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Care Manager I (RN)
 Spectraforce Technologies | |
 United States, California, Los Angeles | |
 April 19, 2024 | |
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Clinical - Care Manager I (RN) Remote Duration: 2 months Must have CA RN licensure. Can live anywhere in the US but must work West Coast hours. 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 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. *Pediatrics - birth to 21 *Work-from-home case management role Note: The Company is committed to complying with the California Privacy Rights Act ("CPRA") effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our . Applicants with disabilities may access this notice in an alternative format by contacting . | |