Clinical - Care Manager I (RN)

2 weeks ago

Buena Park, United States Axelon Services Corporation Full time
Location: Remote- PST, but MUST have CA licensure

SHIFT: 8a-5pm PST (No OT required)

*Attention: This is a 60 day contract position. Must have CA RN licensure. Can live anywhere in the US but must work West Coast hours.

Job Description: Description - External
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care

" Develop, assess and adjust, as necessary, the care plan and promote desired outcome
" Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
" Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
" Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
" Provide patient and provider education
" Facilitate member access to community based services
" Monitor referrals made to community based organizations, medical care and other services to support the members overall care management plan
" Actively participate in integrated team care management rounds
" Identify related risk management quality concerns and report these scenarios to the appropriate resources
" Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
Qualifications - External

Education/Experience: Graduate from an Accredited School of Nursing. Bachelor s degree in Nursing preferred. 2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred. Florida residency required. Knowledge of healthcare and managed care preferred. Prior experience working in a remote role preferred. Prior case management experience preferred. Bilingual in Spanish and English is preferred.

Licenses/Certifications: Current state s RN license.

Walk me through the day to day responsibilities of this the role and a description of the project:
  • Outreaching member to enroll them in CM program
  • Building care plans, medication review, assessments care plans
Describe the performance expectations/metrics for this individual and their team:
  • 20 calls/day
Internal/External Groups with which the Candidate will interface: Required Skills/Experience: Preferred Skills/ Experience: 1. Time Management (work fast-paced environment) 1. Technical skills 2. Works independently 2. 3. Work remotely in telephonic CM 3. Education Requirement: Associate s degree Education Preferred: Software Skills Required: Microsoft Office Suites Required Certifications: Must have CA RN licensure. Required Testing:

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