Medical Case Manager Specialist
4 days ago
About the Job
We are seeking a skilled Medical Case Manager to join our team at Kinetic Personnel Group. As a Medical Case Manager, you will be responsible for providing ongoing case management services for health plan members. This role requires strong communication and coordination skills to facilitate collaboration among healthcare teams and ensure quality, cost-effective outcomes.
Job Summary
- Participate in a mission-driven culture of high-quality performance with a member focus on customer service, consistency, dignity, and accountability.
- Review and evaluate proposed services utilizing medical criteria and established policies and procedures.
- Determine the appropriate action regarding requested services, including approval, modification, or denial, and refer to the Medical Director when necessary.
Responsibilities
- Analyze requests to monitor utilization of services, including medical appropriateness and identify potentially high-cost, complex cases for high-level case management intervention.
- Develop, implement, and monitor care plans through an interdisciplinary team process in conjunction with the individual member and family in internal and external settings across the continuum of care.
- Routinely assess member status and progress; if progress is static or regressive, determine the reason and proactively encourage referrals to higher levels of case management or make adjustments in the care plan, providers, and/or services to promote better outcomes.
Requirements
- Associates degree in Nursing (ADN); or equivalent work experience required. Bachelor's degree in Nursing (BSN) preferred.
- Current, unrestricted Registered Nurse (RN) license to practice in the State of California required.
- 3 years of clinical experience with the health needs of the population served required.
About Us
Kinetic Personnel Group is a renowned government public health plan that prioritizes quality, cost-effective outcomes. We offer a competitive salary range of $43.00 - $69.00 per hour and 40 hours of expected work per week.
-
Inpatient Case Management Specialist
2 weeks ago
Orange, California, United States Regal Medical Group, Inc. Full timeAbout the RoleWe are seeking a highly skilled and experienced Inpatient Case Management Specialist to join our team at Regal Medical Group, Inc. As a key member of our healthcare team, you will play a vital role in coordinating patient care and ensuring the best possible outcomes.Duties and Responsibilities:Assess patient needs and develop individualized...
-
Orange, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is a leading provider of travel nursing services, and we are currently seeking a highly skilled Case Manager to join our team for a 13-week assignment in Orange, California.About the Job:We are looking for an experienced Registered Nurse with excellent case management skills to work with our clients in Orange, California. As...
-
Orange, California, United States Equiliem Full timeEquiliem is seeking a highly skilled Case Management Specialist to join our team in Orange, California. This is a fantastic opportunity for a licensed vocational nurse (LVN) with experience in prior authorization review and medical case management to work on a local contract basis.As a Case Management Specialist, you will play a critical role in reviewing...
-
Medical Case Manager Specialist
3 weeks ago
Orange, California, United States talent4health Full timeAbout This RoleWe are seeking a highly skilled Medical Case Manager to join our team at CalOptima Health. As a key member of our Long Term Care department, you will be responsible for providing exceptional care management services to our members.
-
Registered Nurse
9 hours ago
Orange, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is excited to announce an opportunity for a skilled Registered Nurse to join our team as a travel nurse in Orange, California.About the RoleWe are seeking a dedicated and compassionate Case Manager-Registered Nurse with 8 hour shifts and 40 hours per week to provide exceptional care to patients in need. This assignment...
-
Case Management RN Specialist
3 weeks ago
Orange, California, United States Kaiser Permanente Full timeAbout the RoleWe are seeking a highly skilled Case Management RN Specialist to join our team at Kaiser Permanente in Orange, California. This is an excellent opportunity to work with a talented group of professionals who share your passion for delivering exceptional patient care.Job SummaryThis RN Case Manager will play a critical role in managing the...
-
Travel Nurse RN Case Manager
3 weeks ago
Orange, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a highly skilled travel nurse to join their team as a Case Manager. With a strong background in healthcare, this individual will be responsible for assessing patient needs, developing care plans, and coordinating with other healthcare professionals to ensure seamless patient care.This role offers an exciting...
-
Medical Case Manager Travel Nurse
3 weeks ago
Orange, California, United States OneStaff Medical Full timeAt OneStaff Medical, we're dedicated to providing exceptional care to our patients and delivering unparalleled support to our travel professionals. As a Medical Case Manager Travel Nurse, you'll play a vital role in coordinating long-term care for your patients, ensuring they receive the best possible treatment at optimal times.We're currently seeking an...
