RN Triage Case Manager
3 weeks ago
Position Summary:
The Triage Case Manager - RN is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members. The Triage Case Manager - RN will assess and develop a care plan in collaboration with the admitting, attending and consulting physician, the member and other health care practitioners. The goal of the Triage Case Manager - RN is to effectively manage members on an outpatient basis to assure the appropriate level-of-care is provided, to prevent in patient admission and re-admissions, and ensure that the members’ medical, environmental, and psychosocial needs are met over the continuum of care.
Essential Duties and Responsibilities include the following:
- Keeps member/family members or other customers informed and requests if necessary, further assistance when needed.
- Demonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner.
- Functions as liaison between administration, members, physicians and other healthcare providers.
- Interacts professionally with member/family/physicians and involves member/family/physicians in formation of the plan of care.
- Performs a Clinical Assessment/Questionnaire of the member and determines an acuity score for necessary scheduled follow-up.
- Develops an outcome-based plan of care, based on the member’s input and assessed member needs. Implements and evaluates the plan of care as often as needed as evidenced by documentation in the member’s case file.
- Documents member assessment and reassessment, member care plans, and other pertinent information completed in the member’s medical record in accordance with the FOCUS
- Charting methodology, nursing standards, and company policies and procedures.
- Initiates community visits (hospital, home visits) as needed to assess patient progress and meet with appropriate members of the patient care team.
- Identifies planned and unplanned transitions of care from Requests for Services or daily inpatient and SNF census.
- Educates the member/caregiver on the transition process and how to reduce unplanned transitions of care.
- Manages transition of care from the sending to receiving settings ensuring that the Plan of Care moves with the member and updates/modifies the care plan as the member’s health care status changes.
- Communicates appropriately and clearly with physicians, in patient case managers and Prior-Authorization nurses
- Identifies and addresses psychosocial needs of the members and family and facilitates consultations with Social Worker, as necessary.
- Identifies and addresses pharmacological needs of the members and facilitates consultations with the pharmacy department, as necessary.Identifies community resources to address needs not covered by the member’s benefit plan, and coordinates member benefits as needed, with the health plan.
- Participates in the efficient, effective and responsible use of resources such as medical supplies and equipment.
- Responsible for the coordination and facilitation of member and family conferences as determined by assessment of member’s needs.
- Identifies the appropriate members to participate in the interdisciplinary case round process. Prepares the necessary summary information to present to the team.
- Responsible for the coordination of clinic appointments, medication reconciliation, PCP and SPC visits.
- Ability to collaborate and communicate with all members of the healthcare team (concurrent review, pre-authorization, PCP/SPC, Social Services, Pharmacy) to coordinate the continuum of care of developing plans for management of each case.
- Responsible for the identifying members that are appropriate for hospice conversion or Palliative care.
- Meet with members/caregiver face to face in different locations (clinic, home, hospital, and community) in order to build a rapport with member so that the case manager can better support member/caregiver with care coordination and the plan of care.
- Other duties as assigned.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:
- Employer-paid comprehensive medical, pharmacy, and dental for employees
- Vision insurance
- Zero co-payments for employed physician office visits
- Flexible Spending Account (FSA)
- Employer-Paid Life Insurance
- Employee Assistance Program (EAP)
- Behavioral Health Services
- 401k Retirement Savings Plan
- Income Protection Insurance
- Vacation Time
- Company celebrations
- Employee Assistance Program
- Employee Referral Bonus
- Tuition Reimbursement
- License Renewal CEU Cost Reimbursement Program
- Business-casual working environment
- Sick days
- Paid holidays
- Mileage
Requirements
Education and / or Experience:
- Current CA RN License
- Triage experience preferred
- Acute Care or E.R. experience preferred
- Strong communication, critical thinking, and multitasking skills
-
RN Triage Case Manager
3 weeks ago
Covina, United States Regal Medical Group Full timeJob DescriptionPosition Summary: The Triage Case Manager - RN is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members. The Triage Case Manager - RN will assess and develop a care plan in collaboration with the admitting, attending and consulting physician, the member and...
-
Outpatient Case Manager
4 weeks ago
Covina, United States REGAL MEDICAL GROUP, INC Full time**Position Summary**: The Outpatient Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members. The Outpatient Case Manager will assess and develop a care plan in collaboration with the admitting, attending and consulting physician, the member and other health...
-
Outpatient Case Manager
2 months ago
Covina, United States Regal Medical Group Full timeJob DescriptionPosition Summary: The Outpatient Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members. The Outpatient Case Manager will assess and develop a care plan in collaboration with the admitting, attending and consulting physician, the member and...
-
Case Manager
4 weeks ago
Covina, United States TEA Healthcare Services, Inc. Full time**Case Manager - Home Health** **Required Education and Experience** Experience: A minimum of 2 years of previous experience in home health and case management, or a related field is required. **Qualifications** Knowledge and Skills: Strong clinical knowledge and critical thinking skills are essential for effective assessment and care...
