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Demonstrates expertise in analyzing care management data and managing departmental quality assurance and performance improvement activities, as well as effectively participating in interdepartmental and Medical Center wide teams. | Monitors care managers’ involvement in the development of plans of care that are continuum-based; maintaining strong working relationships with other transitional levels of care within the community and surrounding areas. Redwood City, CA24 days ago Ability to provide leadership, influence others to meet patient needs and achieve shared goals, to effectively prioritize system resources to provide quality and valued patient care, promote cooperative behaviors, act as a role model, resource and mentor. Assistant Patient Care Managers differ from Patient Care Managers in that the latter are unit managers with total responsibility and accountability for one or more patient care units or services. Redwood City, CA24 days ago Stanford Nursing offers a wide array of career advancement opportunities, access to the latest technologies and health care innovations, and boasts a workplace culture that encourages personal growth and work-life balance, while honoring its commitment to delivering evidence-based and patient-centered care. ANCC Magnet Designation: The American Nurses Credentialing Center (ANCC) Magnet Model provides a framework for clinical, operational, and leadership practice, serving as a roadmap for Stanford Nursing''s ongoing pursuit toward nursing excellence. REDWOOD CITY, CA12 days ago li>Ability to provide leadership, influence others to meet patient needs and achieve shared goals, to effectively prioritize system resources to provide quality and valued patient care, promote cooperative behaviors, act as a role model, resource and mentor. Assistant Patient Care Managers differ from Patient Care Managers in that the latter are unit managers with total responsibility and accountability for one or more patient care units or services. Dublin, California30+ days ago This role is pivotal in mentoring Care Managers, monitoring caseload performance, and fostering strong collaboration across teams and community partners. The Senior Care Manager provides leadership and supervision to a team of Care Managers, each responsible for a portfolio of approximately 50 clients. San Leandro, CA30+ days ago The clinic care manager will also be the nurse case manager for an assigned panel of participants, responsible for comprehensive nursing assessment, care planning and effectuation, care coordination across settings (PACE center, home, contracted providers, hospital/SNF), and proactive management of chronic conditions to support participant safety, independence, and quality of life. To address these gaps, we've found a solution and model of care that integrates the quality care our elders receive at our health center with the most comprehensive support system, like transportation, culturally-inclusive meals, and social activities, our elders deserve. San Francisco, CA30+ days ago em> Valid Compact RN License Valid California RN license Valid Illinois RN license (or ability to obtain) Strong background with high risk Obstetrics To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Essential Job Duties Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. San Francisco, CA18 days ago p>. California pay range $100,000—$105,000 USD San Francisco, CA30+ days ago The Lead Care Manager (LCM) at the ECM program will maintain a caseload of members served under the Managed Care Plan (MCP) providing care by linking the client with appropriate services to address specific needs such as: health benefits, mental health, substance use disorder, physical health, employment, family and children services, Justice-Involved concerns, housing, community resources, outpatient substance use disorder services, and aftercare. A key feature of CalAIM is the statewide introduction of an Enhanced Care Management (ECM) benefit and a menu of Community Supports, which, at the option of a Managed Care Plan (MCP), publicly funded health insurance plans for low-income citizens, can address the clinical and non-clinical needs of Populations of Focus with the most complex medical and social needs. Redwood City, CA24 days ago Ability to provide leadership, influence others to meet patient needs and achieve shared goals, to effectively prioritize system resources to provide quality and valued patient care, promote cooperative behaviors, act as a role model, resource and mentor. Participates in unit goal and program planning, development, and evaluation of programs and special projects as assigned; participates in and supports continuous quality, process, and performance improvement and risk management programs at the unit(s) level. Drives services related to the initial case assessment by: interviewing patients and their families to evaluate needs, goals, and current services independently; identifying and proposing process improvements for determining initial eligibility, benefits, and education