Care Manager
4 weeks ago
**Care Manager (Transitional Care Services Maternal Health)**
**CalOptima**
**CalOptima Health** is seeking a highly motivated an experienced **Care Manager (Transitional Care Services Maternal Health)** to join our team. Case Management is an advanced specialty collaborative practice, responsible for providing ongoing case management services for CalOptima Health's members. The Care Manager for Transitional Care Services (TCS) Maternal Health will facilitate communication and coordination among all participants of the health care team and the member to ensure the services provided promote quality and cost-effective outcomes for all members along with focus on pregnant or 12-month postpartum members who have recently discharged from the hospital or emergency department (ED). The incumbent will be responsible for providing intensive case management, which includes assessment, planning, implementation, coordination, monitoring and evaluation of the member's needs
**Position Information**:
- Department**:Case Management**:
- Salary Grade**:310 - $72,096 - $115,353 ($34.66 - $55.4582)**:
- Work Arrangement**:Full Telework**
**This position is eligible for telework in California.***
**Duties & Responsibilities**:
- 85% - Care Management
- Assesses member needs using a standardized health needs assessment or health risk assessment with member or member's representative.
- Performs post-discharge assessment to identify member's post-hospital or post-ED discharge needs including but not limited to:
- Member's physical, functional, social and psychological status
- Member's cultural and linguistic needs
- Caregiver resources and available benefits
- Follow-up provider care and ensuring scheduled appointments.
- Durable medical equipment and supplies.
- Community resources.
- Collaboration with the member's Medical Therapy Program and Regional Center Service Coordinator if appropriate.
- Develops and implements a member's specific care plan which includes prioritized SMART goals.
- Care plan will be continuously reviewed, modified and updated to reflect the member's needs.
- Schedules weekly follow-ups with member or member's representative to assess progress towards goals and identifies barriers to meeting goals.
- Provides regular outreach to assigned members along with assigned members from a worklist and evaluates quality of service given to members according to department contact standards.
- Coordinates care and services with members, members' family members/representatives and other providers, as appropriate, including Community Supports and LTSS.
- Conducts face-to-face meetings at settings outside of CalOptima Health's locations such as in hospitals, skilled nursing facilities, long-term acute care hospitals, recuperative care and in member's home settings with members, members' family members/representatives and other providers, as appropriate.
- Communicates with member's physicians, specialists, community agencies and vendors to ensure coordination of services.
- Facilitates referrals to behavioral health/substance use disorder services and identifies and makes referrals to Long-Term Support Services (LTSS) department, Community Supports and community resources.
- Facilitates and participates in Interdisciplinary Care Team meetings as applicable.
- Collaborates with interdepartmental staff in case resolution as needed.
- Identifies cases needing manager, director or medical director review or input, routes accordingly and closes cases according to procedures and guidelines in a timely manner.
- Prepares and maintains appropriate documentation of patient care and progress within the documentation platform or care plan as appropriate. Advocates in the member's best interest for necessary funding, treatment alternatives, timelines and coordination of care and frequent evaluations of progress and goals.
- 10% - Administrative Support
- Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short
- and long-term goals/priorities for the department.
- Follows CalOptima Health's protocol for documenting all case interventions. Ensures reporting of productivity metrics to supervisor.- 5% - Completes other projects and duties as assigned.
**Minimum Qualifications**:
- Bachelor's degree in social work, psychology, gerontology, public health or related field required.
- 5 years of clinical experience and/or managed care experience required.
- An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
- Valid driver's license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 20% of t
-
Care Manager
2 months ago
Orange, United States Sabine Place Full time**About Morada Senior Living**: Morada Senior Living, proudly part of the Discovery Senior Living family of operating companies, manages care - and lifestyle-focused senior living communities in Texas, Oklahoma, New Mexico, and Colorado. Our company, which was built on our “Pillars of Excellence,” employs thousands of vital Team Members and is committed...
-
Care Manager
2 months ago
Orange, United States Morada Senior Living Full timeAbout Morada Senior Living:Morada Senior Living, proudly part of the Discovery Senior Living family of operating companies, manages care- and lifestyle-focused senior living communities in Texas, Oklahoma, New Mexico, and Colorado. Our company, which was built on our "Pillars of Excellence," employs thousands of vital Team Members and is committed to...
-
Care Manager
1 week ago
Orange, United States Morada Senior Living Full timeAbout Morada Senior Living:Morada Senior Living, proudly part of the Discovery Senior Living family of operating companies, manages care- and lifestyle-focused senior living communities in Texas, Oklahoma, New Mexico, and Colorado. Our company, which was built on our "Pillars of Excellence," employs thousands of vital Team Members and is committed to...
-
Care Manager
1 month ago
Orange, United States Morada Senior Living Full timeAbout Morada Senior Living: Morada Senior Living, proudly part of the Discovery Senior Living family of operating companies, manages care- and lifestyle-focused senior living communities in Texas, Oklahoma, New Mexico, and Colorado. Our company, which was built on our "Pillars of Excellence," employs thousands of vital Team Members and is committed to...
-
Care Manager
1 week ago
Orange, United States Morada Senior Living Full timeAbout Morada Senior Living: Morada Senior Living, proudly part of the Discovery Senior Living family of operating companies, manages care- and lifestyle-focused senior living communities in Texas, Oklahoma, New Mexico, and Colorado. Our company, which was built on our "Pillars of Excellence," employs thousands of vital Team Members and is committed to...
