Top 28 Registered nurse case manager Jobs in Greer, Sc

Case Manager (PRN)
Spartanburg Regional Healthcare System —Greer, SC
- PRN
- Master of Social Work
- Nursing
- RN License
Quick Apply
(RN) Remote Care Manager - SC based
Molina Healthcare —Spartanburg, SC
- $25.08 - $51.49 an hour
- Full-time
- Remote
- RN License
- HIPAA
- Mid-level
- Health insurance
Case Manager
Spartanburg Regional Healthcare System —Spartanburg, SC
- Full-time
- Master of Social Work
- Nursing
- RN License
Quick Apply
Registered Nurse (RN) -Hospital Case Manager, Part-Time, Weekends
Prisma Health —Greenville, SC
- Part-time
- Acute care
- Nursing
- RN License
Field Nurse Case Manager - Greenville, SC
Gallagher Bassett —Greenville, SC
- $64,000 - $96,000 a year
- Full-time
- Nursing
- Medicine
- Microsoft Outlook
- Paid parental leave
- Health savings account
Field Nurse Case Manager -Greenville, SC
Gallagher Bassett —Greenville, SC
- $64,000 - $96,000 a year
- Full-time
- Nursing
- Medicine
- Microsoft Outlook
- Paid parental leave
- Health savings account
(LPN) Nurse Patient Care Coordinator/Educator (NPCC/E) - Ryan White Department
New Horizon Family Health Services —Greenville, SC
- Nursing
- RN License
- Mid-level
- Health savings account
- Paid holidays
7d
Medical Field Case Manager
Enlyte —Greenville, SC
- $70,600 - $75,000 a year
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- Travel reimbursement
- Health savings account
5d
Registered Nurse (RN) - Hospital Care Manager, FT, Days
Prisma Health —Greenville, SC
- Full-time
- Acute care
- Nursing
- RN License
8d
Nurse Case Manager (NCM)
Goldbelt, Inc. —Spartanburg, SC
- Full-time
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
RN Field Case Manager
Sedgwick —Spartanburg, SC
- Full-time
- Nursing
- RN License
- Mid-level
- Continuing education credits
- Health insurance
Nurse Case Manager (NCM)
KSA Integration —Spartanburg, SC
- Weekends as needed
- Background check
- Nursing
- RN License
- Health savings account
- Health insurance
Registered Nurse (RN)-Hospital Case Manager, Pediatrics, PRN, Days
Prisma Health —Greenville, SC
- PRN
- Acute care
- Nursing
- RN License
Integrated Care Management Optimization and Training Coordinator, Ambulatory Care, Full Time, Days
Prisma Health —Greenville, SC
- Full-time
- Nursing
- RN License
- Word processing
14d
Hospice RN Case Manager - Spartanburg, SC
Patriot Healthcare —Spartanburg, SC
- Full-time
- Nursing
- Management
- RN License
- Mileage reimbursement
- Health savings account
Quick Apply
7d
Nurse Manager II (RN)-Acute Care, Operating Room, FT, Day
Prisma Health —Greenville, SC
- Full-time
- Acute care
- Nursing
- Surgery
Assistant Nurse Manager (ANM) - Acute Care, Emergency Dept (ED) - N. Greenville, FT, Variable
Prisma Health —Travelers Rest, SC
- Full-time
- Nursing
- Surgery
- RN License
13d
Assistant Nurse Manager (RN) - Acute Care, Family Beginnings (Postpartum), FT, Nights
Prisma Health —Greenville, SC
- Full-time
- Acute care
- Nursing
- RN License
Nurse Manager II - Long-Term Acute Care (LTAC) and Emergency Dept (ED), FT, Variable
Prisma Health —Travelers Rest, SC
- Full-time
- Nursing
- RN License
- Research
13d
Inpatient Unit Registered Nurse Case Manager PRN Nights/Weekends
Compassus —Simpsonville, SC
- Part-time
- CPR Certification
- Nursing
- RN License
- Tuition reimbursement
- Flexible schedule
Quick Apply
1d

I want to receive the latest job alert for registered nurse case manager in greer, sc

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

registered nurse case manager jobs near greer, sc

Training Coordinator jobs in Greenville, SC

Case Manager jobs in Greenville, SC

Patient Care Coordinator jobs in Greenville, SC

Nurse Manager jobs in Greenville, SC

Case Manager jobs in Greer, SC

Case Manager jobs in Spartanburg, SC

Registered Nurse Manager jobs in Greenville, SC

Case Manager jobs in Amarillo, TX

Registered Nurse jobs in Lawrenceville, GA

Registered Nurse Case Manager jobs in Boynton Beach, FL

Rn Case Manager jobs in Mobile, AL

Registered Nurse Case Manager jobs in Mount Airy, NC

Registered Nurse Case Manager jobs in Federal Way, WA

Registered Nurse jobs in Philadelphia, PA

Registered Nurse Case Manager jobs in North Andover, MA

Case Management jobs in Albuquerque, NM

Case Manager jobs in Palmdale, CA

Aesthetic Nurse jobs in Idaho

Registered Nurse Case Manager jobs in Kankakee, IL

Clinical Nurse Educator jobs in Raleigh, NC

Case Manager (PRN)

