Senior Nurse Case Manager for Population Health

3 weeks ago


Los Angeles, California, United States Pyramid Consulting Full time
About the Role

We are seeking an experienced Senior Nurse Case Manager for Population Health to join our team in Los Angeles, California.

This is a 13-week contract position with a guaranteed 40 hours per week. The shift will be from 8 AM to 5 PM, Monday to Friday, with occasional overtime.

Job Responsibilities
  • Plan, develop, assess, and evaluate care provided to members, collaborating with physicians, other healthcare professionals, and patients/family in developing, implementing, and documenting individualized plans of care to ensure continuity, quality, and appropriate resource use.
  • Recommend alternative levels of care and ensure compliance with federal, state, and local requirements.
  • Assess high-risk patients needing post-hospital care planning.
  • Develop and coordinate the implementation of discharge plans to meet patient needs, communicating the plan to physicians, patients, family/caregivers, staff, and relevant community agencies.
  • Review, monitor, evaluate, and coordinate hospital stays to ensure timely and efficient delivery of essential services.
  • Participate in Bed Huddles, carry out recommendations aligned with patient needs, and coordinate interdisciplinary approaches to provide continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining necessary authorizations/approvals for outside services.
  • Conduct daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in various settings, including outpatient, emergency room, inpatient, and non-KFH facilities.
  • Act as a liaison between in-patient facilities and referral agencies, providing case management to patients referred.
Requirements
  • Bachelor's degree in nursing or a related field.
  • Completion of an accredited RN training program that allows graduates to take the RN license exam.
  • Two years of experience as an RN in an acute care setting.
  • Demonstrated ability to utilize/general principles, practices, techniques, and methods of utilization review/management, discharge planning, or case management.
Compensation Package

The estimated salary for this position is $120,000 - $150,000 annually, depending on experience and qualifications. This figure includes benefits and compensation for working overtime, if required.



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