Care Manager I
2 weeks ago
Job Location - Remote - CA
Job Duration: 3 Months Shift (Start/End Time):
Overtime required? 8-5 Mon-Friday
Can work at 7am if needing an earlier shift
Note: Training is about 3-4 weeks and then the candidate will work with Senior Case Managers to start ramping up.
Position Purpose:
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience in an clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.
Licenses/Certifications: Current state's RN license. Internal/External Groups with which the Candidate will interface: Required Skills/Experience: Preferred Skills/ Experience: 1. Experience with Medicare/Medicare required 1. Psych/Behavioral Health Background/Experience 2. Case management experience 2. Bilingual in Spanish
Responsibilities:
* Develop, assess and adjust, as necessary, the care plan and promote desired outcome
* Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
* Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
* Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
* Provide patient and provider education
* Facilitate member access to community based services
* Monitor referrals made to community based organizations, medical care and other services to support the members' overall care management plan
* Actively participate in integrated team care management rounds
* Identify related risk management quality concerns and report these scenarios to the appropriate resources
* Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
Note: The Company is committed to complying with the California Consumer Privacy Act ("CCPA") effective January 1, 2020; and all data privacy and laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAhr@spectraforce.com. -
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