Current jobs related to Case Manager - Monterey, California - Astrana Health

  • Clinical Case Manager

    4 weeks ago

    Monterey, California, United States Astrana Health Full time

    About the Role:We are seeking a highly motivated Clinical Case Manager to join our team. As a Clinical Case Manager, you will play a critical role in ensuring the best possible outcomes for our patients. Your primary responsibility will be to coordinate and manage the care of patients with complex medical needs, working closely with healthcare providers,...

  • Nurse Case Manager

    1 month ago

    Monterey, California, United States Samuel Contract Staffing Full time

    We are seeking a skilled and compassionate Registered Nurse to join our team as a Case Manager at our senior living center in Monterey, CA. This is a full-time opportunity offering a competitive benefits package and salary. **Job Summary:** As a Registered Nurse Case Manager, you will work closely with physicians to identify and coordinate...

  • Healthcare Case Manager

    4 weeks ago

    Monterey, California, United States Astrana Health Full time

    Job Summary:Astrana Health is seeking a skilled Case Manager to join our team. As a Case Manager, you will play a critical role in ensuring the highest quality of care for our patients.Key Responsibilities:Comply with Case Management Department's policies and proceduresUtilize Milliman Care Guidelines, CMS, Title 22 guidelines and criteria for...

  • Senior Complex Case Manager

    4 weeks ago

    Monterey, California, United States Central California Alliance for Health Full time

    Job SummaryWe are seeking a highly skilled Senior Complex Case Manager - Adult (RN) to join our Care Management team at Central California Alliance for Health. As a Senior Complex Case Manager - Adult (RN), you will be responsible for developing and managing individualized comprehensive plans of care for members referred into the assigned Case Management...

  • Senior Complex Case Manager

    4 weeks ago

    Monterey, California, United States Central California Alliance for Health Full time

    Job SummaryWe are seeking a skilled Senior Complex Case Manager - Adult to join our Care Management team. As a key member of our team, you will be responsible for developing and managing comprehensive care plans for members with complex needs.About the RoleThe Senior Complex Case Manager - Adult will work closely with members, families, providers, and...

  • RN Case Manager

    4 weeks ago

    Monterey, California, United States Central Coast Community VNA Full time

    Job Summary:VNA is dedicated to providing the highest quality health care to residents of the Central Coast. Our Home Health services focus on the rehabilitation and restoration of independence after surgery, an acute illness, as well as management and stabilization of chronic diseases.As a skilled RN Case Manager, you will work with physicians in...

  • Home Health Case Manager RN

    4 weeks ago

    Monterey, California, United States HexaQuEST Health, Inc. Full time

    Job Title: Home Health Case Manager RN - Day ShiftJob Summary: We are seeking a skilled and compassionate Registered Nurse to join our Home Health team as a Case Manager.Responsibilities:* Work directly with physicians to identify and coordinate patient/family/caregiver home care needs* Provide skilled supportive care to patients and their families* Utilize...

  • Care Manager

    4 weeks ago

    Monterey, California, United States Institute on Aging Full time

    About the Role:The Institute on Aging is seeking a skilled Care Manager to join our team. As a Care Manager, you will be responsible for providing case management services to clients with multiple medical and psychosocial needs.Key Responsibilities:Conduct comprehensive assessments of clients to identify their needs and develop personalized care...

  • Care Manager I

    4 weeks ago

    Monterey, California, United States Institute on Aging Full time

    Job SummaryThe Care Manager I provides case management services for CalAIM clients, ensuring the assessment and planning of services to meet their complex medical and psychosocial needs.Key ResponsibilitiesComprehensive Assessments: Conduct thorough assessments and ongoing re-assessments of clients, including psychosocial, physical, and mental health,...

  • Criminal Defense Attorney

    4 weeks ago

    Monterey, California, United States The Matian Firm, APC Full time

    Job SummaryWe are seeking an experienced Criminal Defense Attorney to join our team at The Matian Firm, APC. As a key member of our Criminal Defense Team, you will be responsible for managing caseloads, client interaction, and collaborating with our team of attorneys and legal assistants.ResponsibilitiesAdvise clients on their legal rights and draw up legal...

  • Food Preparation Specialist

    3 weeks ago

    Monterey, California, United States Whole Foods Market Full time

    Job SummaryWe are seeking a highly skilled Food Preparation Specialist to join our team at Whole Foods Market. In this role, you will be responsible for preparing and maintaining a clean and sanitary environment in the cold case, fresh pack, salad, and hot bars, ensuring the highest quality products for our customers.Key ResponsibilitiesFood Preparation:...

  • Psychiatrist - Correctional Facility

    1 month ago

    Monterey, California, United States AvaMed Workforce Full time

    Job Title: PsychiatristAvaMed Workforce is seeking a highly skilled Psychiatrist to join our team in a Correctional Facility setting. As a Psychiatrist, you will be responsible for providing comprehensive psychiatric services to mentally ill inmates/wards.Job Summary:Under the clinical direction of the Chief Psychiatrist/Senior Psychiatrist or designee, and...

