ALL’s WELL Health Care Services
OUTREACH CASE MANAGER - (LVN or RN) $31-$39/hourly
Job Description: Well established medical group who provides medical services to over 80,000 subscribers throughout the greater Los Angeles and Orange Counties areas are looking for an OUTREACH CASE MANAGER - (LVN or RN) to take on a Temporary/Ongoing Temporary assignment in Cypress, CA. Position Summary: The Outreach Program Case Manager will be assigned to patients who require special coordination due to the complexity of their illness, psychosocial circumstances, or a pattern of frequent utilization of the acute hospital and other services as well as another other barriers that might hinder the member from achieving health goals or quality of health services. The Outreach Case Manager will coordinate the ambulatory care needs of those members requiring increased resources and support secondary to the complexity of their condition and or social circumstance, providing resources through the members Health Plan and available community and government programs where indicated. The Outreach Case Manager will perform an initial assessment and care-plan with member centric goals and interventions and will maintain frequent telephone contact with the patient along the continuum of care. Qualifications ? California RN MINIUNAM 2 YEARS of EXPEREINCE as a case management, utilization management and or discharge planning experience in an IPA, Medical Group, Hospital or Health Plan environment. ? California LVN License with MINUINAM 3 YEARS of EXPREINCE in managed care and or acute care hospital setting, IPA, Medical Group or Health Plan environment. ? Knowledge of Miliman, Interqual, Medicare, Medi-Cal, NCQA guidelines. ? Home Health or Hospice experience preferred. ? California driver license. ? Computer literate. ? Outreach background highly preferred. ? Bilingual Spanish Desired, but NOT mandatory. Duties: ? Initiate a case management screening assessment, reviewing claims history, encounter history, chronic conditions etc. ? Develop an initial intake & care plan based on screening and or referral to Case Management. ? Schedule and conduct an initial assessment to include: medical history, medications, DME, support systems, barriers to compliant behaviors, educational needs, and significant impairments of ADL's, behavioral and or social barriers, cognitive barriers. ? Develops an evidence based plan of care that is member centric and based on risk and acuity. ? Implement plan of care, document all patient encounters and contacts made on behalf of the patient in the case management system. ? Communicate and coordinate care with ancillary providers, PCP, Specialists, or other involved members of the healthcare delivery team. ? Identify patients that meet criteria for extended benefits or programs offered by the Health Plan or other programs such as State or Federal programs and refer as appropriate. ? Identify and enroll members in Health Plan disease management programs as appropriate. ? Collaborate with the hospital, SNF, IPA & Health plan while coordinating care. ? Manage and coordinate care for high risk patient's discharged from skilled nursing. ? Prepare reports and maintain records on each member. ? May perform related duties or fill in for others in the department as assigned. Contact: Jason Pondexter We are an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability. You can view all of our jobs online at ~~~ Job Experience: ,
ALL’s WELL Health Care Services
Website : http://www.allswell.net/
ALL’s WELL Health Care Services is a privately held, diversified service organization comprised of a cohesive team of innovative people dedicated to providing the highest quality healthcare staffing services with the greatest value.