High-Risk Case Manager (RN or LVN)
at RCM Health Care Services

Date Posted: 4/17/2019

Job Description

Leading Managed Care organization with a highly professional office environment is seeking a High-Risk Case Manager (RN or LVN) for an exciting new opportunity near Covina, CA


High-Risk Case Manager (RN or LVN)

Job Description:
  • Manage the utilization of healthcare services and resources for each patient across our continuum of care.
  • Establish measureable goals that promote evaluation of the cost and quality outcomes of the care provided
  • Coordinate and monitor services, including comprehensive tracking of client activities on the case management software program
  • Collaborate with healthcare team, including Community Health Navigators, to optimize patient adherence to medical plan of care, including: medication adherence, evidence based care, and specific screenings for recommended preventive care
  • Responsible for the coordination of post-discharge clinic appointments, medication reconciliation, ancillary services (DME, Home Health, etc) and PCP and specialist visits.
  • Participate and assist in all quality improvement initiatives in addition to providing feedback for the continuing improvement of systematic functions
  • Identify and coordinate care for high-risk patients in order to close gaps in care

Qualifications:
  • CA RN (Registered Nurse) or LVN
  • 2+ years of High Risk clinical experience
  • Experience ACO Case Management Preferred.
  • 1+ years Utilization Review, Case Management and/or Prior Authorizations
  • Excellent communication skills when interacting with physicians, patients, and service providers

Compensation:
  • Generous Salary plus bonus, flexible based on experience
  • Full benefits package which includes employer paid medical, pharmacy and dental benefits. Generous PTO package, 401k Retirement Savings, Life Insurance, Flexible Spending Account (FSA), Tuition Reimbursement & Licensed Renewal Fees for clinical staff

Job Snapshot

About Us

RCM Health Care Services offers career defining opportunities to candidates from the leading employers in health care. Whether you’re looking for a new job or seeking to hire the best medical talent, RCM Health Care Services has the solution for you. Since 1975, we’ve established ourselves as a leader in the recruitment industry by connecting thousands of healthcare professionals with placements that support their needs. If you’re looking to make the next move in your career, let RCM be your guide, we’re with you every step of the way!

We proudly hold the Joint Commission Gold Seal of Approval.

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