Care manager
Job Title: Care Manager
Duration: 3 months
Shift: 8:00am to 5:00pm PST, Mon to Fri (Can work at 7am if needing an earlier shift)
Location: Remote, CA
Day To Day Responsibilities
Duration: 3 months
Shift: 8:00am to 5:00pm PST, Mon to Fri (Can work at 7am if needing an earlier shift)
Location: Remote, CA
Day To Day Responsibilities
- Must have a private space/work area due to sensitive information.
- Must be comfortable to be on phones at home.
- Training is about 3-4 weeks and then they will work with Senior Case Managers to start ramping up.
- Experience Working with Medicare/Medi-caid.
- Assisting with Backlog-referrals from CA-members sending referrals to case managers
- Will be Assigned 5-10 referrals daily.
- Ability to work in Fast paced environment.
- Case Management exp required.
- At least 4 hours a day are spent on outbound phone calls reaching out to members.
- Calls are recorded-will have audio audits.
- Data entry-tracking data
- Case load requirement is seventy-five active cases-(will be ramped up to this amt) Cases are 90 days.
- Excel (data entry-basic knowledge)
- True Care medical records system
- Must be able to navigate multiple systems.
- Pharmacy system, eligibility system, Workforce management
- 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 members’ 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.
- 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, 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 members’ 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.
- Graduate from an Accredited School of Nursing. Bachelor’s degree in nursing preferred.
- 2+ years of clinical nursing experience in a clinical, acute care, or community setting.
- Knowledge of healthcare and managed care preferred.
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Seniority level
Mid-Senior level -
Employment type
Full-time -
Job function
Health Care Provider -
Industries
Staffing and Recruiting
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