Catastrophic Nurse Case Manager

24 hours ago

Signal Hill, CA, United States FutureRecruit Full time
Catastrophic Nurse Case Manager - Full-time

Location: Signal Hill, CA

Required Qualifications:
  • Registered nurse
  • BSN preferred
  • CCM or equivalent certification
  • Three years or more of related experience and/or training or an equivalent combination of education and experience
Job Description
  • Identify, assess, plan, coordinate, implement, monitor, and evaluate options and services for individuals requiring case management services
  • Provide quality, cost-effective outcomes for the client through collaboration and communication with the client, the family, the physician, and other members of the healthcare team
  • Process the case utilizing the client's outcome management model and tools
  • Obtain written authorization for case management services as well as release of information
  • Assess the client/family to identify their strengths and resources; problems; psychosocial, financial, and medical history; current status; diagnosis; prognosis; functional status; goals; current treatment plan; and needs
  • Develop a plan of care with client's model through interdisciplinary collaboration, which identifies realistic short- and long-term goals
  • Identify, secure, and coordinate the services and resources to implement the plan
  • Monitor services being provided for continued appropriateness and report to client and insurance carrier
  • Evaluate the client's progress, the plan, and the appropriateness of the services provided, with modifications as necessary
  • Provide ongoing instruction to the client and family regarding the injury/disease process, treatment options, and present care
  • Promote the client's/family's self-advocacy skills to achieve maximum self-sufficiency
  • Have knowledge of the benefit package as well as all available funding sources and systems of care and coordinate with the payer for authorization of payment
  • Provide in-depth reporting of outcomes encompassing clinical, functional, financial, and customer satisfaction areas
  • Demonstrate effective, accurate, and timely verbal and written communication in all work situations
  • Identify and disclose all situations that might result in exposure to legal liability and/or are indicative of poor quality care negatively affecting the client
  • Frequently travel to patient appointments
  • Perform other related duties as assigned in accordance with the necessary job function
Benefits:
  • Tremendous Career Growth Opportunities
  • Senior management and leadership are very well respected by the team
  • Great work environment with a family-like work culture
  • Medical, Dental and Vision + 401k + Tuition Assistance + Disability

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