Jobs in the United States

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Added 1 min 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 2 mins ago
Store Manager - Hamilton, NJ
Save A Lot
Hamilton, NJ
Must have the ability to stand, walk and / or move about for extended periods of time
Added 3 mins ago
FM
Case Manager RN - Travel Nurse
Fusion Medical Staffing
Bel Air, MD
- $2,005.4 to $2,133.4 USD / week
Sensory - Must possess visual acuity and ability to effectively communicate
Added 4 mins ago
W
Crew - Lunch Shift
Wendy's
COLUMBUS, OH
- $12.75 to $14 USD / hour
Perks – FREE MEALS while you’re working, 401(k) and employee assistance program for all employees. Plus PTO and healthcare benefits for qualifying employees
Added 4 mins ago
W
Crew - Dinner Shift
Wendy's
COLUMBUS, OH
- $12.5 to $14 USD / hour
Perks – FREE MEALS while you’re working, 401(k) and employee assistance program for all employees. Plus PTO and healthcare benefits for qualifying employees
Added 4 mins ago
Cook - Per Diem
Trinity Health
Silver Spring, MD
Rotating Shift · Must have or be pursuing high school diploma or equivalent four years of work-related experience
Added 5 mins ago
H
Construction Material Field Technician/Inspector - Annapolis Junction, MD
Hillis-Carnes
Annapolis Junction, MD
- $20 to $24 USD / hour
Through our ESOP (Employee Stock Option Program), you receive ownership stock in the company!
Added 5 mins ago
H
Construction Material Field Technician - Hagerstown, MD (No Experience Necessary) plus $$SIGN ON BONUS!$$
Hillis-Carnes
Hagerstown, MD
- $15 to $23 USD / hour
Through our ESOP (Employee Stock Option Program), you receive ownership stock in the company!
Added 5 mins ago
H
Construction Material Field Technician - Chantilly, VA
Hillis-Carnes
Chantilly, VA
- $18 to $23 USD / hour
Through our ESOP (Employee Stock Option Program), you receive ownership stock in the company!
Added 6 mins ago
Medical Assistant 2 OBGYN
Inova
Fairfax, VA
This role will be Full-Time, Day Shift from Monday – Friday
Added 6 mins ago
Manager, Clinic Operations, Pediatric Neurology & Pulmonary
Inova
Fairfax, VA
1 year of healthcare leadership experience OR completion of a 12-month healthcare administrative fellowship program
Added 6 mins ago
Manager, Clinic Operations, Pediatric Cancer & Blood Disorders
Inova
Fairfax, VA
1 year of healthcare leadership experience OR completion of a 12-month healthcare administrative fellowship program
Added 6 mins ago
*Therapist - Salaried Clinician
Cape Cod Healthcare
Hyannis, MA
Participates in regular clinical supervision. Consults with medical director, program manager and colleagues when clinical decisions regarding risk arise.
Added 6 mins ago
*Therapist - Salaried Clinician
Cape Cod Healthcare
MA
Participates in regular clinical supervision. Consults with medical director, program manager and colleagues when clinical decisions regarding risk arise.
Added 7 mins ago
Maintenance Technician II
Highmark Residential, LLC
Jacksonville, FL
Assist Service Manager with various tasks as required by the needs of the community
Added 7 mins ago
Maintenance Technician II
Highmark Residential, LLC
Tampa, FL
Assist Service Manager with various tasks as required by the needs of the community
Added 8 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 8 mins ago
Dance Fitness Instructor
Brown University
United States
…Acting under direct supervision of the Fitness and Wellness Manager, the Dance Fitness Instructor will provide excellent instruction in a variety of Dance fitness formats including but not…
Added 9 mins ago
Outside Sales Representative
State Industrial Products
Charleston, WV
Ability to travel within the local market area using a personal vehicle; valid driver’s license required
Added 9 mins ago
Skilled Maintainer (37.5 Hour)
State of Connecticut
Southbury, CT
Added 10 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 11 mins ago
UG
Associate Clinical Admin Coordinator
UnitedHealth Group
Colorado Springs, CO
- $16 to $29 USD / hour
Schedule: 8-hour shifts, Monday-Friday between the hours of 7am-6pm MST. Schedule to be determined by manager upon hire.
Added 11 mins ago
UG
Senior Community Pharmacy Technician
UnitedHealth Group
Braintree, MA
- $18 to $32 USD / hour
…Sunday shifts will be rotating. Schedule to be determined by manager upon…
Added 11 mins ago
Pharmacy Technician
Virginia CVS Pharmacy, L.L.C.
Petersburg, VA
Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…
Added 11 mins ago
CR
Staff Pharmacist Full Time
CVS Rx Services, Inc.
Richmond, VA
- Full-time
…care for our patients. In addition to supporting the Pharmacy Manager in leading and directing your Pharmacy Technician Support Staff, you are accountable for supporting the management,…

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