Case Manager
hace 2 días
**Who we are**:
**About the position**:
Are you a healthcare professional passionate about patient well-being and skilled in case management? This opportunity is for you As a **Case Manager**, you will play a key role in ensuring our members receive the best possible care through efficient and compassionate case management.
**Responsibilities**:
- Assess and manage member cases to ensure comprehensive and personalized care.
- Develop individualized care plans tailored to each patient's medical, physical, and psychosocial needs.
- Coordinate follow-ups and continuity of care between hospitals, home care, and other healthcare services.
- Identify and address barriers to treatment adherence.
- Educate and guide patients and caregivers on chronic disease management and health prevention.
- Ensure proper medication reconciliation and coordinate post-hospital discharge care.
- Collaborate with an interdisciplinary team to provide the highest quality of care.
- Provide telephonic support to members and be available for on-call rotations as needed.
- Participate in audits, meetings, and training sessions to continuously improve service quality.
- Maintain confidentiality and protect members’ right to privacy.
**Required skills and qualifications**:
- ** Current and active nursing license (LVN/RN) or a related healthcare certification in Ca**lifornia**.**:
- Experience in case management, healthcare coordination, or managed care settings (IPA, MSO, health plans).
- Strong analytical, critical thinking, and communication skills.
- Excellent written and verbal communication, with the ability to explain medical information clearly.
- Organizational and multitasking abilities, with great decision-making skills.
- Ability to work autonomously while being an active team player.
- High level of discretion and professionalism when handling sensitive information.
- ** Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).**:
- Knowledge of **ICE, DHS, DMHC, NCQA, and CMS standards** is a plus.
- Previous experience in **Case Management (BCM, CCM, SNP, ECM)** is highly valued.
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