Case Manager

2 weeks ago

Monterey Park, United States Astrana Health Full time

Job 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 and in compliance with time requirements per Model of Care/Health Plan/DHCS. This position will entail a caseload of 50 members.

**What You'll Do**:

- Comply with organization and department policies & procedures and Model of Care to ensure all appropriate services for the eligible population are completed and acted upon within established timeframes
- Collaborate with a team of Community healthcare workers to address social needs
- Manage a case load of 50 Medi-Cal members with complex needs
- Adhere to DHCS requirements to include outreach within required time frame, comprehensive assessment/HRA-Health Risk Assessment, care plan creation to address all medical and social needs, ICT performance, coordination of care for all transitions of care to include PCP post hospital/SNF follow up appointments, risk stratification of members based on assessment and outreach performance based on risk stratification
- Review claims and authorization data for member history and care planning
- Perform medication reconciliations per initial assessments and transitions of care
- Offer services where the member lives, seeks care, or finds most easily accessible and within health plan guidelines
- Connect member to other social services and support, including transportation services, and provide referrals as appropriate
- Use motivational interviewing, trauma
- informed care, and harm-reduction approaches
- Coordinate with hospital staff on discharge plan and coordination of care
- Evaluate assessment findings against evidenced-based guidelines to develop a plan of care based on member needs and findings with collaboration from interdisciplinary team
- Identify potential barriers to adherence to treatment plan and modifies plan by mutual agreement with the member
- Educate member/caregiver on specific disease using approved evidence-based guideline and modify plan of care/goals based on member’s readiness to change
- Facilitates care coordination across the care continuum (home, hospital, home health)
- Attends/participates in interdisciplinary team meetings
- Provides enrollee with support telephonically to ensure appropriate utilization of benefits, treatment and plan of care, and member’s understanding of healthcare system
- Participates in all health plan audits and seminars as applicable

**Qualifications**:

- Current and active LVN CA license
- Experience with clinical issues and guidelines
- Excellent analytical, critical reasoning, organizational and interpersonal communication skills
- Strong written and oral communication skills
- Ability to multi-task, work autonomously, and think outside the box
- Ability to keep a high level of confidence and discretion when dealing with sensitive matters relating to providers, members, business plans, strategies and other sensitive information is required.
- Proficient with Microsoft Office (Word, Excel, Power Point), EZCAP

**You're a great fit for this role if**:

- Knowledge of enhanced case management, SNP case management, complex case management
- Experience in managed care environment - health plans, IPA, or MSO
- 1+ years of Case Manager experience
- Basic knowledge of DHCS, DMHC, NCQA, ICE, and CMS standards
- Bachelor's degree

**Who We Are**:
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 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_

**Environmental Job Requirements and Working Conditions**:

- 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 Cent

  • Case Manager

    2 days ago

    Monterey, United States RVM Work force corp. Full time

    **Working under the Direction of the program DPCS and within an interdisciplinary team Philosophy, the nurse will directly work with physician in identifying and coordinating Patients/Family/Care Giver Home care needs and providing skilled supportive care' to patients and families.** Job title**:Home Health Cases Manager RN** **Shift: Day with rotating...

  • Case Management

    3 days ago

    Newbury Park, United States Dale Workforce Solutions Full time

    Title (Role) Case Management - ManagerOrganization Global Patient SafetyLocation: Remote•Act as US/EU local safety office and FDA/EMA point of contact for safety reporting•Submission of all individual case safety reports to FDA/EMA, business partners (license partners) and vendors•Support interactions with, business partners (license partners) and...

  • Case Manager

    1 week ago

    Fruitland Park, United States Bell's Disability Consultants Full time

    Job DescriptionJob DescriptionCompany DescriptionDisability Consultants at Chris Bell's Office is dedicated to providing assistance and support for individuals with disability claims. Located in Fruitland Park, FL, we prioritize our clients' needs and aim to offer exceptional service throughout the claims process.Role DescriptionThis is a full-time...

  • Case Manager

    4 weeks ago

    Manassas Park, United States Bull Run Alcohol Safety Action Prog Full time

    Job DescriptionJob DescriptionThis position will be responsible for the screening, management, monitoring and supervision of program participants. The position will also prepare court reports and other documents related to monitoring participants and will testify in court hearings. The case manager will be responsible for evaluating all aspects of program...

  • Travel Nurse

    2 days ago

    Monterey, United States Secure Nursing Service Full time

    Secure 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...

  • Case Manager

    7 days ago

    Manassas Park, United States Bull Run Alcohol Safety Action Prog Full time

    Job Description Job Description This position will be responsible for the screening, management, monitoring and supervision of program participants. The position will also prepare court reports and other documents related to monitoring participants and will testify in court hearings. The case manager will be responsible for evaluating all aspects of program...

  • Case Manager

    4 days ago

    Manassas Park, United States Bull Run Alcohol Safety Action Prog Full time

    Job Description Job Description This position will be responsible for the screening, management, monitoring and supervision of program participants. The position will also prepare court reports and other documents related to monitoring participants and will testify in court hearings. The case manager will be responsible for evaluating all aspects of program...