-
Orange, California, United States TotalMed Case Management Staffing Full timeUnlock Your Potential as a Travel NurseWe are seeking a highly skilled and dedicated Registered Nurse to join our team as a travel nurse in Orange, California. As a case manager-registered nurse, you will have the opportunity to make a meaningful impact on the lives of patients while exploring new destinations.About TotalMed Case Management Staffing:TotalMed...
-
Travel Healthcare Professional
4 weeks ago
Orange, California, United States TotalMed Case Management Staffing Full timeWe are seeking a dedicated and compassionate Registered Nurse (RN) for our case management team. This exciting opportunity is perfect for individuals who are passionate about delivering exceptional patient care and making a meaningful difference in the lives of others.About TotalMed Case Management StaffingTotalMed Case Management Staffing is a leading...
-
Case Manager Specialist
2 days ago
Orange, California, United States Akua Behavioral Health Inc Full timeJob OverviewAkua Behavioral Health Inc is seeking a skilled Case Manager Specialist to join our team. As a key member of our substance use prevention treatment program, you will be responsible for conducting comprehensive assessments, developing personalized treatment plans, and providing support to clients.About the Role:Conduct ASAM assessments and create...
-
Inpatient LVN Case Manager Specialist
4 weeks ago
Orange, California, United States Regal Medical Group, Inc. Full timeJob OverviewWe are seeking an Inpatient LVN Case Manager to join our team at Regal Medical Group, Inc. in Orange County. As a key member of our healthcare team, you will be responsible for assessing, treating, and managing patient care during their hospital stay.
-
Orange, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is a leading healthcare staffing agency seeking a highly skilled Registered Nurse to fill a Case Management position in Orange, California.About the JobThis 13-week assignment offers the opportunity to work with a dynamic team and contribute to providing exceptional patient care. As a Registered Nurse in this role, you will...
-
Medical Case Management Professional
5 days ago
Orange, California, United States Equiliem Full timeAbout the RoleAs a Medical Case Management Professional at Equiliem Healthcare, you will be responsible for reviewing and evaluating healthcare services to ensure they meet certain criteria.Key ResponsibilitiesCase Management: Participate in a mission-driven culture of high-quality performance, focusing on customer service, consistency, dignity, and...
-
Pediatric Medical Case Manager
3 weeks ago
Orange, California, United States talent4health Full timeAbout the JobTalent4Health is seeking a highly motivated and experienced Pediatric Medical Case Manager to join our team. As a member of our case management team, you will play a critical role in ensuring the health and well-being of our pediatric members.Job SummaryThe successful candidate will be responsible for providing intensive case management services...
-
Nurse Case Manager Position
4 weeks ago
Orange, California, United States VitalHire Full timeJob OverviewVitalHire is a healthcare organization seeking an experienced travel nurse RN to fill a challenging case management position in California.About the RoleThis 13-week opportunity offers a unique blend of skills and experience, with a focus on delivering exceptional patient care. As a vital member of our team, you will be responsible for managing...
-
SNF Case Manager
4 weeks ago
Orange, California, United States Prospect Medical Full timeJob SummaryThe Inpatient Case Manager at Prospect Medical is responsible for coordinating daily services including assessments, treatment planning, monitoring, evaluation, and discharge planning in accordance with company policies and procedures.Key ResponsibilitiesManage patient care to ensure the appropriate level of care is provided for the patient's...
-
Nurse Case Manager
4 weeks ago
Orange, California, United States OneStaff Medical Full timeJob Opportunity OverviewWe are seeking a skilled Nurse Case Manager to join our team in Orange, California.About the JobThis is a travel nursing position that offers the opportunity to work with a dynamic team and contribute to the well-being of patients. As a Nurse Case Manager, you will be responsible for coordinating long-term care and ensuring that...
-
Travel Nursing Case Management Specialist
4 weeks ago
Orange, California, United States Magnet Medical Full timeMagnet Medical is a leading healthcare provider seeking a skilled Travel Nurse RN for a challenging opportunity in Orange, California.Job Summary:We are looking for an experienced Registered Nurse (RN) to join our team as a Travel Nurse RN Case Management. The ideal candidate will have a strong background in nursing and excellent communication skills.The...
-
Pediatric Medical Case Manager RN
3 weeks ago
Orange, California, United States talent4health Full time**About the Role**Talent4Health is seeking a highly skilled Pediatric Medical Case Manager RN to join our team. As a key member of our case management department, you will be responsible for providing high-quality care to our pediatric members.Job Summary:Care Management: Assess and evaluate the medical needs of pediatric members, including their physical,...
