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- 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
Care Manager I - Los Angeles, United States - Spectraforce Technologies
Description
Care Manager I (CA)
Fully remote-must sit in PST or MT time zones and have CA RN license and work PST hours (8 Am - 5 PM)
Remote- CA
03 months
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.
Responsibilities:
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience in an clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.
Required Skills/Experience:
1.
Experience with Medicare/Medicare required
2.
Case management experience, home health, hospice, clinical
3.
Experience with Geriatrics,
Education Requirement:
Current RN license in CA