Case Manager III

Job Title: Case Manager III
Job Location: San Diego, CA (Remote + Field Visit)
Job Duration: 3+ Months+ (Possibilities of Extension).
 
Shift: Monday through Friday, 8:30AM to 5:30PM PST
 
Pay rate: $47.27/Hour. on W2
  
Job Description:

• RN Case Manager in San Diego County - must live in CA (San Diego area)
• This position will be remote, but there may be times the Case Manager may need to work in the office or make visits to see members in-person. It’s very minimal at this time, but could happen.

 
Day-to-day job duties: CMs will need to outreach to members assigned to them, complete various assessments, create individualized care plans, assist members with community resources/linkages.
 
Top Skills Required: Strong computer skills as this job requires being able to navigate different systems; organization as there is a lot of work and very independent; health literacy – as this position is for a CM so they will need to be able to assess/understand different physical and mental health diagnoses/symptoms and educate members
 
Required Years of Experience:

• Prefer 3, but open to someone with less years, depending on what work they have been doing

 
Summary:

• Responsible for health care management and coordination of Client's members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care.
• Coordinates and monitors Client members progress and services to ensure consistent cost effective care that complies with Client policy and all state and federal regulations and guidelines.

 
Essential Functions:

• Provides case management services to members with chronic or complex conditions including: Proactively identifies members that may qualify for potential case management services.
• Conducts assessment of member needs by collecting in-depth information from Clients information system, the member, members family/caregiver, hospital staff, physicians and other providers.
• Identifies, assesses and manages members per established criteria. Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Documents care plan progress in Clients information system.
• Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes. Measures the effectiveness of interventions to determine case management outcomes. Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for Client members.
• Conducts face to face or home visits as required. Maintains department productivity and quality measures.
• Manages and completes assigned work plan objectives and projects in a timely manner. Demonstrates dependability and reliability.
• Maintains effective team member relations.
• Adheres to all documentation guidelines. Attends regular staff meetings. Participates in Interdisciplinary Care Team (ICT) meetings.
• Assists orientation and mentoring of new team members as appropriate. Maintains professional relationships with provider community and internal and external customers. Conducts self in a professional manner at all times.

 
Required Experience:

• 3 years of clinical experience with case management experience.

 
Required Licensure/Certification:

• Active, unrestricted State Registered Nursing license in good standing.

 
Feel free to forward my email to your friends/colleagues who might be available. We do offer a referral bonus! Thank you for your time and consideration.
I am looking forward to hearing from you.