-
Care Manager
3 weeks ago
Orange, United States Agency on Aging of South Central CT Full timeJob DescriptionJob DescriptionAttention Care ManagersSUMMARY:For over forty-five years, the Agency on Aging of South-Central Connecticut (AOASCC) has been helping people age in their homes and remain engaged with their communities. We serve older adults, people with disabilities, and caregivers through various programs to provide care management, social...
-
Care Manager
2 weeks ago
Orange, United States Agency on Aging of South Central CT Full timeJob DescriptionJob DescriptionAttention Care ManagersSUMMARY:For over forty-five years, the Agency on Aging of South-Central Connecticut (AOASCC) has been helping people age in their homes and remain engaged with their communities. We serve older adults, people with disabilities, and caregivers through various programs to provide care management, social...
-
Care Manager
1 week ago
Orange, United States Agency on Aging of South Central CT Full timeJob DescriptionJob DescriptionAttention Care ManagersSUMMARY:For over forty-five years, the Agency on Aging of South-Central Connecticut (AOASCC) has been helping people age in their homes and remain engaged with their communities. We serve older adults, people with disabilities, and caregivers through various programs to provide care management, social...
-
Care Manager
5 hours ago
Orange, United States Agency on Aging of South Central CT Full timeJob DescriptionJob DescriptionAttention Care ManagersSUMMARY:For over forty-five years, the Agency on Aging of South-Central Connecticut (AOASCC) has been helping people age in their homes and remain engaged with their communities. We serve older adults, people with disabilities, and caregivers through various programs to provide care management, social...
-
Care Manager
2 weeks ago
Orange, United States Sabine Place Full timeJob DescriptionJob DescriptionAbout Morada Senior Living:Morada Senior Living, proudly part of the Discovery Senior Living family of operating companies, manages care- and lifestyle-focused senior living communities in Texas, Oklahoma, New Mexico, and Colorado. Our company, which was built on our “Pillars of Excellence,” employs thousands of vital Team...
-
Care Manager
1 week ago
Orange, United States Sabine Place Full timeJob DescriptionJob DescriptionAbout Morada Senior Living:Morada Senior Living, proudly part of the Discovery Senior Living family of operating companies, manages care- and lifestyle-focused senior living communities in Texas, Oklahoma, New Mexico, and Colorado. Our company, which was built on our “Pillars of Excellence,” employs thousands of vital Team...
-
Care Manager RN
3 weeks ago
Orange, United States Providence Full timeCare Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination. The goal of the Care...
-
Business Development Manager
1 week ago
Orange, United States Falck Mobile Care Full time**Falck Mobile Care** is part of Falck, a global emergency medical services (EMS) provider originating from Denmark, that helps reduce avoidable ER visits, inpatient hospitalization and skilled nursing facility requirements. Falck has been operating in the US since 2010 and one of the largest private provider of emergency medical services in the country...
-
Rn Care Manager
1 week ago
Orange, United States CHOC Children's Full timeWork Location Orange, California Work Shift Day - 08hrs (United States of America) Why CHOC? Job Summary Responsible for the delivery of care coordination services for patients in the clinic setting. Is involved in the planning and delivery of family-centered patient care through a collaborative process including the patient and family, nurses, social...
-
Social Worker
3 days ago
Orange, United States CalOptima Full time**Social Worker (Care Manager) (MSSP)** **CalOptima** **CalOptima Health** is seeking a highly motivated an experienced **Social Worker (Care Manager) (MSSP)** to join our team. This Social Worker (Care Manager) will assess prospective members for the various programs available. The incumbent will be responsible for developing, implementing, monitoring,...
-
Managed Care Pharmacist 5
3 weeks ago
Orange, California, United States University of California Irvine Health Full timeManaged Care Pharmacist 5 - Population Health - P/T Days Updated: Apr 21, 2024 Location: Orange Job Type: Department: Population Health UC Title: PHARMACIST 5 Position Number: Reports to: Admin Director Pop Hlth Mgmt Working Title: Managed Care Pharmacist 5 Cost Center: Population Health Bargaining Unit: No Bargaining Unit FLSA: Exempt ...
-
Managed Care Pharmacist 5
1 week ago
Orange, California, United States University of California Irvine Health Full timeManaged Care Pharmacist 5 - Population Health - P/T Days Updated: Apr 21, 2024 Location: Orange Job Type: Department: Population Health UC Title: PHARMACIST 5 Position Number: Reports to: Admin Director Pop Hlth Mgmt Working Title: Managed Care Pharmacist 5 Cost Center: Population Health Bargaining Unit: No Bargaining Unit FLSA: Exempt ...
-
RN Care Manager-Outpatient Hematology
1 week ago
Orange, United States CHOC - Children's Health Orange County Full timeWork Location Orange, California Work Shift Day - 08hrs (United States of America) Why CHOC? At CHOC, we strive to be the leading destination of children's health by providing exceptional and innovative care. We are responsible for the overall health of our community's pediatric population in our hospitals, clinics, and practices. And because of our breadth...
-
Care Manager Rn
2 weeks ago
Orange, United States Providence Full time**Description** Care Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination. The goal of...
-
Care Manager Rn
2 weeks ago
Orange, United States Providence Full time**Description** Care Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination. The goal of...
