Current jobs related to Case Management - Los Angeles - Blue Shield of California
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Travel Nurse Case Manager
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Travel Nurse Case Manager
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Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing job.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment in California.TotalMed Case Management Staffing Job ID # Pay...
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Travel Nurse Case Manager
3 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management professional for a travel nursing opportunity.Job DetailsSpecialty: Case ManagementDiscipline: RN40 hours per weekShift: 10 hours, nightsEmployment Type: TravelWe are looking for a skilled Case Manager-Registered Nurse to join our team in California.TotalMed Case Management...
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Travel Nurse Case Manager
3 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing job.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 16 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment in California.TotalMed Case Management Staffing Job ID #1597463....
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTravel Case Management Nursing Job OpportunityTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join their team in Los Angeles, California.Job Details:Specialty: Case ManagementDiscipline: RNDuration: 13 weeksHours per week: 36Shift: 12 hours, daysThis travel case management nursing job offers a unique opportunity to work...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join their team in Los Angeles, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeksHours: 40 hours per weekShift: 8 hours, daysEmployment Type: TravelTotalMed Case Management Staffing is...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join their team.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelWe are looking for a dedicated and experienced case manager-registered nurse to work with our team in Los Angeles,...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTravel Nurse RN Case Management Job OpportunityTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join our team in Los Angeles, California.Job Description and RequirementsSpecialty: Case ManagementDiscipline: RNShift: 12 hours, daysEmployment Type: TravelWe are looking for a dedicated case manager-registered nurse to work...
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Travel Nurse RN Case Manager
3 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerJob Summary:TotalMed Case Management Staffing is seeking a travel nurse RN case manager for a travel nursing job in a dynamic healthcare setting. As a case manager, you will be responsible for coordinating patient care and ensuring seamless transitions between healthcare providers. This is a great opportunity to work...
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Travel Nurse RN Case Manager
1 month ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join their team in Los Angeles, California.Job Details:Specialty: Case ManagementDiscipline: RNDuration: 13 weeksHours per week: 36Shift: 12 hours, daysEmployment Type: TravelTotalMed Case Management Staffing is a leading healthcare...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join our team in Los Angeles, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are looking for a dedicated case...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled Travel Nurse RN Case Manager to join our team.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RN40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are looking for a dedicated Case Manager-Registered Nurse to work with our team in San...
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Travel Nurse RN Case Manager
3 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing job.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment.TotalMed Case Management Staffing Job ID #1643971. Pay package is based on 12 hour shifts and 36...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Opportunity: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a highly skilled Travel Nurse RN Case Manager to join their team.Job Requirements:Specialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are looking for a dedicated and experienced Case Manager-Registered...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled Travel Nurse RN Case Manager to join our team.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelWe are looking for a dedicated Case Manager-Registered Nurse to work with us in Los Angeles, California.TotalMed Case...
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Travel Nurse RN Case Manager
3 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management professional for a travel nursing assignment in California.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are looking for a skilled Case Manager-Registered Nurse to join our team in...
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Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing opportunity in California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment in California.TotalMed Case Management Staffing Job ID #1648435. Pay package is...
Case Management
4 months ago
Your Role
The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians.
Your Work
In this role, you will:
- Research and design treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type.
- Initiation of timely individualized care plans (ICP) based on applicable assessments and assisting in transitions of care across all ages.
- Determines appropriateness of referral for CM services, mental health, and social services.
- Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD).
- Conducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases.
- Assessment: Assesses members health behaviors, cultural influences, and clients belief/value system. Evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers.
- Research opportunities for improvement in assessment methodology and actively promotes continuous improvement. Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers and BSC.
- Determines realistic goals and objectives and provides appropriate alternatives. Actively solicits client’s involvement.
- Planning: Designs appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Adjusts plans or creates contingency plans as necessary.
- Assesses and re-evaluates health and progress due to the dynamic nature of the plan of care required on an ongoing basis. Initiates and implements appropriate modifications in plan of care to adapt to changes occurring over time and through various settings.
- Develops appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes.
- Recognizes need for contingency plans throughout the healthcare process.
- Develops and implements the plan of care based on accurate assessment of the member and current of proposed treatment.
- Assumes supervisor day to day responsibilities in manager’s absence and under the direction of the manager
- Analyze productivity and internal reports to ensure compliance.
- Collaborates with department leadership to identify program development opportunities.
- Mentors case managers with complex cases to promote quality of care, cost effective health care services based on medical necessity and complies with contract for each appropriate plan type
- Performs precepting for new hires or those who are not meeting expectation.
- Participates in special projects as needed
Your Knowledge and Experience
- Current CA RN License. Bachelors of Science in Nursing or advanced degree preferred.
- Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
- Requires at least 7 years of prior experience in nursing, healthcare or related field
- A minimum of 3+ year experience in inpatient, outpatient or managed care environment required
- Health insurance/managed care experience desired.
- Transitions of care experience desired
- Excellent communications skills
Pay Range:
The pay range for this role is: $ 109120.00 to $ 163680.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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