for all admissions; analyzing and ensuring authorization data (e.g., authorization data regarding admitting/principle diagnoses, bed type(s), and disposition data for accuracy, after visit summary) and correcting and escalating inaccuracies; recommending and designing research plans that identify new and/or existing options to assure that quality, cost-efficient care is provided; and leveraging advanced knowledge to assess medical necessity for hospital admission and required level of care to inform physicians. Supports efforts to remain updated on current research, policies, and procedures by: researching, recommending, and attending pertinent seminars, workshops, and approved educational programs and workshops specific to professional needs; implementing systems, processes, and methods to maintain team knowledge of community resources; monitoring and/or reviewing operational team data and key metrics applied to own work; making suggestions for change or improvement as needed, and helping others to develop ideas as needed; and implementing policy updates to ensure that regulatory requirements are being met. Greenbrae, CA30+ days ago MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being Named One of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parent, among others. Job Description Summary: The Social Work (SW) Case Manager, in collaboration with members of the inter-disciplinary healthcare team, leads the development and implementation of the multidisciplinary plan of care for patients, determining appropriate patient status and level of care; ensuring effective quality and cost-efficient outcomes, and supervising the provision of the discharge plan of care. p>MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being Named One of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parent, among others. EXPERIENCE: Internal Candidates: - Requires at least two years of service at MarinHealth Medical Center as a Licensed Clinical Social Worker (LCSW) I, with progressing leadership qualities, duties, and responsibilities as evidenced by participation in quality improvement projects, committee participation, or other approved professional practice development projects.
MarinHealth is already realizing the benefits of impressive growth and has consistently earned high praise and accolades, including being Named One of the Top 250 Hospitals Nationwide by Healthgrades, receiving a 5-star Ranking for Overall Hospital Quality from the Centers for Medicare and Medicaid Services, and being named the Best Hospital in San Francisco/Marin by Bay Area Parent, among others. Job Description Summary: The Social Work (SW) Case Manager, in collaboration with members of the inter-disciplinary healthcare team, leads the development and implementation of the multidisciplinary plan of care for patients, determining appropriate patient status and level of care; ensuring effective quality and cost-efficient outcomes, and supervising the provision of the discharge plan of care. p>Requsition ID: 435224 Company: Providence Jobs Job Category: Care Management Job Function: Clinical Care Job Schedule: Full time Job Shift: Day Career Track: Leadership Department: 7821 CASE MANAGEMENT PV Address: CA Petaluma 400 N McDowell Blvd Work Location: Petaluma Valley Hospital Workplace Type: On-site Pay Range: $89.73 - $141.64 Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care. San Mateo, California3 days ago Under the direction of the Director of Enhanced Care Management, ECM Clinical Manager and/or ECM Program Manager, the LCM serves as the client’s primary point of contact and works with all their providers such as doctors, specialists, pharmacists, social services providers, and others to make sure everyone is in agreement about the client’s needs and care. Assess member needs in the areas of physical health, mental health, SUD, oral health, palliative care, memory care, trauma-informed care, social supports, housing, and referral and linkage to community-based services and supports .
p>Our work is powered by a deeply collaborative team of nurses, social workers, community health workers, and medical professionals working alongside product, technology, and operations to close care gaps and improve outcomes for high-need patients. Meet members in person at their homes, in the community, or at partner organizations to complete new patient onboardings, deliver care packages, or collect health readings such as blood pressure. San Mateo, California30+ days ago p style="min-height:1.5em">Remote care management duties as described below: Assess member needs in the areas of physical health, mental health, SUD, oral health, palliative care, memory care, trauma-informed care, social supports, housing, and referral and linkage to community-based services and supports. Under the direction of the ECM Clinical Manager, the CLCM serves as the client’s primary point of contact and works with all their providers such as doctors, specialists, pharmacists, social services providers, and others to make sure everyone is in agreement about the client’s needs and care.
