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Case Manager
4 days ago
St. Joseph Center Los Angeles, United States Full timeCompany Description · Background · Since 1976, St. Joseph Center has been meeting the needs of low-income and homeless individuals and families in Venice, Santa Monica, Mar Vista, and surrounding communities. The Center is a 501(c)(3) nonprofit community organization that assist ...
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Case Manager
5 days ago
AGG Legal Staffing Los Angeles, United StatesJob description · Are you an experienced Case Manager, able to handle a Pre-litigation file from A-Z with little to no supervision? Do you believe passionately in stellar customer service and going "above and beyond" for your clients? Do you thrive in an environment where you get ...
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Case Management
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Blue Shield of California Los Angeles, United States Full timeYour Role · The Federal Employee Program (FEP) team performs integrated case management (CM) and disease management (DM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care including clinical nurse ...
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Case Manager
2 weeks ago
Kent Daniels and Associates, Inc. Los Angeles, United States Direct Hire· Position: Case Manager · Location: Century City, CA (Onsite) · Experience: At least five (5) years of experience · Type: Full-time; Direct Hire or Temp to Hire · Schedule: M-F 8am - 5pm or 9am - 6pm · Pay: $72-80k/yr depending on experience · Kent Daniels & Associates is seeki ...
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Case Manager
2 days ago
Gpac Los Angeles, United States Full timeOne of our clients is seeking a experienced Case Manager to work in their Pre-Litigation Personal Injury plaintiff's firm. If you are compassionate and detail oriented and enjoy being the point of contact for clients, this may be an opportunity for you. This is a very team orient ...
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Case Manager
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Dayan | Houman - The Accident Guys Los Angeles, United StatesThe Accident Guys are currently hiring multiple Case Managers to join our Personal Injury department in the Mid-Wilshire Area No experience necessary but Personal Injury knowledge preferred, as we prefer to train all of our staff to make sure our clients are getting the best serv ...
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Case Manager
1 week ago
Kent Daniels and Associates, Inc. Los Angeles, United States Direct HirePosition: Case Manager · Location: Century City, CA (Onsite) · Pay: $72,000 to 80,000 annually · Experience: At least 5 years of experience. · Type: Full-time; Direct Hire or Temp to Hire · Schedule: Monday - Friday, 8:00am - 5:00pm or 9:00am - 6:00pm · Kent Daniels & Associates ...
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Case Manager
3 weeks ago
The People Concern Los Angeles, United StatesCase Manager · Los Angeles, CA 90037, USA ● Los Angeles, CA, USA Req #11052 Tuesday, April 30, 2024 TITLE: Case Manager · DEPARTMENT: Permanent Supportive Housing · LOCATION: King 1101 Apartments, 1101 Martin Luther King Jr. Blvd, LA, CA 90037 · REPORTS TO: Program Manager · S ...
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Case Manager
3 weeks ago
Gpac Los Angeles, United States Part timeOne of our clients is seeking a experienced Case Manager to work in their Pre-Litigation Personal Injury plaintiff's firm. If you are compassionate and detail oriented and enjoy being the point of contact for clients, this may be an opportunity for you. This is a very team orient ...
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Case Manager
2 weeks ago
Downtown Women's Center Los Angeles, United StatesSummary · The Downtown Women's Center seeks a full-time Case Manager to provide outreach, housing placement, and individualized case management services to individual women and women with children who are homeless due to domestic violence. The Case Manager will be integral in d ...
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Case Manager
3 weeks ago
Amity Foundation Los Angeles, United States Full timeAmity Foundation , internationally acclaimed teaching, and therapeutic community is seeking compassionate and enthusiastic individuals with a desire to teach, learn and join our community as a Case Manager (Advocate) this groundbreaking opportunity not only will allow you to wor ...
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Case Manager
3 weeks ago
Kindred Los Angeles, United StatesRegistered Nurse Case Manager: · Job Summary · Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and en ...
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Case Manager
6 days ago
Gpac Los Angeles, United States Full timeOne of our clients is seeking a experienced Case Manager to work in their Pre-Litigation Personal Injury plaintiff's firm. If you are compassionate and detail oriented and enjoy being the point of contact for clients, this may be an opportunity for you. This is a very team orient ...
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Case Manager
4 days ago
Downtown Women's Center Los Angeles, United States· Summary · Contribute directly to breaking the cycle of homelessness for women through comprehensive supportive services offered at DWC's drop-in Day Center and in the community The Case Manager - Day Center delivers services with a trauma-informed approach and is a patient s ...
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Case Manager
3 weeks ago
Medix™ Los Angeles, United StatesMedix is looking to hire a Case Manager to join a well-established non-profit Mental Health Center in Los Angeles, CA 90004 for a 6 month assignment. · Responsibilities · :Overseeing a caseload of up to 17 clients with a wide spectrum of mental health illnesses · .Assist clients ...
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Case Manager
2 weeks ago
State Trustees Limited Los Angeles, United StatesRole · Internally known as a Specialised Support Consultant, you will develop a comprehensive understanding of your client's complex needs, enabling you to deliver quality service and support, whilst managing their financial a legal affair in line with the Guardian and Administr ...