  • Registered Nurse

    1 week ago

    Monterey, United States Assist Medical Staffing LLC Full time

    Hiring a Home Health Case Manager Registered Nurse (RN) for a full time, 13 weeks contract position in Monterey, CA for a healthcare facility. The pay rate is $75 hr, weekly pay. Full time hours Hiring for shifts: Days, with rotating weekends Contract extensions available To do well in this role you should have your state Registered Nurse (RN) license...

  • Case Manager

    4 weeks ago

    Woodland Park, United States Resources for Human Development Full time $22

    Do you enjoy making a positive impact in the community?RHD's SALT Passaic is looking for a Full-time Case Manager to join our Team!The case manager will determine the resources needed to meet the individualized needs of the participant. The case manager will take all necessary actions in assuring the implementation of the service treatment plan including...

  • Exceptional Family Member Case Liaison

    4 weeks ago

    Monterey, United States Commander, Navy Installations Full time

    Summary The primary purpose of this position is to serve as the installation non-clinical case liaison for the Exceptional Family Member Program (EFMP). Serves as a liaison and works closely with military families to coordinate services and supports with health care professionals, military and community service agencies, recreational programs, and...

  • Manager Case Management

    2 weeks ago

    Orange Park, United States Becker Health Full time

    Manager of Case ManagementHCA Florida Orange Park HospitalFull Time - Days 7-10 Hrs/Weekdays Only Orange Park Medical Center is a full service, certified Level II Trauma Center with 300 plus inpatient beds located in the heart of Orange Park, FL and just outside of Jacksonville, FL. This state-of-the-art facility provides top-notch medical care to Clay...

  • Manager Case Management

    4 days ago

    Orange Park, United States Becker Health Full time

    Manager of Case ManagementHCA Florida Orange Park HospitalFull Time - Days 7-10 Hrs/Weekdays Only Orange Park Medical Center is a full service, certified Level II Trauma Center with 300 plus inpatient beds located in the heart of Orange Park, FL and just outside of Jacksonville, FL. This state-of-the-art facility provides top-notch medical care to Clay...

  • Travel Nurse

    2 weeks ago

    Monterey, United States NationWide Therapy Group Full time

    NationWide Therapy Group is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Monterey, CA. Shift: 4x8 hr days Start Date: ASAP Duration: 13 weeks Pay: $2176 / Week About NationWide Therapy Group:Nationwide Therapy Group is a leading provider of healthcare staff in all 50 states. We specialize in all areas of...

  • CCS COORDINATOR

    5 days ago

    Monterey Park, CA 91756, USA, United States Astrana Health Full time

    DescriptionJob Title: CCS Coordinator Department: Health Services - ICMAbout the Role: The CCS Coordinator will assist the inpatient case management department in assigned areas of responsibility, including creation of authorizations/cases, tracking/maintaining records, conducting phone and fax communication, and sending/generating authorizations and denial...

  • Travel Nurse

    2 weeks ago

    Monterey, United States ADN Healthcare Full time

    ADN Healthcare 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: $2340 / Week About ADN Healthcare:ADN Healthcare is an industry leading healthcare staffing solutions provider dedicated to identifying Healthcare Professionals that are in...

  • Travel Nurse

    2 days ago

    Monterey, United States Coast Medical Service Full time

    Coast Medical 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: $2337.43 / Week Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the...

  • Travel Nurse

    1 day ago

    Monterey, United States Coast Medical Service Full time

    Coast Medical 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: $2342.53 / Week Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the...

  • Case Manager

    1 week ago

    Walnut Park, United States InsideHigherEd Full time

    Job no: 494417Work type: RegularLocation: HybridCategories: SalariedTitle: Case ManagerDepartment: Dean of Faculty's OfficeDuration: 12 months Job SummaryIn compliance with the Americans with Disabilities act as amended in 2008, Section 504 of the rehabilitation act of 1973 and the Fair Housing Act, the Case Manager coordinates student accommodations and...

  • Paralegal Case Manager

    4 days ago

    Highland Park, United States Kass and Moses, PC Full time

    Job DescriptionJob DescriptionPosition: Associate Case Manager Location: Northbrook, Ilinois Salary: $40,000 annually Benefits:Contribution towards health insurance; 401(k) plan   Job Overview:We are seeking a motivated and detail-oriented Associate Case Manager to join our team. The ideal candidate is a fast learner, excellent problem solver, and strives...

  • REGISTERED NURSE(RN)

    1 week ago

    Monterey, CA, USA, United States MAS Medical Staffing Full time

    Seeking a(n) Registered Nurse (RN) professional with Registered Nurse (Case Manager) experience for a 12 week contract in the Monterey CA area. MAS Medical Staffing offers rewarding travel opportunities to healthcare professionals throughout the Unit Registered Nurse, Case Manager, Travel, Manager, Registered, Nurse, Staffing