Excellent employment opportunity!
About Us:
CareMore is looking for a dynamic individual to join our team!
CareMore is a leading healthcare system specializing in providing a complete, pro-active health care experience to Senior Americans. CareMore strongly believes in our innovative and caring vision to lead the next generation of health care and we look for candidates that share in our passion.
As a leader in senior healthcare for over 20 years, our vision is to significantly improve the lives of Medicare recipients throughout California by employing a dedicated staff of professionals who are passionate about changing lives. When you join CareMore, we’ll give you every opportunity to make a real difference.
Be More with CareMore.
CASE MANAGER
CLICK HERE TO APPLY ONLINE!
Job Description:
The Case Manager collaborates in a patient care process to assess, plan, implement, coordinate, monitor, and evaluate options and services to meet member’s health needs. The goal of the Case Manager is to utilize available resources to provide quality, cost effective care using selective benefits and alternative services best suited for the member while ensuring optimal outcomes.
Responsibilities Include:
• Develops and implements a comprehensive clinical case management plan for each patient.
o Obtains input from all providers, including the Primary Care Physician (PCP), the patient and the family as appropriate.
o The plan is periodically evaluated by RN staff and revised as needed.
• Analyzes patient variances from the plan and initiates the appropriate steps to resolve those variances.
• Performs admission and concurrent stay reviews daily on assigned hospitalized patients.
o Uses established criteria to ensure placement at the appropriate level of care.
• Develops and implements discharge planning for patients in conjunction with Hospitalists and hospital based Case Managers.
o Facilitates the transfer or discharge from the acute care setting to a lower level of care.
o Obtains appropriate “Notice of Non-Coverage.”
• Performs telephonic, fax and/or on-site reviews with skilled nursing facilities, home health agencies or other contracted service agencies as appropriate to determine need for continued care.
• Uses effective negotiation skills to obtain the resources necessary to achieve preferred outcomes.
• Provides communication and leadership to the care team in order to facilitate maximum patient outcome.
• In conjunction with the physician and Case Management Nurse Extender, the Case Manager applies financial information in planning cost-effective care without compromising the quality of patient care.
• Advises the Medical Director promptly of level of care and patient needs.
• Identifies and monitors patients utilizing the following services: SNF, HH, DME, IV Therapy, and communicates information to the Physician.
• Maintains accurate database of patient activity.
• Collects and inputs data to support claims review process.
• Accurately reports bed days, home health hospice, and DME.
• Keeps accurate accounts of all institutionalized patients.
Education and Experience:
• Current Registered Nurse or LVN license in the state for which you are applying.
• Must have at least two years experience in acute hospital care preferably in the discharge planning or medical review areas.
• Utilization Review/Case Management experience in a hospital and/or medical group setting is desirable.
• Knowledge of managed care (HMO, PPO, POS, etc.) is preferred.
Compensation/Benefits:
CareMore offers a comprehensive benefits package to include medical, dental, vision, life, long term disability, flexible spending accounts, 401(k), PTO, and much more.
AA/EOE M/F/D/V
Watch how our CareMore Nurse Practitioners care more, in the video below.
