div>Job Title: Workers’ Compensation Case Manager - MUST HAVE WORKERS' COMPENSATION EXPERIENCE IN A LAW OFFICE. A growing California-based law firm with offices in Encino, Oakland, Riverside, and Palm Desert is seeking a Workers’ Compensation Case Manager.
Advantis Medical, the #1 rated travel nurse agency, is currently seeking an experienced Case Manager Registered Nurse (RN) for an exciting new travel job in Upland, CA 91786. If you are an experienced Case Manager Registered Nurse (RN) with a passion for providing exceptional patient care, just let us know you’re interested.
Rancho Cucamonga, CA30+ days ago
Serves as Lead Care Manager for members with complex co-occurring conditions, including individuals experiencing homelessness with serious mental illness, justice-involved adults and transition-age youth re-entering the community, individuals with high utilization patterns (frequent ED or inpatient use), pregnant and postpartum individuals with complex needs, and members transitioning from incarceration, hospitals, or institutions. Master of Social Work (MSW) preferred, OR Bachelor's degree in Social Work, Psychology, Nursing, Public Health, or related field with three (3) or more years of progressive case management experience in Medi-Cal managed care, ECM, Community Supports, Health Homes, Whole Person Care, behavioral health, hospital case management, or community-based care coordination.
Skills/Experience REQUIRED: Acute Hospital; Long Term Acute Care/Rehab/Skilled Nursing; Admission Criteria; Care Coordination; Discharge Planning; Utilize InterQual Criteria; Utilize Milliman Guidelines; UR Admission Criteria; UR Appeals and Denials; UR Concurrent Review; UR Continued Stay Reviews; UR Medical Necessity; UR Retrospective Review; UR Utilize InterQual Criteria; UR Utilize Milliman Guidelines; CMS: Centers for Medicare and Medicaid Services; CPT (Current Procedural Terminology) coding and billing; Department of Health; DRG (Diagnosis Related Groups); HEDIS (The Healthcare Effectiveness Data and Information Set) Measures; HIPAA guidelines (Health Insurance Portability and Accountability Act); ICD 10 Coding; NCQA (National Committee for Quality Assurance); OSHA; The Joint Commission/ Core Measure/National Safety Goals . Complex inpatient Case Manager and Utilization Review RN for Cancer Specialty Hospital.
The Substance Use Disorder Counselor will work with individuals, families, and groups to provide therapeutic support and education to those affected by substance misuse in a manner that upholds Unicare Community Health Center's mission to improve the health status and well-being of underserved segments of the population in the communities we serve through the direct provision or coordination of health care, health education, and services The Substance Use Disorder Counselor will help clients understand the nature of substance misuse develop coping strategies, and work toward reducing and/or eliminating use, guided by evidence-based harm reduction strategies. Coordinates and collaborates with Behavioral Health Providers, Primary Care Providers, Behavioral Health Coordinators and MA's, Case Managers, Substance Use Disorder Counselor, Director of Behavioral Health, Chief Medical Officer, MAT team and other Staff to improve health outcomes and to support patient adherence and engagement to this care.
p>Skills/Experience REQUIRED: Acute Hospital; Admission Criteria; Care coordination; Concurrent Review; Determine Medical Necessity per Evidence-Based Guidelines; Discharge Planning; Needs Assessment/ Order DME; Plan of Care; Utilize InterQual Criteria; Admission Criteria; Concurrent Review; Medical Necessity; Utilize InterQual Criteria; CMS: Centers for Medicare and Medicaid Services; HIPAA guidelines (Health Insurance Portability and Accountability Act); The Joint Commission/ Core Measure/National Safety Goals. ATC HEALTHCARE IS CURRENTLY HIRING FOR A REGISTERED NURSE CASE MANAGER TRAVEL ASSIGNMENT FOR A PROMINENT HEALTHCARE FACILITY IN REDLANDS, CA.
It will also include identifying insight of patient population in cooperation with the clinical informatics team and working directly with RN Case Manager, care teams, referral coordinators, community health workers, housing navigators, and clinical social workers, To ensure appropriate care management, as well as care coordination for target populations as described in Enhanced Care Management description of care. Stays informed about many aspects of the care coordination patient's care: referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services; Works collaboratively with referral coordinators and care teams to facilitate care coordination patients' care transitions.
Riverside, California5 days ago
div class="job__description body">At Geiss Med Hospice, we believe in cherishing every moment of life. Our team of dedicated medical professionals and compassionate caregivers is committed to easing pain, managing symptoms, and providing emotional and spiritual support in a manner that respects your personal choices and preferences.
The primary factor differentiating KPG Healthcare from other recruitment firms is the quality of our experience, the breadth of our industry network, and the creativity that we apply to finding the perfect placement options. KPG Healthcare is a Staffing Firm that provides diverse Supplemental and Permanent Healthcare Staffing solutions to a wide range of Clients throughout the Nation.
p>Under the general supervision of Enhanced Care Management Leadership, the RN Clinical Care Manager develops and implements personalized care plans, conducts comprehensive assessments, facilitates care transitions, and builds strong, trusting relationships with each member. Through collaboration with Primary Care Providers (PCPs), interdisciplinary care teams, and community partners, the CCM ensures that members receive the right care, at the right time, in the right place—supporting improved outcomes and health equity for diverse Medi-Cal populations.
Riverside, CA30+ days ago
Answers, directs and records departmental phone calls from a variety of sources (Insurance companies, Skilled Nursing Facilities, Home Health Agencies, Durable Medical Equipment, other health care providers, etc.) understanding priorities for the delivery of quality patient care. The Case Manager Registered Nurse is primarily responsible for the preparation, recording and tracking of initial and retrospective payments for hospital services.