-
Outpatient Case Manager,
4 weeks ago
Covina, United States REGAL MEDICAL GROUP, INC Full time**Position Summary**: The Outpatient Case Manager-SNP will help to support the Case Management team in regards to handling the number of regulatory components that need to be completed to maintain regulatory compliance including health plans and CMS and NCQA standards. **Essential Duties and Responsibilities include the following**: - Ability to manage...
-
West Covina, United States ScionHealth - Kindred Cornerstone & Solara Hospitals Full timeScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Case Management for a nursing job in West Covina, California. Job Description & Requirements Specialty: Case Management Discipline: RN Duration: Ongoing 36 hours per week Employment Type: Staff Description Job Summary Coordinates and facilitates the care of the patient...
-
Registered Nurse
2 days ago
West Covina, United States ScionHealth - Kindred Cornerstone & Solara Hospitals Full timeScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Case Management for a nursing job in West Covina, California. Job Description & Requirements Specialty: Case Management Discipline: RN Duration: Ongoing 36 hours per week Employment Type: Staff Description $40.48 - $53.11 We would expect those hired into this job would...
-
Case Management Coordinator
2 months ago
Covina, United States Emanate Health Full timeCurrent Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as...
-
Behavioral Health Case Manager
2 months ago
West Covina, United States Kaiser Permanente Full timeDescription: Job Summary:Provide integrated and coordinated case management services for the high risk and high utilizer populations in both inpatient and outpatient psychiatry and addiction medicine settings. Responsible for managing all facets of care and utilization of high risk psychiatric and addiction medicine patients.Essential...
-
West Covina, CA, United States ScionHealth - Kindred Cornerstone & Solara Hospitals Full timeScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Case Management for a nursing job in West Covina, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: Ongoing36 hours per weekEmployment Type: Staff DescriptionJob Summary Coordinates and facilitates the care of the patient...
-
West Covina, CA, United States ScionHealth - Kindred Cornerstone & Solara Hospitals Full timeScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Case Management for a nursing job in West Covina, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: Ongoing36 hours per weekEmployment Type: Staff Description$40.48 - $53.11 We would expect those hired into this job would be paid...
-
West Covina, CA, United States ScionHealth - Kindred Cornerstone & Solara Hospitals Full timeScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a Registered Nurse (RN) Case Management for a nursing job in West Covina, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: Ongoing36 hours per weekEmployment Type: Staff Description$40.48 - $53.11 We would expect those hired into this job would be paid...
-
RN Case Manager
4 weeks ago
Covina, United States Emanate Health Full timeCurrent Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and...
-
RN Case Manager
4 weeks ago
Covina, United States Emanate Health Full timeCurrent Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and...
-
LVN Case Manager
3 weeks ago
West Covina, United States Emanate Health Full timeCurrent Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as...
-
Registered Nurse
4 days ago
Covina, United States VITAS Healthcare Full timeThe VITAS RN is a member of the interdisciplinary team who work together to meet the physical, medical, psychosocial, emotional and spiritual needs of hospice patients and families facing terminal illness and bereavement. The VITAS RN is designated to provide coordination of care, ensure continuous assessment of each patient’s and family’s needs and...
-
Bilingual Lead Care Manager
3 weeks ago
Covina, United States Heritage Group Homes, Inc. Full time**Company Profile**: Heritage Group Homes, Inc. stands at the forefront of healthcare services, committed to enriching lives with cutting-edge care management solutions. Our focus is on crafting individualized care management programs that elevate patient outcomes and deliver compassionate support. We are on the lookout for a passionate individual to embrace...
-
Aba Case Supervisor
4 weeks ago
West Covina, United States Positive Behavior Steps Full time**About the Job**: **If you are a Board-Certified Behavior Analyst (BCBA), Board-Certified Assistant Behavior Analyst (BCaBA), or have your Master working towards your BCBA, **we invite you to join our team as an ABA Case Supervisor to serve our clients in the San Gabriel Valley area. As a member of our clinical team, you will have the opportunity to...
-
RN Case Manager
3 weeks ago
West Covina, United States Emanate Health Full timeCurrent Emanate Health Employees - Please log into your Workday account to apply Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as...
-
Case Aide
3 weeks ago
West Covina, United States FIVE ACRES - THE BOYS' AND GIRLS' AID SOCIETY OF LOS ANGELES COUNTY Full timeSummary: Responsible for providing assistance to various members of clinical team. This incumbent is expected to: - Have a basic knowledge of practices and standards of the clinical team they are supporting - Assist clinical team in tracking, monitoring and completing clinical administrative duties Essential Duties: - Administers, uploads, scores and...
