Position Title – Care Manager RN
Work Location: Remote PST, but must have CA license
Pay – $40/hr
Start date – ASAP
Hours – 8am-5pm PST
Contract Type – contract to possible hire
Description:
- Working with Medicare/Medicaid
- Assisting with Backlog-referrals from CA-members sending referrals to case managers
- Will be Assigned 5-10 referrals daily.
- Ability to work in a fast-paced environment.
- At least 4 hours a day is spent on outbound phone calls-reaching out to members.
- Calls are recorded-will have audio audits.
- Case load requirement is 75-(will be ramped up to this amt)
- Excel (data entry-basic knowledge)
- True Care medical records system
- Must be able to navigate multiple systems.
- Pharmacy system, eligibility system, Workforce management
Required Skills & Education:
- Experience with Medicaid/Medicare
- 2+ years of telephonic Case management experience
Preferred:
- Psych/Behavioral Healthcare background
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
Responsibilities:
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
#INDMLK
Job Types: Full-time, Contract
Pay: $40.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- Case management: 1 year (Preferred)
License/Certification:
Location:
Work Location: Remote