High Intensity Case Manager RN

2 weeks ago


Orange, California, United States Prospect Medical Holdings Full time
Job Title: High Intensity Case Manager RN

At Prospect Medical Holdings, we are seeking a highly skilled and experienced High Intensity Case Manager RN to join our team. As a key member of our healthcare team, you will be responsible for managing complex and chronic care needs of our members, ensuring they receive the appropriate level of care and support.

Responsibilities:
  • Identify and assess members with high-risk needs, developing individualized care plans to address their specific objectives and goals.
  • Collaborate with healthcare providers, community-based programs, and other stakeholders to ensure seamless coordination of care and services.
  • Monitor and evaluate the effectiveness of care management plans, making adjustments as necessary to minimize unnecessary utilizations and readmissions.
  • Provide education and support to members and their families, empowering them to take an active role in their healthcare.
  • Meet health plan and NCQA requirements for assessments, care plans, and IDTs.
Requirements:
  • At least two years' experience in the medical field, with one year in a case management role.
  • Knowledge of NCQA requirements and experience working in a managed care organization, medical group, or health plan setting.
  • RN/LVN unrestricted active license required, with CCM certification preferred.

We offer a dynamic and supportive work environment, with opportunities for professional growth and development. If you are a motivated and compassionate healthcare professional, we encourage you to apply for this exciting opportunity.



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