san francisco, CA30+ days ago Rather than focusing on archaic outdated design, we strive to consistently question the "status-quo" and create new and more innovative ways to help aging adults and adults with disabilities maintain their quality of life. The PACE Care Manager I provides case management and care coordination support to a panel of assigned participants enrolled in the On Lok Program of All-Inclusive Care for the Elderly (PACE) at IOA. san francisco, CA30+ days ago Rather than focusing on archaic outdated design, we strive to consistently question the "status-quo" and create new and more innovative ways to help aging adults and adults with disabilities maintain their quality of life. The PACE Care Manager I provides case management and care coordination support to a panel of assigned participants enrolled in the On Lok Program of All-Inclusive Care for the Elderly (PACE) at IOA. Walnut Creek, California7 days ago Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. The Nurse Case Manager I will be responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. San Francisco, CA28 days ago li>Alternatively, in lieu of a Masters degree, an employee may qualify for a Care Manager II position with a BA or BS in Social Work or another appropriate major and a minimum of two (2) years of relevant social work experience and the ability to demonstrate autonomous work in conceptualizing and formulating biopsychosocial assessments, identifying care needs and necessary interventions, and then executing effective care interventions. Attends continuing education classes and/or in-service training to increase knowledge, skills and attitudes related to case management, gerontology, family and community systems and other areas relevant to the Community Living Fund client population. SUMMARY: Under the supervision of the Clinical Manager, the AHD Wound Care Center Case Manager (RN) is responsible for providing comprehensive case management services to clients identified with complex wound conditions and assist them with social challenges that are at risk for health status decline. Final compensation will be determined based on several factors, including but not limited to a candidate's experience, education, skills, licensure and certifications, departmental equity, applicable collective bargaining agreements, and the operational needs of the organization. San Francisco, CA11 days ago ul>Individuals transitioning from incarceration/Justice Involved: Adults transitioning from a correctional setting or transitioned from a correction setting within the past 12 months, or children and youth who are transitioning from a youth correctional facility or transitioned from being in a youth correctional facility within the past 12 months. - Adults living in the community and at risk for long-term care institutionalization: Adults who are living in the community who meet the SNF Level of Care criteria; or who require lower-acuity skilled nursing or equipment for prevention, diagnosis, or treatment of acute illness or injury.
San Mateo, California18 days ago p>As part of the pediatric team, the Pediatric NurseCase Manager will provide skilled nursing assessment, planning, and care to maximize the comfort and health of pediatric patients and families in compliance with organization policies and procedures and applicable laws and regulations. Essential Duties & Responsibilities include (but are not limited to): - Assume primary responsibility for pediatric patient/family using the nursing process to assess, plan, implement and evaluate patient/family needs, goals, and interventions.
San Ramon, CA30+ days ago p>The individual’s responsibilities include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs , m) timely complete and concise documentation in Case Management system, n ) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) identification and reporting over and underutilization, q) and other duties as assigned. Required at least two (2) years of recent Case Management acute hospital experience or Masters Degree in Case Management; Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computer literacy. San Francisco, CA12 days ago p>Enhanced Care Management (ECM) is a Medi-Cal managed care benefit that addresses clinical and non-clinical needs of high-need youth and families through the coordination of services and comprehensive care management. This vital role involves close collaboration with an extended ECM team across counties, partnering with managed care plans, and building strong relationships to ensure youth and families receive the services they need to thrive. Fairfield, CA30+ days ago Enhanced Care Management (ECM) is a Medi-Cal managed care benefit that addresses clinical and non-clinical needs of high-need youth and families through the coordination of services and comprehensive care management. This vital role involves close collaboration with an extended ECM team across counties, partnering with managed care plans, and building strong relationships to ensure youth and families receive the services they need to thrive. San Mateo, CA30+ days ago The Care Manager/“Designated Care Manager” is responsible for providing the highest degree of quality care and services to a consistent group of residents and their families in our assisted living/long term care and reminiscence neighborhoods. Understand and practice the proper method of attending to and disposing of, and the possibility of exposure