16 rn care manager hybrid jobs found

We are hiring for an RN/Patient Care Manager (PCM) Hybrid role with Home Health experience.  This role will be a few days in office as the PCM, reviewing documentation and a few days in the field as a home health RN. At Elite Home Health, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve—it truly is all about helping people. You can find a home for your career here. As a Patient Care Manager, RN, you can expect:  opportunities to get closer to patients and provide quality support to your patient-facing teams to be valued and respected by patients and their families a sense of security, incredible team support, and flexibility for true work-life balance leadership development opportunities Our Patient Care Manager, RN role might be a great opportunity if you believe in putting the patient at the center of...

Description ** This position will be Hybrid** Job Summary Provides support for quality improvement initiatives utilizing clinical knowledge and expertise. Translates data from various registries and collaboratives into meaningful information for quality improvement initiatives relating to patient outcomes. Partners with leadership and clinical subject matter experts to identify, analyze, monitor, and improve key performance indicators. Job Specific Duties Works with leadership in the identification/development of PI plans through monitoring of quality data, national collaborative reports, and other processes of quality validation.  Works with leaders on defining appropriate process and patient outcome benchmarks, data capture processes, and dashboards.  Coordinates and collaborates with stakeholders, multidisciplinary teams, and internal and external customers to create collaborative work relationships that drive performance and quality outcomes...

Description Clinical Documentation Specialist RN \ Hybrid The MCO Clinical Reviewer is accountable for utilization management activities including evaluation of appropriateness and medical justification of health services for MCO eligibles. The position has specific focus on researching, developing, and communicating implementation of Medical Policies, including facilitating Medical Policy Committee work. In addition, the position is responsible for providing medical treatment reviews, case management, and treatment interventions the promote cost effective medical care and early return to work in workers' compensation cases. The position identifies and coordinates opportunities for Continuous Quality Improvement projects as well as provider profiling, benchmarking, and provider education. Providence Health Plan welcomes Hybrid work for applicants who reside in the greater Portland, OR area. You will be expected to work onsite at our offices...

Description Clinical Documentation Specialist RN \ Hybrid The MCO Clinical Reviewer is accountable for utilization management activities including evaluation of appropriateness and medical justification of health services for MCO eligibles. The position has specific focus on researching, developing, and communicating implementation of Medical Policies, including facilitating Medical Policy Committee work. In addition, the position is responsible for providing medical treatment reviews, case management, and treatment interventions the promote cost effective medical care and early return to work in workers' compensation cases. The position identifies and coordinates opportunities for Continuous Quality Improvement projects as well as provider profiling, benchmarking, and provider education. Providence Health Plan welcomes Hybrid work for applicants who reside in the greater Portland, OR area. You will be expected to work onsite at our offices in Portland or on client...

Education Required: Graduate of an accredited nursing program or NLN approved program Preferred: Bachelor’s Degree in Nursing | Experience Required: At least two years’ nursing experience Preferred: Preceptor and Charge nurse experience | Skills Accountable and responsible for own safe clinical practice Basic computer skills and knowledge Excellent customer service skills Thrives in rapidly changing environment Self-motivated Excellent verbal and written communication skills Demonstrate effective leadership abilities Exhibits valuable time management skills Strong critical thinking/problem solving skills. Flexibility and ability to work in a multi-tasking environment. | Licensure/Certification/Registration Required: RN license active in the state of Missouri Required: BLS must be obtained within 90 days | | Position Competencies: Competencies are essential skills needed to be successful in...

General Information Req ID: R020092 State: New York Work Type: Hybrid Description and Requirements Healthfirst is New York City's largest not-for-profit health insurer, dedicated to improving health through community-driven, value-based care. For over 30 years, we have led the shift from volume to value by focusing on better outcomes, preventative care, and cost efficiency. Recognized by Forbes as a Dream Employer of 2025 , Healthfirst is committed to fostering a culture of innovation, creativity and belonging. As a UAS Nurse Assessor, you will help ensure our members receive the care and services they need to lead healthier, more independent lives. This role is perfect for RNs who are passionate about making a positive impact in the lives of patients/families and appreciates a job with flexibility and manageable caseloads. Whether you're an experienced nurse or a new graduate eager to start your career, you'll have the opportunity to grow in a...

