, nurse diagnosis, planning and coordination, implementation, and evaluation.
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These services are funded through state and federal resources and include prevention education, community outreach screening for infectious disease, immunization services, health service navigation, medical case management, insurance enrollment, housing assistance, and referral and linkage to infectious disease treatment.
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The Medical Director may occasionally speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management.
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1-3 years in case management, disease management, managed care or medical or behavioral health settings. 3-5 years in case management, disease management, managed care or medical or behavioral health settings.
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Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management and managed care reimbursement.
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Active, unrestricted, current, and valid Registered Nurse licenses in the States of Practice (Nevada, Texas and/or Florida), required Certified Case Manager (CCM), Case Management Nurse – Board Certified (CMGT-BC), Accredited Case Manager – RN (ACM-RN), or Certified Managed Care Nurse (CMCN), Minimum of three years in clinical nursing practice, required.
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Case management nurse, case management RN, case manager nurse, case manager RN, CM RN, healthcare, health care, registered nurse, RN, R.N., nurse, nursing. AMN Healthcare Nursing is seeking a travel nurse RN Case Management for a travel nursing job in FREMONT, California.
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Experience in utilization management, case management, discharge planning or other cost/quality management program preferred. Leads the development, implementation, evaluation and revision of clinical pathways and other Case management tools as a member of the clinical resource/team.
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You’ll be part of an integrative primary care team including an embedded APP who will support your panel and In Basket management, a behavioral health provider, clinical pharmacist, diabetes educator, and case management team.
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Monogram's innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum.
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ACM Accredited Case Manager - ACMA American Case Management Association or. The RN Case Manager is expected to function within the full scope of the nursing practice with specialized focus on care coordination, compliance, transition management, education, and utilization management.
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Coach and train staff to identify the potential quality of care/service and accessibility concerns and refer to Grievance and Appeals (G&A), Case and Disease Management (CM/DM), Behavioral Health/ABA or Quality Improvement (QI.
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This position is a member of BIDLS senior management team and is responsible for setting policy and recommending regulatory direction in response to infectious disease in Massachusetts. This includes 351 local boards of health within Massachusetts, the CDC, FDA, USDA, MA Department of Agricultural Resources, and Bureaus within DPH such as the Bureau of Climate and Environmental Health, the Bureau of Healthcare Safety and Quality and the Office of Preparedness and Emergency Management.
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