* Although this is remote - you MUST have experience with CM within California.*
Provide case management services for health plan members with highly complex medical and psychiatric conditions. Work closely with a team comprised of the Complex Case Manager, a Medical Social Worker, and a Health Navigator to collaborate with key departments at the health plan, including Utilization Management and Pharmacy. Externally, team will work closely with community partners to make referrals for care and resources and to best manage members across the care spectrum. The goal of the Complex Case Management program is to improve members' quality of life and assure cost-effective outcomes by utilization all available and appropriate resources.
Top Skills You Should Possess:
- Active/unrestricted Registered Nurse (RN) license in state of California
- Minimum (3) years' experience in clinical case management
- Certified Case Manager (CCM) preferred
- Knowledge of Medi-Cal and Medicare regulations a plus
- Demonstrate ability to critically think, problem solve, and make independent decisions supporting the case management process
What You’ll Be Doing:
- Assessment, planning, facilitation and advocacy through collaboration with the member and other health care resources involved in the member's care
- Work closely with licensed and unlicensed staff to co-manage the care of complex cases telephonically through regular contact with members, caretakers, healthcare professionals and others involved in the member’s care
- The nurse will be responsible for triage and all aspects of the nursing process, including assessing, diagnosing, planning, implementing, and evaluating care
- Develop multi-disciplinary care plans with the input of the member and PCP to address identified member problems using evidence-based goals and interventions
- Participate in the ongoing process of identifying the health plan’s members who are most at-risk of poor health outcomes and in need of care management services
- Communicate with providers, members, and community resources as necessary, to support the planning, implementation and evaluation of care management programs
- Complete other duties and special projects as assigned
What You Need to Bring to the Table:
- Must be able to consistently work Monday-Friday 8:00am to 5:00pm
- Required: Bachelor's Degree in Nursing (BSN) or Master's Degree in Nursing (MSN)
- Computer savvy (including EMR and Microsoft Office products)
- Demonstrate effective oral and written communication skills (communicate effectively with employees, providers, and operational leaders)
- Three years of clinical experience in an acute care setting (desired)
- Excellent organizational and time-management skills
What’s In It For You?
- Remote position with a great work-life balance
- Work at a company that focuses on mission-driven work with real community impact
- Foot in the door at a company with strong name recognition in Bay Area healthcare
- Competitive pay with weekly direct deposit every Friday
KNOW A GREAT HEALTHCARE PRO LOOKING FOR WORK? REFER THEM TODAY!
*Yoh Health Care specializes in occupational/employee health as well as case management, and we place health care professionals on jobs nationwide with well-known corporations. Feel free to reach out to hear about the latest Medical Assistant, Nurse, Nurse Practitioner, and Physician Assistant openings!
Recruiter: Hana Daniels
Phone: 818.307.8541
Estimated Min Rate: $52.93
Estimated Mid Rate: $66.16
Estimated Max Rate: $79.39
What’s In It for You?
We welcome you to be a part of the largest and legendary global staffing companies to meet your career aspirations. Yoh’s network of client companies has been employing professionals like you for over 65 years in the U.S., UK and Canada. Join Yoh’s extensive talent community that will provide you with access to Yoh’s vast network of opportunities and gain access to this exclusive opportunity available to you. Benefit eligibility is in accordance with applicable laws and client requirements. Benefits include:
- Medical, Prescription, Dental & Vision Benefits (for employees working 20+ hours per week)
- Health Savings Account (HSA) (for employees working 20+ hours per week)
- Life & Disability Insurance (for employees working 20+ hours per week)
- MetLife Voluntary Benefits
- Employee Assistance Program (EAP)
- 401K Retirement Savings Plan
- Direct Deposit & weekly epayroll
- Referral Bonus Programs
- Certification and training opportunities
Note: Any pay ranges displayed are estimations. Actual pay is determined by an applicant's experience, technical expertise, and other qualifications as listed in the job description. All qualified applicants are welcome to apply.
Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Visit https://www.yoh.com/applicants-with-disabilities to contact us if you are an individual with a disability and require accommodation in the application process.
For California applicants, qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All of the material job duties described in this posting are job duties for which a criminal history may have a direct, adverse, and negative relationship potentially resulting in the withdrawal of a conditional offer of employment.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
By applying and submitting your resume, you authorize Yoh to review and reformat your resume to meet Yoh’s hiring clients’ preferences. To learn more about Yoh’s privacy practices, please see our Candidate Privacy Notice: https://www.yoh.com/privacy-notice