to, blood borne pathogens, bodily fluids, infectious waste, sharp sticks, and hazardous materials. Walnut Creek, CA5 days ago The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the patient's health care needs through hospitalization and transition back to the community and does this in coordination with the interdisciplinary health team. Strong know ledge of geriatrics and the impact to health and function in the aged as w ell as a working know ledge of chronic/progressive disease states such as CHF, COPD, Diabetes and End Stage Renal Disease, etc. Walnut Creek, CA30+ days ago The inpatient case manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the patient's health care needs through hospitalization and transition back to the community and does this in coordination with the interdisciplinary health team. Strong know ledge of geriatrics and the impact to health and function in the aged as w ell as a working know ledge of chronic/progressive disease states such as CHF, COPD, Diabetes and End Stage Renal Disease, etc. Sonoma, California30+ days ago For details on how we handle your information, please review our Privacy Policy: $120,000 - $135,000 a year Wage range Registered Nurse, Level 1: 120, 000.00- Full Time Registered Nurse Case Manager Anticipated Territory: Sonoma What you’ll do as a Registered Nurse (RN) Home Health Case Manager: Utilize your outstanding clinical skills as you create, implement and execute the overall plan of care to promote wellness and prevent re-hospitalization for patients in their homes. San Francisco, CA30+ days ago largely virtual outpatient multidisciplinary care model that we are learning to scale, and this role must be able to thrive working in a fast-paced, often ambiguous, high-patient-touch outpatient environment that includes phone calls, text messages, virtual visits, and community visits with operational elements still being defined. Who we are: Vayu Health is an equity-focused non-profit start-up healthcare company in California, launching an innovative, largely virtual outpatient care model designed for low-income. Oakland, California30+ days ago For details on how we handle your information, please review our Privacy Policy: AMD140,000 - AMD160,000 a year Target Wage range Registered Nurse, Level 1: 140, 000.00- Full Time Registered Nurse Case Manager, Level 2 Anticipated Territory: Oakland Area What you’ll do as a Registered Nurse (RN), Level 2 Home Health Case Manager: Utilize your outstanding clinical skills as you create, implement and execute the overall plan of care to promote wellness and prevent re-hospitalization for patients in their homes. San Francisco, CA30+ days ago Rather than focusing on archaic outdated design, we strive to consistently question the "status-quo" and create new and more innovative ways to help aging adults and adults with disabilities maintain their quality of life. Demonstrated ability to supervise intensive care management staff who work with adults with disabilities at risk of hospitalization, which present with complex medical conditions, mental health diagnoses, substance abuse, as well as physical rehabilitation needs. San Leandro, CA24 days ago Drives services related to the initial case assessment by: interviewing patients and their families to evaluate needs, goals, and current services independently; identifying and proposing process improvements for determining initial eligibility, benefits, and education for all admissions; analyzing and ensuring authorization data (e.g., authorization data regarding admitting/principle diagnoses, bed type(s), and disposition data for accuracy, after visit summary) and correcting and escalating inaccuracies; recommending and designing research plans that identify new and/or existing options to assure that quality, cost-efficient care is provided; and leveraging advanced knowledge to assess medical necessity for hospital admission and required level of care to inform physicians. Supports efforts to remain updated on current research, policies, and procedures by: researching, recommending, and attending pertinent seminars, workshops, and approved educational programs and workshops specific to professional needs; implementing systems, processes, and methods to maintain team knowledge of community resources; monitoring and/or reviewing operational team data and key metrics applied to own work; making suggestions for change or improvement as needed, and helping others to develop ideas as needed; and implementing policy updates to ensure that regulatory requirements are being met. li>Drives services related to the initial case assessment by: interviewing patients and their families to evaluate needs, goals, and current services independently; identifying and proposing process improvements for determining initial eligibility, benefits, and education for all admissions; analyzing and ensuring authorization data (e.g., authorization data regarding admitting/principle diagnoses, bed type(s), and disposition data for accuracy, after visit summary) and correcting and escalating inaccuracies; recommending and designing research plans that identify new and/or existing options to assure that quality, cost-efficient care is provided; and leveraging advanced knowledge to assess medical necessity for hospital admission and required level of care to inform physicians. Supports efforts to remain updated on current research, policies, and procedures by: researching, recommending, and