ED UR Case Manager II
2 weeks ago
Requisition ID 37567 Department Clinical Resource Management Location Escondido, California Union CNA Salary Range 47.17 - 68.67 Job Type Part-Time Shift Night Hours Per Shift 8 Hours Per Pay Period 45 Position at Palomar Health Description Responsible for implementing the utilization management process for patients admitted to the acute level of care and coordinating clinical case management and discharge planning for the Emergency Department patients based on acute care guidelines/standards with focus on appropriateness of admission, level of care, and discharge. Provides telephonic or fax reviews to multiple health plans/medical groups. Collaborates with the health care team in the development, implementation, and documentation of an appropriate safe care plan. Provides retro-review of identified cases denied by health plans for financial reimbursement. Participates in appeals process to recover fluids for services rendered by Palomar Health and ensures that patients/families understand their rights to appeal when they disagree with a medical determination. Analyzes and identifies utilization patterns and trends and participates in utilization monitoring activities. Coordinates appropriate, safe discharge plan with patients/families and in consultation/collaboration with health plan providers and internal as well as community resources. Obtains authorizations needed to implement appropriate care plan and assure financial reimbursement for care services. Understands effect of health care management and reimbursement on both patients and health care system. Accurately documents the care plan in the patient chart and communicates plan to patients/families. Maintains ongoing education/knowledge of case management and utilization concepts, State and Federal health care programs, changes in health care law, criteria for multiple levels of care; utilization process related to criteria for acute care admission and impact on health care system; and never ending changes in delivery of health care. Applies Case Management principles and strategies in the planning process. Receives ongoing education related to managed care organizations, preferred provider health plans, workers compensation plans, private health plans and third party payers. Functions as a key resource provider related to health care management, delivery of care, and effects or reimbursements on both patients and health care system. Performs other assigned duties. Understands and adheres to the California Nurse Practice Act, The American Nurses Association (ANA) Code of Ethics for Nurses, the ANA Bill of Rights for Registered Nurses and the ANA Scope and Standards of Practice for Nursing. Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.Job RequirementsMinimum Education: As required by certification and/or licensurePreferred Education: Bachelor's Degree and/or National Certification in Case Management and/or Utilization ReviewMinimum Experience: 1 - 3 years of directly related RN experiencePreferred Experience: 3 - 5 years acute care nursing experienceCompletion of Utilization Review/Case Management courseRequired Certification: American Heart Association recognized BLS - Healthcare ProviderPreferred Certification: Not ApplicableRequired License: Current CA RN LicensePreferred License: Not Applicable Current employees are not eligible for hiring incentives. We are an equal opportunity employer and do not discriminate against applicants or employees based on race, color, gender, religion, creed, national origin, ancestry, age, disability, sexual orientation, marital status or any other characteristic protected by law.
-
Case Manager
5 days ago
Escondido, United States Marsell Wellness Center Full time**Job Title**: - Case Manager **Department**: **Location**: - Family Wellness - Escondido **Reports To**: - Lead Case Manager **FLSA Status**: **Salary**: - Non-Exempt - Starting at_ $57,000 **Position Summary**:The Case Manager will perform a full range of targeted and/or general case management that is strength-based, needs-based, community-based,...
-
Case Manager
5 days ago
Escondido, United States Marsell Wellness Center Full timeJob DescriptionJob DescriptionJob Title:Case ManagerDepartment:Location:Family WellnessEscondidoReports To:Lead Case ManagerFLSA Status:Salary: Non-ExemptStarting at $57,000Position Summary: The Case Manager will perform a full range of targeted and/or general case management that is strength-based, needs-based, community-based, and family-driven. The Case...
-
Case Manager
4 weeks ago
Escondido, United States DSSI, Inc. Full timeDSSI is hiring Case Managers to work with a workforce services company in the Escondido area. This role focuses on helping individuals address any barriers they are facing by navigating them through their benefits and resources. **Details**: - Workdays: Monday-Friday - Work Hours: 8am-5pm **Duties**: - Meets with participants to identify barriers and...
-
Utilization Review Case Manager
2 months ago
Escondido, United States Palomar Health Full timeRequisition ID 37398 Department Clinical Resource Management Location Escondido, California Union CNA Salary Range 47.17 - 68.67 Job Type Per Diem Shift Day Hours Per Shift 8 Hours Per Pay Period 0 Position at Palomar Health Description Responsible for implementing the utilization management process for patients admitted to acute level of care....
-
Care Case Manager
1 month ago
Escondido, United States Mental Health Systems, Inc. Full timeAt TURN our mission is Improving Lives. Our organization embraces the tenets of client-centered care, and our core values Integrity, Diversity, Mentorship, and Inclusion are at the forefront of everything we do. We hire exceptional individuals seeking meaningful opportunities in a purpose-driven environment. JOB SUMMARY Recommend and assist access to...
