Jobs in the United States

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Added 11 mins ago
Account Manager - Global Health Benefits
The Cigna Group
United States
Active Life, Accident, and Health license required by the state, or the ability to obtain it within the required business timeframe
Added 19 mins ago
Research Project Manager
Brown University
United States
The Research Project Manager will support a body of work related to teacher professional learning and growth as part of the Annenberg Institute’s Research Partnership for Professional…
Added 20 mins ago
Skilled Maintainer (37.5 Hour)
State of Connecticut
Southbury, CT
Added 20 mins ago
MM
Manufacturing Engineering Manager
Moog Military Aircraft LLC
Torrance, CA
- $150,000 to $210,000 CAD / year
Onsite – Torrance, CAOur team at Moog Military Aircraft Group is looking for a Manufacturing Engineering Manager to join us. You will report to the Site Fabrication Director, and you will…
Added 21 mins ago
UG
Senior Community Pharmacy Technician
UnitedHealth Group
Braintree, MA
- $18 to $32 USD / hour
As a Senior Pharmacy Technician, you will perform a wide range of routine and complex pharmaceutical duties in support of pharmacy operations. Assume a lead role among support staff within…
Added 21 mins ago
Pharmacy Technician
Highland Park CVS, L.L.C.
Chicago, IL
As a new Pharmacy Technician, you are required to complete an extensive CVS Pharmacy Technician Training Program as well as satisfy all registration, licensing and certification…
Added 31 mins ago
*Case Manager
Cape Cod Healthcare
MA
Initiates timely HINN Notices and letters of reinstatement. Coordinates patient appeal rights under the Discharge Appeals program.
Added 31 mins ago
Oracle Services - NetSuite Finance/SCM Senior Manager- Tech Consulting - Open Location
EY
Jefferson City, MO
To qualify for the role, you must have
Added 31 mins ago
Oracle Services - NetSuite Finance/SCM Senior Manager- Tech Consulting - Open Location
EY
Kansas City, MO
To qualify for the role, you must have
Added 31 mins ago
Oracle Services - Oracle Cloud Finance - Senior Manager -Tech Consulting - Open Location
EY
Saint Louis, MO
To qualify for the role, you must have
Added 31 mins ago
Oracle Services - NetSuite Finance/SCM Senior Manager- Tech Consulting - Open Location
EY
Saint Louis, MO
To qualify for the role, you must have
Added 31 mins ago
Oracle Services - Oracle Cloud Finance - Senior Manager -Tech Consulting - Open Location
EY
Kansas City, MO
To qualify for the role, you must have
Added 32 mins ago
Credentialing Data Analyst (Hybrid)
University Hospitals Career Section
Chesterland, OH
…involved in data entry and integrity. This position works with the Manager for installation, maintenance, security, compliance with policies and procedures, and interfaces with UH users and…
Added 32 mins ago
GOVERNMENT OPERATIONS CONSULTANT III - 40044084
State of Florida
TALLAHASSEE, FL
…management activities and consultation and direction to business/program area contract and grant managers regarding the establishment, execution, tracking, amendment, and overall…
Added 39 mins ago
J
Technical Program Manager with Supply Chain
Jobgether
Remote, United States
- $80 to $85 USD / hour
As a Technical Program Manager, you will lead large-scale enterprise implementations and complex transformation programs across supply chain technology environments.
Added 43 mins ago
Engineering Manager- Technical Program Manager
PwC
Saint Louis, MO
What You Must Have
Added 43 mins ago
Engineering Manager- Technical Program Manager
PwC
Kansas City, MO
What You Must Have
Added 52 mins ago
BS
Engineering Leader - Optical Communications
Bright Silicon Technologies
Pleasanton, CA
- $175,000 to $275,000 USD / year
We’re looking for a hands-on Engineering Manager who has brought multiple electronics, optical, or other complex hardware products to market. You’ll lead OCTANE from a laboratory prototype…
Added 53 mins ago
CH
Pharmacy Technician
CVS Health
Chicago, IL
- $17.05 USD / hour
As a new Pharmacy Technician, you are required to complete an extensive CVS Pharmacy Technician Training Program as well as satisfy all registration, licensing and certification…
Added 1 hour ago
CM
Buyer II
Cadrex Manufacturing Solutions
Mukilteo, WA
- $80,000 USD / year
Cadrex is searching for a Buyer II which under supervision of the Manager of Global Procurement, will be responsible to source, negotiate, and procure materials, supplies, and services…
Added 1 hour ago
Software Development Manager, Amazon Leo - Payload Dataplane Team
Amazon Kuiper Manufacturing Enterprises LLC
Sunnyvale, CA
…systems at scale? We're looking for a Software Development Manager to lead a team responsible for designing, implementing, and maintaining satellite networking software systems that solve…
Added 1 hour ago
Senior Sales Manager - Polymers
ExxonMobil
Spring, TX
As a Senior Account Manager, you will leverage your sales expertise and business judgment to drive commercial success for our polymers product lines. Your key responsibilities will include…
Added 1 hour ago
Director of Engineering - Custer State Park Resort
Xanterra Travel Collection
Custer, SD
…strategies, leads engineering and maintenance personnel, oversees complex technical systems and construction projects, and partners with resort leadership, South Dakota State…
Added 1 hour ago
J
Senior Program Manager M3
Jobgether
Remote, United States
- $120,000 to $125,000 USD / year
As a Senior Program Manager, you will provide strategic and operational leadership for large-scale enterprise programs, translating organizational and client objectives into measurable…
Added 1 hour ago
J
Pricing Strategy & Insights Manager
Jobgether
Remote, United States
- $101,200 to $161,900 USD / year
The Pricing Strategy & Insights Manager will shape pricing strategies across a diverse portfolio of consumer products and services, including digital, assisted, and emerging offerings. This…

