About this opportunity
Vivo HealthStaff lists this Case Manager (RN) opportunity in encino, California. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Case Manager
The Case Manager is responsible for health care management and coordination, within the scope of licensure, for members with complex and chronic care needs. The Case Manager delivers care to members utilizing the nursing process and effectively interacts with members, care givers, and other interdisciplinary team participants. The Case Manager will assist with closing gaps in care and resolving barriers that prevent members from attaining improved health. The Case Manager will connect with members telephonically.
General Duties/Responsibilities:
Coordinate care by serving as a resource for the member, their family and their physician.
Ensure access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate.
Complete comprehensive assessments within their scope of practice that includes assessing the member's current health status, resource utilization, past and present treatment plan and services.
Collaborates with the member, the PCP and other members of the care team to implement a plan of care.
Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners and specialists on the development of care management treatment plans.
Provide education and self-management support based on the member’s unique learning style.
Assists in problem solving with providers, claims or service issues.
Works closely with delegated or contracted providers, groups or entities to assure effective and efficient care coordination.
Maintains confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy.
Supervisory Responsibilities:
None.
Minimum Requirements:
Minimum Experience:
1-3 years clinical experience, 2 or more years of case management experience; or any combination of education and experience, which would provide an equivalent background.
Health Plan experience preferred
Education/Licensure:
Must have and maintain an active, valid, and unrestricted RN license in the state for which you are applying
Other:
Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs
Extensive knowledge of the management of chronic conditions
Bilingual in Spanish preferred
Excellent verbal and written communications skills
Team player who builds effective working relationships
Ability to work independently
Experience using standardized clinical guidelines required
Strong organizational skills
Ability to operate PC-based software programs including proficiency in Word, Excel and PowerPoint
Worksite address
encino, CA, 91416, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.