attending pertinent seminars, workshops, and approved educational programs and workshops specific to professional needs; implementing systems, processes, and methods to maintain team knowledge of community resources; monitoring and/or reviewing operational team data and key metrics applied to own work; making suggestions for change or improvement as needed, and helping others to develop ideas as needed; and implementing policy updates to ensure that regulatory requirements are being met. Walnut Creek, CA30+ days ago The Nurse Case Manager ll (California HMO) is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. p>About the team: Our Care Managers are supported by a collaborative multi-disciplinary team committed to a culture of excellence, backed by company leadership that prioritizes work-life balance and lifelong learning. Exercise independent authority to communicate and collaborate with healthcare providers, family members, responsible parties, community resources, and internal care teams to ensure client needs are met. The goal of the Inpatient Care Management MSW is to ensure the continuity of care for vulnerable patients by identifying needed resources to address social, financial, cognitive/behavioral or legal barriers to care access. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Requsition ID: 429404 Company: Providence Jobs Job Category: Care Management Job Function: Clinical Care Job Schedule: Per-Diem Job Shift: Day Career Track: Clinical Professional Department: 7810 UTILIZATION REVIEW Address: CA Napa 1000 Trancas St Work Location: Queen of the Valley Medical Center Workplace Type: On-site Pay Range: $43.26 - $67.18 Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care. San Francisco, California30+ days ago p style="margin:0px">Under supervision of the Program Director, the clinical case manager participates in a multidisciplinary team serving older adults, aged 60 and over, with severe psychiatric disorders and co-occurring disorders, providing comprehensive and integrated treatment services, including mental health and substances abuse treatment, case management, and other service connections. Commits to ongoing training in the geriatric specialization of mental health services, as provided by the Senior Division and Felton Institute.including developing specializations in evidence-based treatments and practices and the geriatric specialization of mental health services, as provided by the Senior Division and Felton Institute. Walnut Creek, CA6 days ago p>The Nurse Case Manager I will be responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. This leadership role is responsible for overseeing care coordination activities, supporting interdisciplinary collaboration, and ensuring patients receive appropriate services across the continuum of care. The position works closely with patients, families, physicians, social workers, payers, community partners, and post-acute providers to ensure comprehensive and coordinated care delivery. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. He/She collaborates with patients, families, physicians, the interdisciplinary team, nursing management, quality, ancillary services, third party payers and review agencies, claims and finance departments, Medical Directors, and contracted providers and community resources. This position works in collaboration with the Physician, Utilization Manager, Medical Social Worker and bedside RN to assure the timely progression and transition of patients to the appropriate level of care to prevent unnecessary admissions or readmissions. Burlingame, CA17 days ago p>Nurse Case Managers act as consultant to the clinical team, service lines, and other departments regarding patient assessment and patient care, and participate in program development and quality improvement initiatives in their role, by applying guidelines and collaborating with multidisciplinary teams, Case Managers influence and direct the delivery and quality of patient care. Nurse Case Managers differ from other roles in professional nursing/health care practice in that they do not provide direct medical care to patients; rather, a Nurse Case Manager will be assigned to specific patients to ensure that the medical services and treatments are accomplished in the most financially and clinically efficient manner. Walnut Creek, CA30+ days ago ul>Responsible for monitoring and evaluating assigned residents and regularly assess levels of care, whenever there is a change in condition and/or to determine whether a resident is no longer appropriate for the setting, notifying Assistant Living Director as required. The Resident Care Manager @ Byron Park directs, coordinates, and supervises care services provided by care associates for the residents within the Assisted Living Department. Alameda, California25 days ago p style="margin:0px">The Adult Protective Case Management Program, under contract with Alameda County Adult Protective Services, provides time-limited case management services with the goal of assisting functionally impaired seniors and adults with disabilities obtain services that promote and maintain optimal functioning, as identified by APS. The Case Manager also participates in a supervisory collaborative and meets regularly with the supervisors and other case managers in Alameda County for case review and consultation, as well as participating in relevant training and collaborative efforts within the agency. |