RN Case Manager
2 weeks ago
We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care.
We are looking to directly hire RN Case Managers, to work remotely, Monday-Friday from 8am-5pm (Pacific Standard Time). The starting pay is between $45/hr.-$49/hr.
*Please note that this position requires Candidates to have a Valid CA RN License, work remotely (but be able to be out in the field 20% of the time) and live in Orange, CA or its surrounding areas*
Job Duties:
- Identifies appropriate members for case management (CM) and conducts assessments to identify individual needs.
- Develop Individual Care Plan (ICP) by conditions identified in health plan HRA, patient assessment, medical records authorizations/referrals, primary care physician, member, and Interdisciplinary Care Team (ICT).
- Documentation including but not limited to; cognitive, functional, ADL, environmental factors, psychosocial, medical and benefits etc.
- Collaborate with member’s family and physicians for seamless coordination of care and services
- Collaborate and coordinate care with Health plans, Community Based Programs (CBAS), Managed Long Term Supportive Services (MLTSS) and Behavioral Health Providers
- Monitors and evaluate effectiveness of the care management plan and modify as necessary based on members’ progress and changes in condition.
- Interfaces with Medical Director and attends ICT as required.
- Conducts outbound calls to assigned case management members.
- Occasional, in person visit may be needed to better facilitate members’ care.
- Meet health plans and NCQA requirements in turn-around-time for assessments, care plans and IDTs.
- Triaging of incoming CM referrals.
Qualifications:
- At least two (2) years’ experience in the medical field required.
- One (1) year experience in a case management role required.
- Knowledgeable in NCQA requirements preferred.
- CA RN unrestricted active license required.
Benefits:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- 401k
Job Type: Full-time
Expected hours: 40 per week
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