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Case Manager
3 weeks ago
State Trustees Limited Los Angeles, United StatesRole · Internally known as a Specialised Support Consultant, you will develop a comprehensive understanding of your client's complex needs, enabling you to deliver quality service and support, whilst managing their financial and legal affairs in line with the Guardian and Admini ...
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Case Manager
3 weeks ago
Ultimate Staffing Los Angeles, United Statesresponsible for assisting individuals or families in need by connecting them with resources, services, and support systems. · Conducting thorough assessments of clients' needs, including their financial, emotional, and social circumstances. This could involve interviews, surveys, ...
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Case Manager
2 weeks ago
Special Service for Groups, Inc- HOPICS Los Angeles, United StatesJob Description · Job DescriptionSpecial for Service Groups Inc · Job Announcement · _____________________________________________________________________________ · Title: Case Manager Division: HOPICS (IH) · FLSA: Non-Exempt, Full time · 8:30am-5:00pm Supervisor: Kevin Woods · ...
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Case Manager
3 weeks ago
San Pedro Convalescent Home Los Angeles, United StatesJob Description · Job Description · Position Summary: · The LVN Case Manager is responsible for the coordination of the patient's care and services. Promotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of ...
In Patient Nurse Case Manager - Los Angeles, United States - MedPOINT Management
Description
Job Description
Job DescriptionMedPOINT Management
Title: Inpatient Nurse - Delegated Plans =====================================================================================
MedPOINT, a large MSO in the San Fernando Valley offers competitive salaries and benefits in a collaborative working environment. For immediate consideration of this position, please e-mail your resume and salary requirements to
Duties and Responsibilities for Delegated Plans:
1. Facilitates patient's transfer to capped hospital when admitted to an out of network or out of capped facility and needs continued hospitalization. The nurse follows the Out of Network Transfer Protocol below:
a. The nurse calls the assigned hospitalist where the patient is to be transferred to and lets him/her know that the current attending physician will be calling to discuss continuation of care or vice-versa.
b. The nurse calls the capitated hospital to check if bed is available, provides patient's demographic information and faxes a face-sheet or pertinent records to the hospital if requested.
c. The nurse checks if MD-to-MD has occurred and once confirmed that the hospitalist has accepted the patient's transfer and if bed is available, the nurse generates a tracking number for the ambulance.
d. The nurse calls the facility where the patient is being transferred from in order to give the room number assigned for the patient, the phone number for the nurse's station where the releasing hospital has to call for report and gives the authorization generated for the ambulance.
2. Facilitates Emergency Room (ER) transfers when patients require admission. The nurse assesses and verifies if the patient is stable for transfer to capped hospital, if stable will proceed to Step 1a. If unstable or no bed is available, the nurse gives authorization to admit the patient
3. Documents the specific reason/s why patient is not repatriated back into network or capped facility.
4. Verifies if the attending physician assigned on the case is the correct hospitalist. If assigned attending is not the correct hospitalist, the nurse switches the providers by calling the contracted hospitalist on the case, once accepted, the nurse informs the attending provider that IPA contracted hospitalist will be taking over the case. The nurse e-mails Provider Relations Department of the incorrect attending physician assignment for hospital ER and admitting staff education to ensure correct Hospitalist assignment on future admissions.
5. Coordinates transfers of patients to tertiary facilities for higher level of care.
6. Calls the hospital UR Department to request initial reviews, concurrent reviews and discharge planning for IPA members.
7. Documents clinical reviews in the EZ-cap system.
8. Assigns the appropriate Level of Care (LOC) and approves the authorization if deemed medically necessary using MCG or Inter-Qual (CareEnhance Review Manager Enterprise) guidelines.
9. Identifies unnecessary or aberrant days and forwards the information to the Medical Director and Inpatient UM Manager for final review and determination of potential denial of days.
10. Forwards the case to the Notice of Action (NOA) Coordinator for denial or modification letter generation if final determination is to DENY or modify continued stay. The nurse ensures that the case is closed accurately and documents on Memo Line #2 of EZ cap the number of approved and denied days i.e. Approved 2 days, denied 2 days.
11. Facilitates discharge planning to home, skilled nursing facility, hospice care, etc. Documents discharge disposition on the date of patient's discharge.
12. Provides authorization for discharge needs i.e. home health care PT, OT, skilled nursing visits, Home infusion, Self-injectable drugs, DME, medical supplies, etc.
13. Reviews and documents clinical reviews of SNF patients at least weekly.
14. Forwards to Disenrollment Coordinator information of SNF patient who is admitted to long-term care and has resided in a nursing facility beyond 30 days. After the month of admission to facilitate disenrollment of member from Managed Care Medi-Cal back to Fee for Service Medi-Cal.
15. Provides authorization for inter-facility ambulance transfers.
16. Attends the daily inpatient meeting to go over daily bed day reports.
17. Reviews and maintains bed day logs weekly and monthly to ensure that Status 7 or pending/open cases are closed timely.
18. Refers potential re-admissions to Outpatient High Risk Case Management for follow-up post discharge.
19. Refers any potential quality of care issues (PQI) identified to the QI Department for review of QI cases.