Case Management
3 weeks 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 Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are provided based on standardized procedures including coordination of care with specialists and 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 applicable assessments and assisting in transitions of care across all ages. Determines appropriateness of referral for CM services, mental health, and social services. Maintains referral tracking data, analyses data for team assignments, and reports outcomes to manager. Provides Referrals to Quality Management (QM), Disease Management, Social Services 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. 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 members, 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. Assumes supervisor day to day responsibilities in manager’s absence and under the direction of the manager. Analyze productivity and internal reports to ensure compliance. Collaborates with department leadership to identify program development opportunities. Mentors case managers with complex cases to promote quality of care, cost effective health care services based on medical necessity and complies with contract for each appropriate plan type. Performs precepting for new hires or those who are not meeting expectation. Participates in special projects as needed-
Case Manager | Enhanced Case Management
3 days ago
Long Beach, United States April Parker Foundation Full timePosition Summary The Case Manager | Enhanced Case Management (ECM) will provide comprehensive case management services to individuals and families, focusing on enhancing their access to necessary resources and support. As a Case Manager, you will work closely with clients to conduct assessments, develop care plans, and provide ongoing support and advocacy....
-
Case Manager | Enhanced Case Management
3 weeks ago
Long Beach, United States April Parker Foundation Full timeJob DescriptionJob DescriptionPosition Summary The Case Manager | Enhanced Case Management (ECM) will provide comprehensive case management services to individuals and families, focusing on enhancing their access to necessary resources and support. As a Case Manager, you will work closely with clients to conduct assessments, develop care plans, and provide...
-
Case Manager
7 days ago
Long Beach, United States PROJECT 180 INC Full timeThe Organization SSG-Project 180 turns lives around through innovative, wraparound services that keep people out of institutions and in their communities. Project 180 is a leader in the forensic treatment space, offering high-quality, specialized treatment programs that serve thousands of justice-involved individuals. Our programs span criminal justice...
-
Case Manager
4 weeks ago
Long Beach, United States Project 180 Full timeJob DescriptionJob DescriptionThe OrganizationSSG-Project 180 turns lives around through innovative, wraparound services that keep people out of institutions and in their communities. Project 180 is a leader in the forensic treatment space, offering high-quality, specialized treatment programs that serve thousands of justice-involved individuals. Our...
-
Case Manager
2 weeks ago
Long Beach, United States PROJECT 180 INC Full timeThe Organization SSG-Project 180 turns lives around through innovative, wraparound services that keep people out of institutions and in their communities. Project 180 is a leader in the forensic treatment space, offering high-quality, specialized treatment programs that serve thousands of justice-involved individuals. Our programs span criminal justice...
-
Case Manager Ii
4 weeks ago
Long Beach, United States TEEMA Group Full time**Case Manager** case management services to clients, including assessment, planning, coordination, monitoring, and evaluation of services. **Responsibilities**: - Provide case management services to clients, including assessment, planning, coordination, monitoring, and evaluation of services. - Develop and implement individualized service plans for...
-
Case Manager I
4 weeks ago
Long Beach, United States Tarzana Treatment Center Full timeJob DescriptionJob DescriptionPosition Title: Case Manager IDepartment: Community Supports- Housing Transition and NavigationReports To: As assigned by Program Senior Supervisor/DirectorPOSITION SUMMARYProvides case management services to members assigned to individual caseload. As a Housing Case Manager, Case Managers are expected provide high quality case...
-
Case Manager | Housing
6 days ago
Long Beach, United States April Parker Foundation Full timePosition Summary The Case Manager (CM) will identify, screen, and assist individuals and families with accessing culturally affirming social support services. This person will work in collaboration with the Outreach Team and community partners to conduct compassionate outreach to hard-to-reach BIPOC residents who may be experiencing multiple barriers to care...
-
Field Case Manager, LTSS
5 days ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONJob Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients...
-
Long Beach, United States Molina Healthcare Full timeJob Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired...
-
Telephonic Case Manager
4 days ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONWe are seeking a (RN) Registered Nurse who lives in Nebraska and is licensed there. Case Manager will work in remote setting supporting our Medicaid Population providing telephonic support to our members, completing assessments and creating care plans., You will participate in interdisciplinary care team meetings for our members...
-
Case Manager
4 weeks ago
Long Beach, United States Molina Healthcare Full timeJob Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired...
-
Telephonic Case Manager
6 days ago
Long Beach, United States Molina Healthcare Full timeJob DescriptionJOB DESCRIPTIONWe are seeking a (RN) Registered Nurse who lives in Nebraska and/or Iowa and must be licensed for the state they reside. Case Manager will work in remote setting supporting our Medicaid Population providing telephonic support to our members, completing assessments and creating care plans., You will participate in...
-
Long Beach, United States Lutheran Social Services of Southern California Full timeDescription: - Lutheran Social Services of Southern California began in December 1944 when a group of Lutheran congregations in San Diego came together to discuss how to better assist families in need. They began discussing how to form a Welfare Commission. Their vision expanded when they came together with another group of Lutheran congregations in Los...
-
Long Beach, United States Mental Health America of Los Angeles Full timeMental Health America of Los Angeles (MHALA) has been a pioneer in mental health service, advocacy, innovation, and training for nearly a century, working to ensure that people with mental health needs achieve meaningful, healthy lives in their communities. MHALA is among the largest and most comprehensive nonprofit mental health agencies in Los Angeles...
-
Case Manager for Veteran Housing and Benefits
4 weeks ago
Long Beach, United States Mental Health America of Los Angeles Full timeJob DescriptionJob DescriptionMental Health America of Los Angeles (MHALA) has been a pioneer in mental health service, advocacy, innovation, and training for nearly a century, working to ensure that people with mental health needs achieve meaningful, healthy lives in their communities. MHALA is among the largest and most comprehensive nonprofit mental...
-
Hospice Registered Nurse Case Manager
7 days ago
Long Beach, United States Mission Healthcare Full timeABOUT THE JOB Service Line: Hospice Job Title/Position: Registered Nurse Case Manager Reports To: Clinical Manager/DPCS Territory: Long Beach/Torrance Area Position Objective The registered nurse plans, organizes and directs hospice care and is experienced in nursing, with emphasis on community health education/experience. The professional nurse builds from...
-
Long Beach, United States MHALA Full timeMental Health America of Los Angeles (MHA) is dedicated to promoting mental health recovery and wellness. Our purpose is to help everyone reach healthy lives – whether the need is recovery from mental illness or is occasional and caused by everyday life. Our message is simple – good mental health is fundamental to the health and well-being of everyone in...
-
Case Manager
24 hours ago
Long Island City, United States Queens Public Library Full time**DUTIES AND RESPONSIBILITIES**: Within the larger scope of formal and informal learning within the Programs & Services Department’s (PSD) Community Learning division, the Adult Learner Program (ALP) Case Manager serves as a member of the Community Learning team reporting to the ALP Site Coordinator. ALP Case Managers provide social services to ALP...
-
Long Beach, United States Mental Health America of Los Angeles Full timeMental Health America of Los Angeles (MHALA) has been a pioneer in mental health service, advocacy, innovation, and training for nearly a century, working to ensure that people with mental health needs achieve meaningful, healthy lives in their communities. MHALA is among the largest and most comprehensive nonprofit mental health agencies in Los Angeles...
