Case Management Specialist Rn-pd

3 weeks ago

Riverside, United States Kaiser Permanente Full time

**Job Summary**:
Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and development of specific care management plan to address needs. In conjunction with the Physician, implements care/treatment plan by coordinating access to health services across multiple providers/disciplines, monitors care, makes determination to arrange transportation and transfer patient if indicated, identifies cost-effective measures, makes recommendations for alternative levels of care and utilization of resources, promotes self-care management and ensures paper work is completed. Is an indirect caregiver. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team.

**Essential Responsibilities**:

- Evaluates and identifies members needs.
- Interfaces with Primary Care Physicians, Specialists and various disciplines on the development of case management plans/programs.
- Monitors and evaluates the effectiveness of the case management plans and modifies as necessary.
- Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.
- Acts as a clinical liaison, per their specialty, with outside agencies such as County CCS, non-plan facilities, outside providers, employers and/or workers compensation carriers and third party administrators.
- Prepares reports, communicates program changes to appropriate staff and develops protocols in accordance with state regulations.
- Acts as a patient advocate and educator to assure that the patient has the knowledge to care for his/her condition and patient is educated and empowered to be responsible for participating in the plan of care.
- Develops individualized patient/family education plan focused on self-management, delivers patient/family education specific to a disease state.
- Develops and updates training and educational materials and presents to appropriate staff, members and families.
- Facilitates patients return to normal daily activities by teaching and making appropriate referrals for outside services/continued care.
- Consults with internal and external physicians, health care providers, discharge planners, and outside agencies regarding continued care/treatment or hospitalization or referral to support services or placement.
- May need to facilitate transportation and housing arrangements for patient.
- Coordinates transmission of clinical and benefit treatment to patients, families and outside agencies.
- Participates in data collection and analysis of clinical outcomes of care and customer satisfaction standards.
- Participates in the formulation and implementation/monitoring of action strategies and outcomes of care or customer service.
- Ensures that accurate records are maintained of the care associated with each patient.
- Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, and contract providers and outside agencies.

**Basic Qualifications**:
Experience
- Minimum two (2) years clinical experience as an RN in an acute care or ambulatory care setting required.

Education
- Bachelors degree or
- Equivalent four (4) experience required.

License, Certification, Registration
- Registered Nurse License (California)
- Basic Life Support

**Additional Requirements**:

- Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).
- Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills required.
- Computer literacy skills required.
- Bilingual (English/Spanish) Level II required.

**Preferred Qualifications**:

- Case Management Certification or certification in the area of specialty preferred.
- Bachelors degree in nursing or healthcare related field preferred.

**Notes**:

- Must successfully pass or have passed the bilingual test (within the last 12 months), or be active in the QBS program.

PrimaryLocation : California,Riverside,Riverside Medical Offices 2

HoursPerWeek : 1

Shift : Day

Workdays : Mon, Tue, Wed, Thu, Fri

WorkingHoursStart : 08:00 AM

WorkingHoursEnd : 05:00 PM

Job Schedule : Per Diem

Job Type : Standard

Employee Status : Regular

Employee Group/Union Affiliation : B21|AFSCME|SCNSC

Job Level : Individual Contributor

Job Category : Nursing Licensed & Nurse Practitioners

Department : Riverside Med Center - Nephrology-Regular Clinic - 0806

Travel : No

  • Case Management Specialist RN-PD

    2 weeks ago

    Riverside, United States Kaiser Permanente Full time

    Job Summary: Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and development of specific care management plan to address needs. In conjunction with the Physician, implements care/treatment...

  • Case Management Specialist RN-PD

    1 day ago

    Riverside, United States Kaiser Permanente Full time

    Job Summary: Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and development of specific care management plan to address needs. In conjunction with the Physician, implements care/treatment...

  • Case Manager RN

    3 weeks ago

    Riverside, United States AHMC Healthcare Full time

    Overview: The Case Manager Registered Nurse is primarily responsible for the preparation, recording and tracking of initial and retrospective payments for hospital services. Answers, directs and records departmental phone calls from a variety of sources (Insurance companies, Skilled Nursing Facilities, Home Health Agencies, Durable Medical Equipment, other...

  • Case Manager RN

    2 days ago

    Riverside, United States AHMC Healthcare Full time

    Overview: The Case Manager Registered Nurse is primarily responsible for the preparation, recording and tracking of initial and retrospective payments for hospital services. Answers, directs and records departmental phone calls from a variety of sources (Insurance companies, Skilled Nursing Facilities, Home Health Agencies, Durable Medical Equipment, other...

  • Case Manager RN

    3 weeks ago

    Riverside, United States AHMC Healthcare Full time

    Overview: The Case Manager Registered Nurse is primarily responsible for the preparation, recording and tracking of initial and retrospective payments for hospital services. Responsibilities: Answers, directs and records departmental phone calls from a variety of sources (Insurance companies, Skilled Nursing Facilities, Home Health Agencies, Durable Medical...