Cape Cod Healthcare

*Case Manager

MA, United States

Apply on capecodhc.taleo.net About employer

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Job details

Apply by: Nov 19, 2026
Posting language: English
Posted: Nov 11, 2026

Original job description

Screen new admissions daily for discharge planning needs. Establish priority of visits based on screening criteria. Verify accuracy of demographics and payer information in and notify admissions of corrections.
Patients with identified needs for follow-up are seen within one (1) business day of identification and the Initial Assessment is completed in InterQual®. Reassessments are done every three (3) days as needed for changes in medical status, diagnosis, or caregiver.
Review appropriateness of patient’s admission and level of care needs (Inpatient and Observation) utilizing InterQual® Criteria. Follow policy and procedure if Level of Care is not met.
Initiates timely HINN Notices and letters of reinstatement. Coordinates patient appeal rights under the Discharge Appeals program.
Identifies patients and families who have high-risk complex psychosocial/financial and legal needs and refers patients to appropriate resources.
Responsible for utilization review on assigned unit. Facilitates third party reimbursement by responding to third party payer requests for concurrent clinical information in support of ongoing services, turnaround time by day end.
Works closely with attending physician/interdisciplinary team to facilitate appropriate care and services. Ensures that the interdisciplinary care plan and the discharge plan are consistent with the patient’s required needs and covered services.
Participate/facilitate in unit’s daily rounds.
Advocates for patients through the development of effective partnerships with patient families, payers and healthcare team. Acts as patient advocate communicating with patients/families regarding adverse determinations and other issues related to insurance coverage and ongoing care requirements. Facilitates and maintains patient’s independence in decision making when appropriate.
Coordinate and communicate thorough and complete referral information to enhance a safe transfer of patient to other facilities or agencies. Complete all necessary paperwork based on need and regulation.
Demonstrates knowledge of community resources and acts as resource to staff in providing safe and effective post hospital care.
Participates and accurately applies approved standards of care/Care Maps and clinical pathways in evaluating and monitoring the patient’s clinical course. Participates in the development and revision of pathways. Participates in care conferences on patients across the continuum.
Evaluates continued length of stay of patients for appropriateness per recognized InterQual® criteria. Makes appropriate referrals to Physician Advisor if criteria is not met and resolution with the attending physician cannot be accomplished.
Identifies days at risk for denial and initiate strategies to facilitate care and accomplish discharge.
Assists medical coders by obtaining necessary diagnostic and procedural information to assure appropriate reimbursement.
Maintains established departmental policies and procedures, objectives, quality assurance program, safety, environmental and Infection Control standards.
Maintains core/clinical competency and current knowledge of regulatory and payer requirements to perform job responsibilities.
Participates in education programs, in-services, and meetings as required.
Recognizes/understands responsibility of this key role and the responsibility this position demands in direct support of high quality patient care delivery regardless of assignment. This will be measured by the accountability/initiative taken in the performance of daily duties and assignments as itemized in major accountabilities section of job description.
Ability to work independently.
Complies with policies regarding dress code.
Performs other related duties as assigned or requested. Displays flexibility, cooperation and characteristics of a team member.

Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Hospital’s commitment to CARES: compassion, accountability, respect, excellence and service.

Ability to read, write and communicate in English;
Current registration as a Registered Nurse in the Commonwealth of Massachusetts;
Bachelor of Science Degree in Nursing preferred, (external applicants);
Certificate in Case Management or CPUM or specialty preferred;
Demonstrates competency with a minimum of 3 years acute care experience within the past 5 years with broad clinical experience in a hospital setting or case management.
Demonstrate recent knowledge/experience within past 4 years in Discharge Planning and Utilization review;
Working knowledge of InterQual®, or equivalent system.
Strong interpersonal and negotiation skills demonstrated by a positive attitude, pleasant, professional and cooperative demeanor, with patients, physicians, fellow employees, and insurance companies;
Excellent organization and time management skills;
Ability to work independently and effectively in a fast pace environment;
Ability to work productively in a stressful environment and effectively handle multiple projects and changing priorities;
Proficient computer skills with ability to utilize and integrate updated software systems into practice.

Apply on capecodhc.taleo.net About employer

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Jobs in the United States