Current jobs related to Case Management - Long Beach California, Los Angeles County, CA - Blue Shield of California
-
Behavior Program Manager
1 month ago
Long Beach, California, 90899, Los Angeles County, CA, United States Intercare Therapy Full timeGeneral information City: Long Beach State: California Team Clinical Services Working time Full- Time Description & Requirements Description Sign-On Bonus: $750 Compensation: $26 - $32 Per Hour - Full time,...
-
Care Manager RN Per Diem/Days
4 weeks ago
Burbank, California, 91506, Los Angeles County, CA, United States Providence Full timeDescription Case Management is a collaborative practice including patients, caregivers, nurses, social workers, physicians, payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management. Recognizing the patient's...
-
Care Manager RN Per Diem/Variable
3 weeks ago
Burbank, California, 91506, Los Angeles County, CA, United States Providence Full timeDescription Case Management is a collaborative practice including patients, caregivers, nurses, social workers, physicians, payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management. Recognizing the patient's...
-
Care Manager RN Per Diem/Evening
3 weeks ago
Burbank, California, 91506, Los Angeles County, CA, United States Providence Full timeDescription Case Management is a collaborative practice including patients, caregivers, nurses, social workers, physicians, payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management. Recognizing the patient's...
-
Care Manager RN
2 weeks ago
Mission Hills, California, 91346, Los Angeles County, CA, United States Providence Full timeDescription Care Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination. Providence...
-
Care Manager RN FT/Days
3 weeks ago
Torrance, California, 90507, Los Angeles County, CA, United States Providence Full timeDescription The case manager performs the primary functions of assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care professionals involved in the client's care. "Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and...
-
ABA Program Manager
1 month ago
South Gate, California, 90280, Los Angeles County, CA, United States Intercare Therapy Full timeGeneral information City: South Gate State: California Team Clinical Services Working time Full- Time Description & Requirements Description Sign-On Bonus: $750 Compensation: $26 - $32 Per Hour - Full time,...
-
Applied Behavior Analysis Program Manager
4 weeks ago
Los Angeles, California, 90033, Los Angeles County, CA, United States Intercare Therapy Full timeGeneral information City: Boyle Heights State: California Team Clinical Services Working time Full- Time Description & Requirements Description Sign-On Bonus: $750 Compensation: $26 - $32 Per Hour - Full time,...
-
ABA Program Manager
1 month ago
Van Nuys, California, 91405, Los Angeles County, CA, United States Intercare Therapy Full timeGeneral information City: Van Nuys State: California Team Clinical Services Working time Full- Time Description & Requirements Description Sign-On Bonus: $750 Compensation: $26 - $32 Per Hour- Full time, based...
-
Care Manager RN Full-Time/Variable
3 weeks ago
San Pedro, California, 90733, Los Angeles County, CA, United States Providence Full timeDescription Care Manager RN at Providence Little Co of Mary Medical Ctr-San Pedro in San Pedro, CA offers a Full-Time (Day shift) that will work 8-hour daily. The case manager performs the primary functions of assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care professionals involved...
-
Behavior Program Manager
1 month ago
Culver City, California, 90232, Los Angeles County, CA, United States Intercare Therapy Full timeGeneral information City: Culver City State: California Team Clinical Services Working time Full- Time Description & Requirements Description Sign-On Bonus: $750 Compensation: $26 - $32 Per Hour - Full time,...
-
Care Manager RN Per Diem/Variable
2 weeks ago
Torrance, California, 90507, Los Angeles County, CA, United States Providence Full timeDescription The case manager performs the primary functions of assessment, planning, facilitation and advocacy, which are achieved through collaboration with the client and other health care professionals involved in the client's care. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Little Company Of Mary...
-
Care Manager RN
3 weeks ago
Anaheim, California, 92816, Orange County, CA, United States Providence Full timeDescription Care Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination. Providence...
-
Manager, School Services
4 weeks ago
Los Angeles, California, 91356, Los Angeles County, CA, United States Intercare Therapy Full timeGeneral information City: Tarzana State: California Team Clinical Services Working time Full- Time Description & Requirements Description Sign-On Bonus: $750 Compensation:$26 - $32 Per Hour - Full time, based upon...