-
Escondido, United States North County Lifeline Full timeJob DescriptionJob DescriptionCase Manager,Community Services for Families (CSF) Program - Bilingual SpanishLifeline Community Services is hiring a Mental Health Therapist to support our growing team. You will be responsible for providing assessment, treatment planning, individual and family therapy, and case management to youth up to age 20, their families....
-
Project Engineer II
2 weeks ago
Escondido, United States Baker Electric Full timeJob Description Posted Wednesday, January 3, 2024 at 8:00 AM At Baker Electric we are energized by truly living our values - Team Builders, Relentless Follow Thru, All-In, and Care for Others. When our team members work together with these things in mind, we do great things both individually and as an organization. Being an employee-owned company shows our...
-
Systems Analyst I/II
6 days ago
Escondido, United States City of Escondido Full timeThis position is open until filled. A first review of applications will take place during the week of December 4, 2023. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Systems Analyst I: $6,368 - $7,740 per month Systems...
-
Case Manager
6 days ago
Escondido, United States Mental Health Systems, Inc. Full timeJob DescriptionJob DescriptionAt TURN our mission is Improving Lives. Our organization embraces the tenets of client-centered care, and our core values Integrity, Diversity, Mentorship, and Inclusion are at the forefront of everything we do. We hire exceptional individuals seeking meaningful opportunities in a purpose-driven environment.JOB SUMMARYRecommend...
-
Human Resources Technician I/ii
7 days ago
Escondido, United States City of Escondido Full time**Summary**: **This position is open until filled.** **Human Resources Technician I: $4,289 - $5,748/mo** **Human Resources Technician II: $4,853 - $6,504/mo** If you want to join a hardworking team that shares a commitment to provide top-quality municipal services in a prime North County location, consider a career with the City of Escondido. We have an...
-
Lead Clinician
5 days ago
Escondido, United States Mental Health Systems, Inc. Full timeJob DescriptionJob DescriptionAt TURN our mission is Improving Lives. Our organization embraces the tenets of client-centered care, and our core values Integrity, Diversity, Mentorship, and Inclusion are at the forefront of everything we do. We hire exceptional individuals seeking meaningful opportunities in a purpose-driven environment.JOB SUMMARYAct as...
-
Regional Vp, Operations Ii
1 week ago
Escondido, United States United Surgical Partners International Full time**REPORTING TO**: Market Vice President, Operations - USPI **LOCATION**:Los Angeles, Orange County or Ventura County - ______________________________________________________________________________________ **JOB DESCRIPTION**: The Regional Vice President will be responsible for ambulatory surgery centers in Southern California. Responsible for overseeing...
-
Escondido, United States North County Lifeline Full timeJob DescriptionJob DescriptionMental Health Therapist, Community Services for Families - Bilingual SpanishGeneral ResponsibilitiesUnder the supervision of the Community Services for Families Program Supervisor, the Mental Health Therapist will provide assessment services for CSF families with children 0-18 and have domestic violence as the reason for the...
-
Escondido, United States North County Lifeline Full timeJob DescriptionJob DescriptionMental Health Therapist II,Community Services for Families (CSF) ProgramBBS Registered - Bilingual SpanishGeneral ResponsibilitiesUnder the supervision of the Community Services for Families Program Supervisor, the Mental Health Therapist will provide assessment services for CSF families with children 0-18 and have domestic...
-
Senior Clinical Data Manager
4 weeks ago
Escondido, United States Allen Spolden Full timeJob DescriptionThe Clinical Data Manager manages the general conduct of project assigned tasks as the Lead Data Manager or under advisement from senior members of the Data Management Team. Responsible for oversight and conducting data activities in an efficient manner and in accordance with regulations. Responsibilities include all data management...
-
Roving Assistant Branch Manager
5 days ago
Escondido, United States SiteOne Landscape Supply Full timeCompany Overview SiteOne associates are customer obsessed, always safe, continuously improving, and having fun! Whether you are experienced in the green industry, a professional looking for a career change, or a new graduate or veteran transitioning into the workforce, we are confident you will find opportunity and reward with SiteOne. SiteOne Landscape...
-
Escondido, United States Neighborhood Healthcare Full timeCommunity health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together.As a...
-
Project Manager
2 weeks ago
Escondido, United States Bilbro Construction Company Inc. Full time $90,000 - $125,000Benefits:401(k)Dental insuranceHealth insuranceLife insurancePaid time offJob Classification: Project Manager – Construction Location: Escondido, CA Travel Involved: 25% Job Type: Full Time Education:...
-
Escondido, United States Neighborhood Healthcare Full timeCommunity health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together. As...
-
Escondido, United States Neighborhood Healthcare Full timeCommunity health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better...