  • Case Manager

    1 day ago

    Riverside, United States NCW Staffing Inc Full time

    **NCW Staffing is looking for Case Manager** **RN's to work at Kaiser Permanente in Riverside, CA!** **Case Manager** **Details**: Duration: 13 Weeks Guaranteed Hours: 40 hours per week | 08:00 AM to 04:30 PM Shift Length: 8 Start Date: 3-4 weeks **Case Manager** **RATE**: Hourly Rate: $70/hr Weekly Rate: $2,800/week Total Contract Pay: $36,400 **Case...

  • Case Manager RN

    2 weeks ago

    Riverside, United States WelbeHealth Full time

    The WelbeHealth PACE program helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. It’s our mission to serve the most vulnerable seniors with better quality and compassion in a value-based model, and the Registered Nurse (RN) Case Manager directly guides this care as a primary voice on the...

  • Case Manager RN

    2 weeks ago

    Riverside, United States Welbe Health Full time

    The WelbeHealth PACE program helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. It’s our mission to serve the most vulnerable seniors with better quality and compassion in a value-based model, and the Registered Nurse (RN) Case Manager directly guides this care as a primary voice on the...

  • Case Manager

    2 weeks ago

    Riverside, United States Molina Healthcare Full time

    CASE MANAGER REGISTERED NURSE for our CALIFORNIA Health Plan. Candidates must live in the state of California in Riverside COUNTY. We are looking for an RN with at least 2 years of relevant Case Management experience. Ambulatory Case Management, OB GYN Case Management or Disease Management. Case Manager RN will work in remote and field settings our...

  • Case Manager

    1 day ago

    Riverside, United States Molina Healthcare Full time

    CASE MANAGER REGISTERED NURSE for our CALIFORNIA Health Plan. Candidates must live in the state of California in Riverside COUNTY. We are looking for an RN with at least 2 years of relevant Case Management experience. Ambulatory Case Management, OB GYN Case Management or Disease Management. Case Manager RN will work in remote and field settings our...

  • Case Manager

    1 day ago

    Riverside, United States Molina Healthcare Full time

    CASE MANAGER REGISTERED NURSE for our CALIFORNIA Health Plan. Candidates must live in the state of California inRiverside COUNTY. We are looking for an RN with at least 2 years of relevant Case Management experience.Ambulatory Case Management, OB GYN Case Management or Disease Management. Case Manager RN will work in remote and field settings our Medicaid...

  • Coordinator - Case Management

    1 week ago

    Riverside, California, United States HCA Healthcare Full time

    Description Hourly Wage Estimate: / hourLearn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The...

  • Coordinator - Case Management

    1 week ago

    Riverside, United States HCA Healthcare Full time

    Description Hourly Wage Estimate: .00 - .00 / hourLearn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this...

  • Coordinator - Case Management

    1 day ago

    Riverside, California, United States HCA Healthcare Full time

    Description Hourly Wage Estimate: / hourLearn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The...

  • Coordinator - Case Management

    6 days ago

    Riverside, United States Riverside Community Hospital Full time

    Hourly Wage Estimate: $.00 - $.00 / hour Learn more about the benefits offered for this job. **Introduction**: Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Coordinator - Case Management with Riverside Community Hospital you can be a part of an organization that is devoted to giving...

  • Coordinator - Case Management

    6 days ago

    Riverside, United States Riverside Community Hospital Full time

    Hourly Wage Estimate: $58.33 - $82.97 / hour Learn more about the benefits offered for this job. **Introduction**: Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Coordinator - Case Management with Riverside Community Hospital you can be a part of an organization that is devoted to giving...

  • Community Tx Specialist-Residential Case Manager

    2 weeks ago

    Riverside, United States East Bay Community Action Program Full time

    $2,000 Sign on bonus East Bay Community Action Program (EBCAP) has an immediate full-time, Community Tx Specialist/Residential Group Home Case Manager for our residential group home in East Providence and Warren, RI that serves up to eleven (11) adult men and women. The individual will assist psychiatrically disabled residents of a Residential Rehabilitation...

  • Community Tx Specialist-Residential Case Manager

    2 days ago

    Riverside, United States East Bay Community Action Program Full time

    $2,000 Sign on bonus East Bay Community Action Program (EBCAP) has an immediate full-time, Community Tx Specialist/Residential Group Home Case Manager for our residential group home in East Providence and Warren, RI that serves up to eleven (11) adult men and women. The individual will assist psychiatrically disabled residents of a Residential Rehabilitation...

  • Optometrist-PD

    1 week ago

    Riverside, United States Kaiser Permanente Full time

    Provides visual examinations, including those conducted to identify the presence of pathology. Conducts detection and differential diagnosis of abnormal visual, ocular and/or systematic conditions. Provides complete high quality optometric/vision care services to members. Essential Responsibilities: + Upholds Kaiser Permanente's Policies and Procedures,...

  • Optometrist - PD

    1 week ago

    Riverside, United States Kaiser Permanente Full time

    Job Summary: Provides visual examinations, including those conducted to identify the presence of pathology. Conducts detection and differential diagnosis of abnormal visual, ocular and/or systematic conditions. Provides complete high quality optometric/vision care services to members. Essential Responsibilities: + Upholds Kaiser Permanentes Policies and...