General Information Req ID: R020011 State: New York Work Type: Hybrid Description and Requirements The Assessment Nurse makes field assessment visits for members or prospective members around downstate New York at intervals required by the Department of Health (DOH) and completes appropriate documentation to determine members' enrollment, service needs, and continued plan eligibility. This position coordinates with Care Management Team (CMT) to maintain efficient and effective operations of Healthfirst's long term care plans such as CompleteCare and Senior Health Partners. Duties and Responsibilities: Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. As needed, conducts assessments in settings other than home as needed, e.g....

Education Required: Graduate of an accredited nursing program or NLN approved program Preferred: Bachelor’s Degree in Nursing | Experience Required: At least two years’ nursing experience Preferred: Preceptor and Charge nurse experience | Skills Accountable and responsible for own safe clinical practice Basic computer skills and knowledge Excellent customer service skills Thrives in rapidly changing environment Self-motivated Excellent verbal and written communication skills Demonstrate effective leadership abilities Exhibits valuable time management skills Strong critical thinking/problem solving skills. Flexibility and ability to work in a multi-tasking environment. | Licensure/Certification/Registration Required: RN license active in the state of Missouri Required: BLS must be obtained within 90 days | | Position Competencies: Competencies are essential skills needed to be successful in...

Description Employee (Caregiver) Health Call Center RN \ Hybrid In promoting optimal health and well-being in Providence Saint Joseph Health caregivers, the CHS Call Center RN is responsible for providing clinical caregiver health services, primarily through telephonic and virtual means, and in Caregiver Health Services offices at times. The CHS Center RN ensures compliance with state and federal requirements and PSJH policies and protocols and utilizes the tools provided to ensure accuracy of information and direction to our caregiver and core leader customers. Accountable for timely and effective response, management, resolution, escalation of incoming inquiries, in accordance with established Service Level Agreements (SLAs). Applies critical thinking to resolve complex questions regarding COVID-19, intake of exposures, caregivers reporting symptoms, exclusion from and clearance to return to work, the after-hours management of blood/body fluid exposures, virtual...

Description & Requirements Road warriors, this opportunity is for you! Maximus is currently seeking Intellectual and Developmental Disabilities (IDD) Assessors to join our team. The IDD Assessor will be responsible for scheduling and conducting field IDD/SIS assessments, ensuring quality standards, supporting activities, and attending monthly assessor calls. This is a hybrid remote opportunity with frequent travel, making it ideal for those who thrive on the go. Position is contingent upon contract award About the program: This potential Maximus opportunity in Pennsylvania involves conducting Supports Intensity Scale (SIS) assessments. This comprehensive planning tool measures exceptional medical and behavioral needs, as well as the areas of home living, community living, lifelong learning, employment, health and safety, and social activities. Why Maximus? - Work/Life Balance Support - Flexibility tailored to your needs! - Competitive Compensation -...

Description & Requirements Road warriors, this opportunity is for you! Maximus is currently seeking Intellectual and Developmental Disabilities (IDD) Assessors to join our team. The IDD Assessor will be responsible for scheduling and conducting field IDD/SIS assessments, ensuring quality standards, supporting activities, and attending monthly assessor calls. This is a hybrid remote opportunity with frequent travel, making it ideal for those who thrive on the go. Position is contingent upon contract award About the program: This potential Maximus opportunity in Pennsylvania involves conducting Supports Intensity Scale (SIS) assessments. This comprehensive planning tool measures exceptional medical and behavioral needs, as well as the areas of home living, community living, lifelong learning, employment, health and safety, and social activities. Why Maximus? - Work/Life Balance Support - Flexibility tailored to your needs! - Competitive Compensation -...

