Concurrent Review Case Manager
About the job
- A current registered nurse license to practice in California is required.
- At least 5 years of clinical experience with the health needs of the population served is required.
- Ability to work toward and/or maintain case management certification (CCM).
- Knowledge of ICD-9, ICD-10, and CPT coding requirements.
- Review and evaluate proposed services using medical criteria and established policies and procedures, including submitted medical documentation and photographs.
- Determine whether requested services should be approved, modified, or denied, and refer cases to the Medical Director when necessary.
- Determine whether the requested inpatient setting for surgery or medical care is appropriate.
- Contact patients, families, and treating physicians as needed to obtain additional information or introduce the role of case management.
- Analyze service requests to monitor utilization, assess medical appropriateness, and identify potentially high-cost or complex cases for high-level case management intervention.
- Conduct thorough and objective assessments of short-term cases, including the member's physical, psychosocial, and environmental status, and gather pertinent case information.
- Report cost analysis, quality-of-care, and quality-of-life improvements against case management goals.
- Assess members' status and progress routinely; determine the reasons for static or regressive progress and proactively encourage appropriate referrals.
- Prepare and maintain documentation of patient care and progress within the care plan.
- Advocate for the client's best interests regarding necessary funding, treatment alternatives, timelines, coordination of care, and frequent evaluations of progress and goals.
- Collaborate with staff from various disciplines involved in patient care, emphasizing interpretation and problem-solving for complex cases.
- Document case notes and the rationale for all decisions in the CCMS system.
- Perform other assigned projects and duties.
- A Bachelor's degree is preferred.
About the company
Cross Country Healthcare offers tech-enabled staffing and advisory services to healthcare organizations, helping them fill roles across home care, education, clinical and non-clinical staff, including temporary coverage through Cross Country Locums. Its platform combines technology and services to connect facilities with doctors, nurses, and allied professionals while providing workforce planning and staffing guidance. The firm differentiates itself with 38 years of industry experience, a history of awards, and certifications such as NCQA for Locums and The Joint Commission, along with a commitment to diversity and inclusion. Its goal is to solve labor-related challenges for healthcare customers by delivering reliable staffing and expert guidance that support high-quality patient care and smooth operations.
Company Size
5,001-10,000
Company Stage
IPO
Headquarters
Boca Raton, Florida
Founded
1996
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Simplify's Take
What believers are saying
- July 21, 2026 Knox Lane closed Cross Country Healthcare for $437 million cash.
- April 23, 2026 Optimé deepened Intellify forecasting for Epic, Kronos, and Lawson.
- Q1 2026 revenue reached $241.1 million, with sequential growth after Q4 2025.
What critics are saying
- Q1 2026 revenue still fell 18% year over year, showing shrinking demand.
- Aya's abandoned 2026 merger proved antitrust regulators can block strategic exits.
- If hospitals standardize direct hiring, Cross Country's staffing middleman role disappears.
What makes Cross Country Healthcare unique
- Intellify unifies contingent labor, compliance, scheduling, and analytics into one platform.
- Knox Lane kept Cross Country Healthcare's brand after the July 21, 2026 acquisition.
- Darrick Sogabe architects agentic-AI workforce planning from inside the product team.
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Benefits
Growth & Insights and Company News
6 month growth
5%1 year growth
5%2 year growth
5%Cross Country Healthcare has announced an exclusive 36-month partnership to integrate Optimé workforce planning solution into Intellify, its workforce intelligence platform. The deal aims to help health systems better align staffing with patient demand and reduce labour costs. Optimé adds advanced forecasting, analytics and workforce optimisation capabilities to Intellify, designed to integrate with major EHR, HR and payroll systems including Epic, Kronos and Lawson. The solution helps health systems improve resource utilisation and spend less time on manual staffing decisions. The partnership marks Cross Country's continued evolution from workforce solutions provider to technology-enabled workforce partner. Optimé, launched in 2010 by Strategic Systems International, consists of a cloud-based suite serving acute care, procedural and specialty care settings.
Cross Country Healthcare, Inc. (NASDAQ: CCRN) (“Cross Country Healthcare” or the “Company”) a leading, technology-driven healthcare workforce solutions compa...
Cross Country Healthcare, a technology-driven healthcare workforce solutions company, has agreed to be acquired by Knox Lane, a growth-oriented investment firm, in an all-cash transaction valued at $437 million. Knox Lane will acquire all outstanding shares at $13.25 per share, representing a 31% premium to the 6 May 2026 closing price and a 45% premium to the 90-day volume-weighted average trading price. Following completion, Cross Country Healthcare will become a privately held company in Knox Lane's portfolio and cease trading on Nasdaq. The company will continue operating under its current name and brand. The transaction is expected to close in the third quarter of 2026, subject to stockholder approval and regulatory clearances. BofA Securities advised Cross Country Healthcare, whilst MTS Health Partners advised Knox Lane.
Cross Country Healthcare has appointed Darrick Sogabe as Chief Product Officer to advance its technology portfolio. Sogabe brings over 20 years of experience in product strategy and technology innovation, having helped architect Intellify, the company's cloud-based workforce intelligence platform. In his new role, Sogabe will lead product strategy and roadmap development across the enterprise. He will focus on advancing Intellify to connect contingent labour, compliance, scheduling and workforce analytics into a single intelligence layer enhanced with agentic AI, helping health systems benchmark against markets and model cost scenarios. Cross Country Healthcare is a technology-driven workforce solutions company that has served the healthcare sector for 40 years. The appointment reflects the company's strategy to strengthen its position by combining healthcare labour expertise with scalable digital platforms and predictive analytics.
Long Cast Advisers highlighted Cross Country Healthcare (NASDAQ:CCRN) in its fourth-quarter 2025 investor letter as one of its largest purchases. The American healthcare talent management company, specialising in nurse, allied and physician staffing, has a market capitalisation of $318.34 million. Trading at $9.78 per share on 11 March 2026, Cross Country Healthcare holds $99 million in net cash with no debt. The company recently received a $20 million termination payment following a failed $615 million acquisition by AYA, bringing cash to over 40% of its market capitalisation. In Q4 2025, the company generated $237 million in revenue, down 5% sequentially and 24% year-over-year. Hedge fund ownership decreased from 33 to 28 portfolios quarter-over-quarter.