Case Manager
1 month ago
Job Title: Case Manager - LVN/RN
Department: Health Services - ICM
**About the Role**:
Astrana Health is looking for a RN/LVN Case Manager and we are willing to train a RN or LVN with case management experience You will have the ability to work with pediatrics and/or adult populations depending on business need.
**What You'll Do**:
- Comply with Case Management Department’s policies and procedures
- 95 - 100% compliance with Utilization Management health plan delegation standards for Case Management
- Utilize Milliman Care Guidelines criteria for appropriateness of transition to care by level of skilled needs and acute rehab for post discharge plan
- Collaborating with Hospitalists, case managers, and discharge planners to establish discharge plans at time of admission
- Responsible for coordinating the required initial and concurrent reviews based on the review of medical records received and daily accurate reporting of all inpatient admissions to Medical Director and Manager and/ or Supervisor of Case Management Department
- Review of medical records and/or other documentation to determine medical necessity, appropriateness and level of care utilizing Milliman Care and other appropriate Guidelines
- Assess, plan, implement, coordinate, monitor, and evaluate all options and services with the goal of reducing hospital readmission
- Attends/coordinates Case Management meetings on and off-site as necessary
- Interacts with the providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirements
- Attend to provider and interdepartmental calls in accordance with exceptional customer service
- Maintain good relationships with health plans, hospitals and medical directors. Resolve problems that arise with any IPA medical directors
- Report to Manager and/or Supervisor of Case Management on activities and/or problems occurring throughout the day
**Qualifications**:
- Active Registered Nurse (RN) license in California OR active Licensed Vocational Nurse (LVN) license in California
- Hospice and Home Health Nursing experience is a plus
**You're great for this role if**:
- Excellent analytical critical reasoning
- Proven ability to prioritize multiple responsibilities simultaneously in a fast-paced, changing environment while meeting deadlines
- Ability to educate and train staff members and other departments as needed
- Experience using EZCAP
- Strong communication and customer service skills
**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 1.2 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 Center Dr., Monterey Park, CA 91754.
- The total compensation target pay range for this role is between $28.00 - $45.00 per hour. The salary range represents our national target range for this role.
**Additional Information**:
-
Case Manager PT Evenings
7 days ago
Monterey Park, United States AHMC Healthcare Full timeOverview: JOB SUMMARY: The Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, concurrent stay and readiness for discharge. She/he assures correct level of care: critical, telemetry, acute, observation, for all patients. The Case Manager provides an efficient, coordinated approach to clinical management, with an emphasis on...
-
Case Management Coordinator hybrid
3 days ago
Monterey Park, United States Astrana Health Full timeJob Title: Case Management Coordinator Department: Health Services - ICM **About the Role**: Assist Case Manager(s), Specialist, Supervisor & Manager in assigned area of responsibility, including compiling information (open & close inpatient cases), fax authorization letters to providers, including sending denial letters and keeping records. Provide and...
-
Case Manager
1 month ago
Monterey Park, United States Astrana Health Full timeJob 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...
-
Ccs Coordinator
5 days ago
Monterey Park, United States Astrana Health Full timeJob Title: CCS Coordinator Department: Health Services - ICM **About 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...
-
Case Management Coordinator
3 days ago
Monterey Park, United States Astrana Health Full timeJob Title: Case Management Coordinator Department: Health Services - ICM **About the Role**: Astrana Health is looking for an ACO SNF Coordinator to assist our Health Services team. This role will report to the ACO case manager and Manager of inpatient case management, and will enable us to continue to scale in the healthcare industry, focusing on...
-
Case Manager
3 days ago
Monterey Park, United States Astrana Health Full timeJob Title: Case Manager Department: Health Services - ICM **About the Role**: - Astrana Health currently seeking a highly motivated Case Manager. This role will report to a Manager - Case Management and will enable us to continue to scale in the healthcare industry, focusing on supporting the APA ACO SNF population. **What You'll Do**: - This case manager...
-
Case Manager/housing Navigator
2 weeks ago
Monterey, United States Community Human Services Full time**Case Manager/Housing Navigator, Shuman HeartHouse** Salary $51,891-$63,075 per year D.O.E. Additional 5% if Bilingual (E/S). Generous benefits package including medical, dental, and vision coverage. AA/EOE. E04JI8000gud403eces
-
Travel Nurse RN
2 weeks ago
Monterey, United States Cross Country Nurses Full timeCross Country Nurses is seeking a travel nurse RN Case Management for a travel nursing job in Monterey, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: 06/10/2024Duration: 13 weeks36 hours per weekShift: 12 hours, daysEmployment Type: TravelJob DescriptionAs a case management nurse (RN CM), you will collaborate...
-
Travel Nurse RN
2 weeks ago
Monterey, United States PHP Full timeJob DescriptionPHP is seeking a travel nurse RN Case Management for a travel nursing job in Monterey, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNStart Date: ASAPDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelPerks: PHP benefits:Weekly pay,Health insurance, Vision insurance, Dental...
-
Case Manager
2 weeks ago
Buena Park, United States Illumination Foundation Full timeJob DescriptionJob Description“Every person deserves compassion, dignity, and the safety of a place to call home.”Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary...
-
Case Manager
5 days ago
Buena Park, United States Illumination Foundation Full timeJob DescriptionJob Description“Every person deserves compassion, dignity, and the safety of a place to call home.”Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary...
-
Travel Nurse
3 weeks ago
Monterey, United States Secure Nursing Service Full timeSecure 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
2 months ago
Manassas Park, United States Bull Run Alcohol Safety Action Prog Full timeJob 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...
-
Case Manager
4 days ago
Manassas Park, United States Bull Run Alcohol Safety Action Prog Full timeJob 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
1 month ago
Monterey, United States Bluepipes Remote Work Freelance Full timeNationWide 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...
-
Case Manager
4 weeks ago
Manassas Park, United States Bull Run Alcohol Safety Action Prog Full timeJob 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
2 months ago
Woodland Park, United States Resources for Human Development Full time $22Do 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...
-
Case Manager
5 days ago
Woodland Park, United States Resources for Human Development Full time $22Do 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...
-
Manager Case Management
4 weeks ago
Orange Park, United States Becker Health Full timeManager 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...
-
Exceptional Family Member Case Liaison
2 months ago
Monterey, United States Commander, Navy Installations Full timeSummary 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...