Case Manager, RN/LVN
3 weeks ago
Job Title: Case Manager - LVN/RN
Department: Health Services - ICM
About the Role:
Astrana Health is looking for a RN/LVN Case Manager and we are willing to train a RN or LVN with case management experience You will have the ability to work with pediatrics and/or adult populations depending on business need.
What You'll Do:
- Comply with Case Management Department’s policies and procedures
- 95 - 100% compliance with Utilization Management health plan delegation standards for Case Management
- Utilize Milliman Care Guidelines criteria for appropriateness of transition to care by level of skilled needs and acute rehab for post discharge plan
- Collaborating with Hospitalists, case managers, and discharge planners to establish discharge plans at time of admission
- Responsible for coordinating the required initial and concurrent reviews based on the review of medical records received and daily accurate reporting of all inpatient admissions to Medical Director and Manager and/ or Supervisor of Case Management Department
- Review of medical records and/or other documentation to determine medical necessity, appropriateness and level of care utilizing Milliman Care and other appropriate Guidelines
- Assess, plan, implement, coordinate, monitor, and evaluate all options and services with the goal of reducing hospital readmission
- Attends/coordinates Case Management meetings on and off-site as necessary
- Interacts with the providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirements
- Attend to provider and interdepartmental calls in accordance with exceptional customer service
- Maintain good relationships with health plans, hospitals and medical directors. Resolve problems that arise with any IPA medical directors
- Report to Manager and/or Supervisor of Case Management on activities and/or problems occurring throughout the day
- Active Registered Nurse (RN) license in California OR active Licensed Vocational Nurse (LVN) license in California
- Experience using Microsoft applications such as Word, Excel and Outlook
- Hospice and Home Health Nursing experience is a plus
- Excellent analytical critical reasoning
- Proven ability to prioritize multiple responsibilities simultaneously in a fast-paced, changing environment while meeting deadlines
- Ability to educate and train staff members and other departments as needed
- Experience using EZCAP
- Strong communication and customer service skills
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 10,000 physicians to provide care for over 1.2 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
- Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.
- The total compensation target pay range for this role is between $28.00 - $45.00 per hour. The salary range represents our national target range for this role.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
-
Case Manager
2 days ago
Monterey Park, United States Astrana Health Full timeJob Title: Case Manager - LVN/RN Department: Health Services - ICM **About the Role**: Astrana Health is looking for a RN/LVN Case Manager and we are willing to train a RN or LVN with case management experience! You will have the ability to work with pediatrics and/or adult populations depending on business need. **What You'll Do**: - Comply with Case...
-
Case Manager
8 hours ago
Monterey Park, United States Astrana Health Full timeJob Title: Case Manager Department: Health Services - ICM **About the Role**: - Astrana Health currently seeking a highly motivated Case Manager. This role will report to a Manager - Case Management and will enable us to continue to scale in the healthcare industry, focusing on supporting the APA ACO SNF population. **What You'll Do**: - This case manager...
-
Case Manager
1 month ago
Monterey Park, United States Astrana Health Full timeJob Title: Case Manager (LVN) - HYBRID Department: Health Services - ECM **About the Role**: Provide efficient and effective Care Management to qualified members by addressing the member’s medical, physical and psychosocial needs. Using clinical judgement develops, modifies and assists the member to implement their care plan. Ensure all tasks are timely...
-
Case Management Nurse
3 weeks ago
Fresno, CA, United States Pinnacle Case Management Solutions, LLC. Full timeCompany DescriptionPinnacle Case Management Solutions, LLC provides nurse case management services to employers, third-party administrators, and insurance carriers in the Workers' Compensation industry. Our dedicated team of nurses support all parties involved in the recovery process, including the claim examiner, employer, provider, and injured worker. We...
-
Travel Nurse
3 weeks ago
Monterey, United States Secure Nursing Service Full timeSecure Nursing Service is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Monterey, CA. Shift: 3x12 hr days Start Date: ASAP Duration: 13 weeks Pay: $2510.43 / Week About Secure Nursing Service:We are Secure Nursing Service (SNS), and we exist to delight our clincians.SNS employs highly skilled and professional...
-
Registered Nurse
2 months ago
Pasco, WA, United States Professional Case Management Full timeMake a Difference on Your Own Schedule and Terms!Hiring Case Managers in Washington Come join our growing team! A few of our perks:Create your own schedule!$42/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with...
-
Registered Nurse
3 weeks ago
Portsmouth, OH, United States Professional Case Management Full timeMake a Difference on Your Own Schedule and Terms!Hiring Case Managers in Ohio Come join our growing team! A few of our perks:Create your own schedule!$38/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with...
-
Registered Nurse
2 months ago
Santa Fe, NM, United States Professional Case Management Full timeMake a Difference on Your Own Schedule and Terms!Hiring Case Managers in New Mexico Come join our growing team! A few of our perks:Create your own schedule!$40/hr. (including 100% of Hourly Wage Paid for All Drive Time) Our RN-Case Managers conduct in-home nursing visits for our clients. All our clients are former Nuclear Weapon's Workers with...
-
Field Nurse Case Manager
3 weeks ago
, CA, United States Pinnacle Case Management Solutions, LLC. Full timeCompany DescriptionPinnacle Case Management Solutions, LLC provides nurse case management services to employers, third-party administrators, and insurance carriers in the Workers' Compensation industry. Our dedicated team of nurses support all parties involved in the recovery process, including the claim examiner, employer, provider, and injured worker. We...
-
Case Manager PT Evenings
4 days ago
Monterey Park, United States AHMC Healthcare Full timeOverview: JOB SUMMARY: The Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, concurrent stay and readiness for discharge. She/he assures correct level of care: critical, telemetry, acute, observation, for all patients. The Case Manager provides an efficient, coordinated approach to clinical management, with an emphasis on...
-
Travel Nurse RN
2 weeks ago
Monterey, CA, United States Cross Country Nurses Full timeCross Country Nurses is seeking a travel nurse RN Case Management for a travel nursing job in Monterey, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/10/2024 Duration: 13 weeks 36 hours per week Shift: 12 hours, days Employment Type: Travel Job Description As a case management nurse (RN CM),...
-
Travel Nurse RN
1 week ago
Sacramento, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/17/2024 Duration: 24 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...
-
Travel Nurse RN
1 week ago
Fremont, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Fremont, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered Nurse...
-
Travel Nurse RN
1 week ago
Sacramento, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/17/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...
-
Travel Nurse RN
1 week ago
Glendale, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Glendale, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered Nurse...
-
Travel Nurse RN
1 week ago
Sacramento, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/17/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...
-
Travel Nurse RN
1 week ago
Helena, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in St Helena, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...
-
Travel Nurse RN
1 week ago
Stockton, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Stockton, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered Nurse...
-
Travel Nurse RN
1 week ago
Sacramento, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: 06/17/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...
-
Travel Nurse RN
1 week ago
Sacramento, CA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Sacramento, California. Job Description & Requirements Specialty: Case Management Discipline: RN Start Date: ASAP Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Travel We are seeking a Case Manager-Registered...