Remote Case Manager – Social Worker (RN) – California
- Clinical License RN
- State(s) CA
- Coordinate care and services and develop patient treatment plans for catastrophic cases.
- Telephonically manage cases on a long or short-term basis per established company guidelines, policies and procedures, as well as other standardized criteria in the healthcare industry.
- Contact patient and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs.
- Develop treatment plan in collaboration with the patient, caregivers or family, community resources and multidisciplinary healthcare providers that include obtainable short and long term goals. Monitor interventions and evaluate the effectiveness of the treatment plan in a timely manner; report measurable outcomes that record effectiveness of interventions.
- Initiate and maintain contact with the patient/family, provider, employer group, and multidisciplinary team as needed through the continuum of care.
- Advocate for the patient by facilitating the delivery of quality patient care, and by assisting in reducing overall costs; provide patient/family with emotional support and guidance.
- Meet daily productivity requirement.
- Negotiate and implement cost management strategies to affect quality outcomes and reflect this data in monthly case management reviews and cost avoidance reports.
- Perform data entry and maintain complete and detailed documentation of case managed patient in the computer system; maintain site specific logs and files, ensuring confidentiality according to company policy and HIPAA.
Skills, Knowledge & Expertise
- Current unrestricted RN license to practice in the state of California.
- 1+ years of case management experience required.
- Computer proficiency and working knowledge of Microsoft Office Suite and Microsoft Outlook required.
- Knowledge of medical claims and ICD-10, CPT, HCPCS coding preferred.
- Knowledge of utilization management/quality management case philosophies and reporting requirements; quality improvement methodologies preferred.
- Competitive pay with opportunity for Career Advancement
- Full offering of health and wellness benefits for you and your family
- Paid Time Off policies to support a healthy work-life environment
- Company paid life insurance and disability plan
- 401K with company matching
- Employee discounts and wellness programs
HealthComp is an Equal Opportunity Employer.
HealthComp recruiting correspondence will always come from a talent acquisition representative with an official @healthcomp e-mail address. In addition, our representatives will never ask for any form of payment from a new hire or candidate. Please report suspicious activity to hiringsecurity@Healthcomp.com.