  • Primary Therapist

    4 weeks ago

    Monterey, California, United States Alsana Full time

    Alsana is seeking a skilled Primary Therapist to join our team of dedicated professionals. As a Primary Therapist, you will provide consultation, case management, and therapy to individuals affected by serious eating disorders.Responsibilities include assessing clients, determining referral needs, providing group therapy, family therapy, and group education,...

  • Cardiac Anesthesiologist Position

    1 month ago

    Monterey, California, United States KTE Services Full time

    Job OverviewWe are seeking a skilled and experienced Cardiac Anesthesiologist to join our esteemed anesthesia group in the Monterey, California area.This position offers an exciting opportunity to work in a collaborative and supportive environment, providing anesthesia services across various specialties with a primary focus on Cardiac...

  • Anesthesiologist Position in Monterey, California

    4 weeks ago

    Monterey, California, United States KTE Services Full time

    Job Title: General Anesthesiologist PositionWe are seeking a skilled General Anesthesiologist to join our established anesthesia group in Monterey, California. As a General Anesthesiologist, you will play a crucial role in providing anesthesia services across various specialties, including Orthopedics, Obstetrics, Cardiac, Thoracic, Pediatric, Vascular, ENT,...

  • Eating Disorder Therapist

    4 weeks ago

    Monterey, California, United States Alsana Full time

    Job Title: Primary TherapistAlsana is seeking a highly skilled and compassionate Primary Therapist to join our team. As a Primary Therapist, you will provide consultation, case management, and therapy to individuals affected by serious eating disorders.Responsibilities:Assess clients and determine referral needsProvide individual and family therapy...

  • Primary Therapist

    4 weeks ago

    Monterey, California, United States Alsana Full time

    Job Title: Primary TherapistAlsana is seeking a skilled Primary Therapist to join our team. As a Primary Therapist, you will provide consultation, case management, and therapy to individuals affected by serious eating disorders.Responsibilities:Assess clients and determine referral needsProvide individual and family therapy sessionsDevelop and implement...

  • Medical Claims Researcher

    1 month ago

    Monterey, California, United States Cypress Healthcare Partners Full time

    Job SummaryWe are seeking a highly skilled Medical Claims Research Specialist to join our team at Cypress Healthcare Partners. The successful candidate will be responsible for researching and resolving medical claims denials, providing exceptional customer service, and working collaboratively with internal teams to resolve billing-related issues.Key...

  • Eating Disorder Therapist

    4 weeks ago

    Monterey, California, United States Alsana Full time

    About the RoleAlsana is seeking a skilled Primary Therapist to join our team. As a Primary Therapist, you will provide consultation, case management, and therapy to individuals affected by serious eating disorders.Key Responsibilities:Assess clients and determine referral needsProvide individual and family therapy sessionsDevelop and implement treatment...

  • Staff Psychiatrist

    4 weeks ago

    Monterey, California, United States California Correctional Health Care Services Full time

    Job Title: Staff Psychiatrist - Correctional and Rehab ServicesCalifornia Correctional Health Care Services is seeking a highly skilled and dedicated Staff Psychiatrist to join our team in Correctional and Rehab Services. As a Staff Psychiatrist, you will be responsible for providing high-quality psychiatric care to inmates in a correctional setting.Key...

Case Manager

1 month ago

Monterey, California, United States Astrana Health Full time
About the Role

We are seeking a highly motivated Case Manager to join our team at Astrana Health. This role will report to a Manager - Case Management and enable us to continue to scale in the healthcare industry, focusing on SNF, SA, ARU, LTAC level of care.

Key Responsibilities
  • Comply with Case Management Department's policies and procedures.
  • Ensure % compliance with Utilization Management health plan delegation standards for Case Management.
  • Utilize Milliman Care Guidelines, CMS, Title 22 guidelines and criteria for appropriateness of transition of care for members in SNF, SA, ARU, LTAC setting.
  • Collaborate with Hospitalists, case managers, and discharge planners to establish discharge plans at time of admission.
  • Coordinate the required initial and concurrent reviews based on the review of medical records received and accurate reporting of all admissions to Medical Director and Manager and/or Supervisor of Case Management Department.
  • Review medical records and/or other documentation to determine medical necessity, appropriateness and level of care utilizing Milliman Care and other appropriate Guidelines.
  • Assess, plan, implement, coordinate, monitor, and evaluate all options and services with the goal of reducing hospital readmission.
  • Attend/coordinate Case Management meetings on and off-site as necessary.
  • Interact with providers or members as appropriate to communicate determination outcomes in compliance with state, federal and accreditation requirements.
  • Attend to provider and interdepartmental calls in accordance with exceptional customer service.
  • Maintain good relationships with health plans, facilities and medical directors. Resolve problems that arise with any IPA medical directors.
  • Report to Manager and/or Supervisor of Case Management on activities and/or problems occurring throughout the day.
Qualifications
  • Active Licensed Vocational Nurse (LVN) or Registered Nurse (RN) license in California.
  • Ability to commute to our Monterey Park, CA office.
  • Experience using Microsoft applications such as Word, Excel and Outlook.
  • Two (2) years of clinical experience as an LVN.
  • Skilled Nursing Facility experience a plus.
What We Offer

Astrana Health is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner.

Our platform currently empowers over 10,000 physicians to provide care for over 1 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.

We are proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.