-
Behavior Program Manager
1 month ago
Los Angeles, California, 90012, Los Angeles County, CA, United States Intercare Therapy Full timeGeneral information City: Los Angeles State: California Team Clinical Services Working time Full- Time Description & Requirements Description Sign-On Bonus: $750 Compensation:$26 - $32 Per Hour - Full time, based...
-
Care Manager RN
2 weeks ago
Apple Valley, California, 92307, San Bernardino County, CA, United States Providence Full timeDescription Case Management is a collaborative practice including patients, caregivers, nurses, social workers, physicians, payers, support staff, other practitioners and the community. The Case Management process facilitates communication and care coordination along a continuum through effective transitional care management. Recognizing the patient's...
-
Registered Nurse
4 weeks ago
GOLD RIVER, California, 95670, Sacramento County, CA, United States Interim HealthCare of Sacramento Full timeRegistered Nurse (RN) Hospice Case Managerin Grass Valley, CAInterim HealthCare Hospice is privileged to guide patients and their families through the delicate journey of end-of-life care with compassion and expertise. Our unwavering dedication is to improve the quality of life for all involved, grounded in both clinical proficiency and empathy. We strive to...
-
Care Manager RN
3 weeks ago
Santa Rosa, California, 95406, Sonoma County, CA, United States Providence Full timeDescription Care Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination. Providence...
-
Revenue Cycle Specialist II
4 months ago
Torrance, California, 90503, Los Angeles County, CA, United States CEDARS-SINAI Full timeJob DescriptionWhat will you be doing in this role?Under general supervision and following established practices, policies, and guidelines, provides Commercial and Government billing and collections support to Insurance Follow up and Accounts Receivable, performing duties which may include reviewing and submitting multi-specialty claims to third party...
-
Clinical Research Associate I
2 months ago
Los Angeles, California, 90071, Los Angeles County, CA, United States CEDARS-SINAI Full timeJob DescriptionThe Smidt Heart Institute reflects Cedars-Sinai's steadfast dedication to heart disease and research innovation giving patients access to the highest level of care. Year after year, thousands of people trust their hearts to Smidt Heart Institute at Cedars-Sinai. Our cardiologists, cardiac surgeons and specialized care teams treat the full...
Case Management
4 months ago
Your Role
The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians.
Your Work
In this role, you will:
- Research and design treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type.
- Initiation of timely individualized care plans (ICP) based on health risk assessment (HRA) completion, participation in and documentation of interdisciplinary meetings (ICT), assisting in transitions of care across all ages.
- Determines appropriateness of referral for CM services, mental health, and social services.
- Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD).
- Conducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases.
- Manages member treatment in order to meet recommended length of stay. Ensures DC planning at levels of care appropriate for the members needs and acuity.
- Assessment: Assesses members health behaviors, cultural influences and clients belief/value system. Evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers.
- Research opportunities for improvement in assessment methodology and actively promotes continuous improvement. Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers and BSC.
- Determines realistic goals and objectives and provides appropriate alternatives. Actively solicits client’s involvement.
- Planning: Designs appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Adjusts plans or creates contingency plans as necessary.
- Assesses and re-evaluates health and progress due to the dynamic nature of the plan of care required on an ongoing basis. Initiates and implements appropriate modifications in plan of care to adapt to changes occurring over time and through various settings.
- Develops appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes.
- Recognizes need for contingency plans throughout the healthcare process.
- Develops and implements the plan of care based on accurate assessment of the member and current of proposed treatment.
Your Knowledge and Experience
- Current CA RN License. Bachelors of Science in Nursing or advanced degree preferred.
- Generally, requires moderate to extensive experience in nursing, health care or related field. Requires 5+ years’ experience in nursing, health care or related field. 3+ years managed care experience preferred.
- Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
- Requires at least 5 years of prior experience in nursing, healthcare or related field
- A minimum of 1 year experience in inpatient, outpatient or managed care environment required
- Health insurance/managed care experience desired.
- Transitions of care experience desired
- Excellent communications skills
Pay Range:
The pay range for this role is: $ 87230.00 to $ 130900.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
#LI-MM4