Spartanburg Regional Healthcare System -
Greer, SC

Quick Apply

Job Details

Qualifications

Master's degree in social work
Collaborate with healthcare professionals
Appeals
Master of Social Work
Nursing
Patient resource coordination
Medicare
Bachelor's degree in social work
RN License
Medical insurance coverage verification
Customer service
LMSW
Insurance claim appeals processing
Client assessment in social work
Mid-level
Managing patients as a nurse case manager
Care planning in social services
Transitional care planning in clinical case management
Overseeing care coordination
Case appeal in utilization management
Clinical data entry
Utilization management
Bachelor of Science in Nursing
Health insurance pre-authorization requirements
Resource utilization in healthcare
Patient family and caregiver education
Health services social work
Financial needs assessment
Concurrent review in utilization management
Bachelor's degree in nursing

Full Job Description

Job Requirements

Position Summary

Under the supervision of the Manager, the Case Manager (CM) has knowledge and skill in the areas of discharge planning, transitions of care, utilization management (UM), medical necessity, and patient status determination. The CM facilitates effective processes based on the regulatory and reimbursement requirements of various commercial and governmental payers. The CM assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. They provide cost-effective services while maintaining quality care through collaboration with health care providers to coordinate the transition of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement. The CM performing utilization management (UM) provides the critical function of obtaining certification and approval of the patient’s hospital stay as required by the payer.

Minimum Requirements

Education

Graduate of an accredited school of nursing, Bachelor’s Degree (other than nursing) with an ADN or an accredited school of Social Work (MSW)

Experience

1-3 years healthcare experience or 1-3 years Case Management experience (Care Coordination, Transitions of Care or Utilization Management)

License/Registration/Certifications

Current R.N. licensure in the state of SC or Current Social Work licensure in the state of SC

Preferred Requirements

Preferred Education

BSN, MSW

Preferred Experience

3-5 years

Preferred License/Registration/Certifications

RN, LMSW

Core Job Responsibilities

Complies with established policies and procedures
Complies with regulatory requirements of utilization review and discharge planning
Responsible for assessment and reassessment of patients’ physical, social, emotional and financial needs.
Develops a comprehensive patient centered discharge plan, incorporating the patient goal into the discharge plan
Communicates with the patient/family/care giver and interdisciplinary patient care team to facilitate patient care, development of a comprehensive patient centered discharge plan and utilization review functions
Negotiates timely decisions to expedite the discharge plan and ensure seamless transitions across the continuum of care
Documents clearly and concisely all contacts and information of the patient’s case management
process in the medical record
Responsible for the core functions of the Utilization Management Plan
Performs initial and subsequent utilization reviews utilizing criteria.
With utilization review, obtains certification on admissions and continued certification by providing clinical information to the payer or to review companies designated by the patient’s payer. Monitor and secures final certification up to and after patient discharge until resolved. Assists with management of incoming faxed communications
With utilization review, assists with initial denial, peer to peer information, status determination and/or appeal process and communicates necessary information to the physician advisor, CM manager, denials team manager and/or QIO as required
Uses communication tools to ensure that information is collected, reviewed, escalated if needed and disseminated appropriately for all commercial, managed care and government plans.
Communicates updated insurance information to the centralized referral center if insurance information provided is not accurate
Performs timely data entry of information when results are received including covered, denied and avoidable days.
Complies with delivery of regulatory notices - Important Message, Medicare Outpatient Observation Notice, Detailed Notice of Discharge and Hospital Issued Notices of Non-Coverage.
Plans effectively in order to meet patient needs, manage length of stay and promote efficient utilization of resources.
Provides cost-effective services through resource management and facilitating throughput while maintaining quality care and meeting customer service needs by collaborating with healthcare providers to coordinate care delivery
Provides patient/family/caregiver with quality data-based information on post-acute providers to facilitate referrals to meet the care transition needs of the patient
Utilizes a secure electronic platform to communicate with post-acute providers and payers
Completes required education and ongoing competencies as assigned
Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
Other duties as assigned

Quick Apply

Refine Your Search

registered nurse case manager jobs in greer, sc

Case Manager (PRN)

(RN) Remote Care Manager - SC based

Case Manager

Registered Nurse (RN) -Hospital Case Manager, Part-Time, Weekends

Field Nurse Case Manager - Greenville, SC

Field Nurse Case Manager -Greenville, SC

(LPN) Nurse Patient Care Coordinator/Educator (NPCC/E) - Ryan White Department

Medical Field Case Manager

Registered Nurse (RN) - Hospital Care Manager, FT, Days

Nurse Case Manager (NCM)

RN Field Case Manager

Nurse Case Manager (NCM)

Registered Nurse (RN)-Hospital Case Manager, Pediatrics, PRN, Days

Integrated Care Management Optimization and Training Coordinator, Ambulatory Care, Full Time, Days

Hospice RN Case Manager - Spartanburg, SC

Nurse Manager II (RN)-Acute Care, Operating Room, FT, Day

Assistant Nurse Manager (ANM) - Acute Care, Emergency Dept (ED) - N. Greenville, FT, Variable

Assistant Nurse Manager (RN) - Acute Care, Family Beginnings (Postpartum), FT, Nights

Nurse Manager II - Long-Term Acute Care (LTAC) and Emergency Dept (ED), FT, Variable

Inpatient Unit Registered Nurse Case Manager PRN Nights/Weekends

I want to receive the latest job alert for registered nurse case manager in greer, sc

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected