- Identification of members appropriate for case management, based on identification of health-related problems.
- Assessing members' physical and psychosocial needs/barriers.
- Developing the case management care plan.
- Developing and implementing the interventions needed to resolve barriers and coordinate care, allowing members to accomplish their goals with physician guidance and supervision.
- Documenting assessments, care plans, interventions, and all other activity related to coordinating the care of case-managed members.
- Maintain client privacy, safety, confidentiality, and advocacy while adhering to ethical, legal, regulatory and accreditation standards.
- Maintain department procedure/policy standards with regard to turnaround time, etc.
- Support the interdisciplinary team approach to ensure effective resource utilization, as well as quality and cost-effective outcomes.
- Coordinate internal and external resources for the individual member.
- Maintain and update a community resource database.
- Document all case management activities in the HPMG case management online system.
- Utilize existing reports and systems to identify and monitor utilization resource patterns and facilitate needed care coordination in order to support Quality Improvement.
- Refer to various departments for supportive interventions, i.e., Health Education, Quality Management, Contracting, Provider Services, Client Data Management, TPL, COB, etc.
- Issue letters of explanation in accordance with department policy.
- Support Medical Management Team, Authorization Review, Clinical Initiatives, and Provider Education.
- Attend and participate in in service programs and conferences that support practice of case management.
- Perform other duties as assigned.
- Minimum 3 - 5 years of experience required
- Minimum three years clinical nursing experience in an area such as medical surgical, critical care, home health or skilled nursing, and;
- Two years of experience in case management, utilization management, discharge planning and or quality improvement in a managed care setting
- Experience with managed care delivery including IPA networks and Medicare.
- Optimum organizational skills with ability to meet both expected and unexpected time frames.
- Excellent verbal and written communication skills.
- Ability to coordinate effectively with a variety of customers including members, providers, office staff, health plans, internal department, community resources, and peers.
- Ability to work independently with self-initiative and discipline.
- Knowledge of ICD-10 and or CPT coding.
- Working knowledge of personal computers.
- A.S. degree
- Unrestricted California Registered Nurse licensure; certification in case management preferred.
-
Case Manager
1 week ago
Leaders in Community Alternatives, Inc. Sacramento, United States**Case Manager**: · - **Sacramento Adult Day Reporting Center** · Leaders in Community Alternatives, Inc. (LCA) is a community -based criminal justice organization which has been providing services in California since 1991. LCA operates several Adult Day Reporting Centers (DRC's) ...
-
Case Manager
1 week ago
ISYS SOLUTIONS INC Sacramento, United States**RN, Case Manager** **( Field based position servicing Sacramento and surrounding areas)** · **RESPONSIBILITIES**: · Feel the Value of Excellence by providing quality medical case management for injured workers, coordinating appropriate care, making recommendations, and professi ...
-
Case Manager
1 week ago
AcademySTAY Sacramento, United StatesAcademySTAY · Position: Student Services Case Manager · Reports to: CEO · Location: Sacramento, CA · Job Status: Non-exempt, Full Time, $55,000-$65,000 DOE · Description: · AcademySTAY is committed to providing a nurturing environment for our staff, empowering them to consistentl ...
-
Case Manager
3 weeks ago
Sierra Vista Hospital Sacramento, United States Part time**Responsibilities**: · Sierra Vista Hospital is seeking Case Managers for our inpatient hospital. If you're passionate about working in the behavioral health setting and have the desire to work with a team of healthcare professionals dedicated to serving our patients, we want to ...
-
Case Manager
2 weeks ago
Downtown Streets Team West Sacramento, United States**COME CREATE IMPACT WITH US** · Downtown Streets Team (DST) is looking for a passionate and outgoing Case Manager at the Rodeway Motel Emergency Shelter site who is ready to help us end homelessness through the dignity of work and the power of community. We run two proven progra ...
-
Case Manager
1 week ago
AcademySTAY Sacramento, United StatesPay: $55, $65,000.00 per year · **Benefits**: · - Dental insurance · - Employee assistance program · - Paid time off · - Vision insurance · Patient demographics: · - Adults · Schedule: · - 8 hour shift · People with a criminal record are encouraged to apply · Ability to Relocate: ...
-
Case Manager
1 week ago
Akua Behavioral Health Sacramento, United States**_ · We want leaders who would like to be a part of a network of treatment centers with integrity. This position will have major opportunities for growth with a company leading the treatment industry in clinical effectiveness. · **_ · Applicants must have a current CADC credenti ...
-
Case Manager
3 days ago
Sutter Health Sacramento, United States**Organization**: · SCAH-Sutter Care at Home - Valley · **Position Overview**: · An experienced RN who is responsible for the overall management of patients, including the provision of direct care with a designated visit productivity standard. This position plans, organizes, and ...
-
Outreach Case Manager
2 weeks ago
Downtown Streets Team West Sacramento, United States**COME CREATE IMPACT WITH US** · Downtown Streets Team (DST) is looking for a passionate and outgoing Outreach Case Manager based at the Rodeway Motel Emergency Shelter site who is ready to help us end homelessness through the dignity of work and the power of community. We run tw ...
-
Case Manager Rn
19 hours ago
UC Davis Health Sacramento, United States**Job Summary** · The purpose of the Clinical Case Manager is to support the interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing tim ...
-
Homeless Outreach Case Manager
1 week ago
Hope Cooperative (aka TLCS, Inc.) Sacramento, United StatesAre you a motivated individual with a passion for supporting others and making a difference in the community? Hope Cooperative is a nonprofit that moves people from a life of instability by providing permanent supportive housing, mental health services, substance-use rehabilitati ...
-
Mental Health Case Manager
1 week ago
Hope Cooperative (aka TLCS, Inc.) Sacramento, United StatesAre you a motivated individual with a passion for supporting others and making a difference in the community? Hope Cooperative is a highly respected, award-winning nonprofit provider of a full array of mental health and supportive housing services in Sacramento and Yolo Counties, ...
-
Hospice RN Case Manager
2 days ago
Home Health Care, Inc. Golden Valley, United StatesJob Title: Hospice RN Case Manager · Location: Twin Cities Metro · Join our compassionate team as a Hospice RN Case Manager, where you'll play a pivotal role in guiding patients and their families through the end-of-life journey with comfort, dignity, and personalized care. · If ...
-
Rn Hospice Case Manager
3 days ago
Advanced Home Health and Hospice Sacramento, United StatesAre you looking for a rewarding career opportunity? Want to provide support to both your patients and their families during end of life care? Advanced Hospice has an opportunity for a Registered Nurse Case Manager to be part of our close knit team to support our hospice organizat ...
-
Alcohol and Drug Counselor and Case Manager
1 week ago
FRANCINE FARRELL AND ASSOCIATES PC Sacramento, United States**Benefits**: · - 401(k) matching · **The Job**: · This job involves becoming part of a team and helping professionals in recovery from substance use disorders. We are looking for a very professional individual who will be at ease interacting with other professionals in recovery. ...
-
Registered Nurse Hospice Case Manager
4 days ago
Advanced Hospice Sacramento, United States**Don't miss this opportunity to work for a 4.5 Star Rated agency** · **IN OFFICE ROLE"** · **JOB DESCRIPTION SUMMARY** · The Clinical Manager is responsible for the planning, coordination, and management of all financial, and clinical operation activities and programs for their ...
-
Avid Healthcare Services Sacramento, United States**Overview**: · Avid Healthcare Services is hiring Registered Nurse (RN's) to work at Sacramento Corrections in the office as an Administrator in Northern California. You will be responsible for case management and/or referrals for the county. This position is from 8:00 AM-5:00 P ...
-
Avid Health Services Sacramento, United StatesDepartment: · - County Staffing · - Location: · - Sacramento, CA, USA · - Pay Rate: · - $47 - $51 per hour · - Pay Type: · - per hour · - Benefits: · - None · - Employment Type: · - Per Diem · **Overview**: · Avid Healthcare Services is hiring Registered Nurse (RN's) to work at S ...
-
Case Manager
3 weeks ago
Hill Physicians Medical Group Sacramento, United StatesWe're delighted you're considering joining usAt Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.Join Our TeamHill Physicians has ...
-
Case Manager
2 weeks ago
Salvation Army Sacramento, United StatesBASIC PURPOSEThe purpose of this position is to assist clients of the Transitional Living Program in their efforts to prepare for and to access affordable housing. It is also to assist client with job search skills, job placement and achieve a level of self-sufficiency to stay in ...
Case Manager - Sacramento, United States - Hill Physicians Medical Group
Description
We're delighted you're considering joining usAt Hill Physicians Medical Group, we're shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.
Join Our Team
Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the "Best Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction.
DE&I Statement:
At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are.
We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right
Job Description:
Responsible for carrying out case management activities for IPA members referred to the case management program across all levels of care. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet the client's health and human service needs. It is characterized by advocacy, communication and resource management and promotes quality and cost-effective interventions and outcomes. Case management activities are based on nationally recognized case management standards and concepts and principles. All contacts are telephonic with an option for on-site case conferences as needed.
Job Responsibilities
Hill Physicians is an Equal Opportunity Employer
Salary
$84, $118,000.00
