Position Summary: We are looking for local or out-of-state experienced RN's looking for an opportunity as a ED Case Manager to join our nationally recognized healthcare system in Pinehurst, NC. Reviews all denials, providing additional clinical as requested, arranges peer to peer as needed, updating Denials Management Specialist of progress in process thereby assisting in facilitating correct billing and payment.
Working within a collaborative care model, the BHCM partners closely with medical providers, a psychiatric consultant, and campus and community stakeholders to ensure students receive coordinated, accessible, and effective care that addresses both physical and mental health needs. Utilizing evidence-based approaches such as motivational interviewing, behavioral activation, and problem-solving treatment, the BHCM supports students in addressing common mental health and substance use concerns while promoting resilience, self-management, and academic success.
p>PRIMARY PURPOSE OF THE ROLE: Sedgwick Field Case Managers work face to face with their injured workers and medical providers to facilitate; though advocacy, progressive medical treatment, and timely return-to-work; while acting as a liaison and providing communication between all involved parties. Identify appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being used in a timely and cost-effective manner in order to obtain optimum value for both the client and the reimbursement source.
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license.
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license.
li>Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client's appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
Fayetteville, NC9 days ago
p>Coho Integrated Solutions is seeking a qualified Licensed Practical/Vocational Nurse - Transfer Center to perform professional nursing services in support of patient care operations at the Military Treatment Facility (MTF) in Camp Lejeune, NC. Serve as a central point of contact for patients transferred from and to NMCCL to external medical facilities (civilian or military); providing professional communication with patient/family members, healthcare workers (internal and external), military unit Medical Officers, MTF Directors, and the Market Director.
Hospice RN Case Manager, Full-timeTransitions LifeCare seeks to hire full-time Community-based Hospice RN Case Managers who embrace our mission of caring for individuals and families with compassion, support, and expertise as they navigate the end of life or life-changing illness. Must have reliable transportation to travel to, enter and function in the homes/facility of any patient/family in the service area to assess and provide patient care.
p/>Education, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Psychiatric Mental Health Nurse Practitioner, (PMHNP) credential required.
Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams.
Fayetteville, NC22 days ago
Coordinate outreach efforts for the SSVF Program including but not limited to: establish an outreach plan to target the participants as outlined in the SSVF program guidelines, develop a set schedule to visit the VA, shelters, and other places that homeless and low-income families (Veterans) are likely to congregate, and develop communication/ updates with the VA and other key housing and community providers. EFFECT ON END RESULT: Participant housing, employment, family, social support and life-skill issues are rapidly addressed and supports and services are amended or adjusted as required to ensure maintaining housing, economic stability or attainment of benefits, and socialization of Participant and family in their home community.
p>Education, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Psychiatric Mental Health Nurse Practitioner, (PMHNP) credential required. Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
Work At Home, NC23 days ago
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client's appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
Pinehurst, NC30+ days ago
em> Strong interpersonal, listening, as well as oral and written communication skills, to include presentation skills and ability to translate complex technical terms in laymen's terms Customer service skills and follow-up skills Strong analytical skills and problem-solving skills Teaching skills Ability to work in a fast-paced environment and to work on multiple tasks at the same time Ability to work with others and in a team environment Ability to stay calm in all situations Proficient in Microsoft Office (Word, Excel, Outlook and PowerPoint) Working knowledge of computerized nursing systems Physical Demands: Being in a stationary position for extended periods of time (4 hours or more) Repetitive motions Moving about Pushing/pulling Reading Bending/stooping Communicating Reaching/grasping/touching with hands Detecting sounds by ear Writing Close, distance and peripheral vision Traveling distances (car, airplane, etc.) Color perception Lifting/moving items up to 20 pounds Viewing computer screen for extended periods of time (4 hours or more) Lifting/moving items up to 75 pounds with equipment assistance Keying frequently on a computer for 4 hours or more Work Environment: Normal office environment Exposure to mechanical equipment Patient care environment Electrical current Proximity to moving objects Exposure to Hazards (blood borne pathogens, body fluids, toxic chemicals, flammable explosive gases, etc) The hourly rate for this position generally ranges between $35.68-$44.97 This entails: Performing the initial nursing assessment, communicating findings with the assigned physician, assessing the wound stage and measurements, documenting care plans, evaluating the patient' status in regards to desired outcomes, and identifying patient care situations that require intervention Participating in quality improvement initiatives, providing education to the patient or caregiver, and serving as a patient advocate in the delivery and coordination of the patient care Performs hyperbaric oxygen therapy (HBO) related duties as assigned, upon completion of the Healogics hyperbaric training May perform hyperbaric safety director duties after completing the required Healogics hyperbaric safety director training Collaborates as needed with other healthcare providers, Wound Care Center Providers, the Program Director and the Medical Director regarding clinic and patient needs May function as a Documentation Assistant (scribe) in accordance with Healogics policy Performs other duties as required.
Stanly County, North Carolina8 days ago
For a list of organizations that perform this specialized service, please visit the NACES membership website at https://www.naces.org/members. Job responsibilities include, but are not limited to, the following: - Assisting in major dynamic programs or coordinating major specialized programs for the rehabilitation of offenders such as offender work assignments, work release, education, or recreation; as well as transition planning and coordinating.
Bertie County, North Carolina4 days ago
p>Associate’s degree in Criminal Justice, Human Services, Recreation or a related field from an appropriately accredited institution; or High school or General Educational Development (GED) diploma and two years of custody experience within the North Carolina Department of Public Safety; or an equivalent combination of training and experience. For a list of organizations that perform this specialized service, please visit the NACES membership website at https://www.naces.org/members.