Description & Requirements Road warriors, this opportunity is for you! Maximus is currently seeking Intellectual and Developmental Disabilities (IDD) Assessors to join our team. The IDD Assessor will be responsible for scheduling and conducting field IDD/SIS assessments, ensuring quality standards, supporting activities, and attending monthly assessor calls. This is a hybrid remote opportunity with frequent travel, making it ideal for those who thrive on the go. Position is contingent upon contract award About the program: This potential Maximus opportunity in Pennsylvania involves conducting Supports Intensity Scale (SIS) assessments. This comprehensive planning tool measures exceptional medical and behavioral needs, as well as the areas of home living, community living, lifelong learning, employment, health and safety, and social activities. Why Maximus? - Work/Life Balance Support - Flexibility tailored to your needs! - Competitive Compensation -...

Description & Requirements Road warriors, this opportunity is for you! Maximus is currently seeking Intellectual and Developmental Disabilities (IDD) Assessors to join our team. The IDD Assessor will be responsible for scheduling and conducting field IDD/SIS assessments, ensuring quality standards, supporting activities, and attending monthly assessor calls. This is a hybrid remote opportunity with frequent travel, making it ideal for those who thrive on the go. About the program: This potential Maximus opportunity in Pennsylvania involves conducting Supports Intensity Scale (SIS) assessments. This comprehensive planning tool measures exceptional medical and behavioral needs, as well as the areas of home living, community living, lifelong learning, employment, health and safety, and social activities. Position is contingent upon contract award Why Maximus? - Work/Life Balance Support - Flexibility tailored to your needs! - Competitive Compensation -...

Description & Requirements Maximus is currently hiring a Part-Time Clinical Assessor LCSW to complete in-person Level II PASRR assessments in accordance with contract directives, company processes, and contract requirements. These field assessments can/may be conducted in nursing homes, hospitals and/or various community settings. This is a part-time 20-25 hour per week position that requires up to 60% travel in and around Denver including the counties of Adams or Arapahoe county. Enjoy reimbursement for mileage, tolls, and parking! About the program: Maximus is contracted with Colorado Department of Health Care Policy and Financing to manage the statewide CO PASRR program. Starting July, 2025, we will begin managing submission of all Level I PASRR referrals and Status Changes, completion of clinical review to determine if a person has a known or suspected PASRR condition (SMI, ID or related condition), completion of the comprehensive person-centered Level II...

Description & Requirements Maximus is currently hiring a Part-Time Clinical Assessor LMSW to complete in-person Level II PASRR assessments in accordance with contract directives, company processes, and contract requirements. These field assessments can/may be conducted in nursing homes, hospitals and/or various community settings. This is a part-time 20-25 hour per week position that requires up to 60% travel in and around Denver including the counties of Adams or Arapahoe county. Enjoy reimbursement for mileage, tolls, and parking! About the program: Maximus is contracted with Colorado Department of Health Care Policy and Financing to manage the statewide CO PASRR program. Starting July, 2025, we will begin managing submission of all Level I PASRR referrals and Status Changes, completion of clinical review to determine if a person has a known or suspected PASRR condition (SMI, ID or related condition), completion of the comprehensive person-centered Level II...

Description & Requirements Maximus is currently hiring a Part-Time Clinical Assessor LPC to complete in-person Level II PASRR assessments in accordance with contract directives, company processes, and contract requirements. These field assessments can/may be conducted in nursing homes, hospitals and/or various community settings. This is a part-time 20-25 hour per week position that requires up to 60% travel in and around Denver including the counties of Adams or Arapahoe county. Enjoy reimbursement for mileage, tolls, and parking! About the program: Maximus is contracted with Colorado Department of Health Care Policy and Financing to manage the statewide CO PASRR program. Starting July, 2025, we will begin managing submission of all Level I PASRR referrals and Status Changes, completion of clinical review to determine if a person has a known or suspected PASRR condition (SMI, ID or related condition), completion of the comprehensive person-centered Level II...