UM Case Manager

URGENT READY TO HIREA leading nationwide care company is looking for a Remote Case Manager to join their team With immense opportunity for growth, this facility is looking for someone who is eager to expand on their skillset AS SOON AS POSSIBLE!If this sounds like something that you are interested in, please email me directly at olpeterson@actalentservices .com.What's In It For You?

Remote (Considered hybrid but at the moment, no office days are required)

Working with a nationwide industry leader in care coordination.

MUST HAVE:

Current California RN License

Local to San Jose or Ventura County

Case Management experience.

Experience working with Medicare/Medi-caid.

Telephonic or remote experience.

Pay: $47/hr Placement: Contract (3 months) Job Description:

Monday - Friday, 8am - 5pm PST.

Develop, assess and adjust, as necessary, the care plan and promote desired outcome

Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options

Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients

Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs

Provide patient and provider education

Facilitate member access to community based services

Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan

Actively participate in integrated team care management rounds

Identify related risk management quality concerns and report these scenarios to the appropriate resources

Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems

Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan

Actively participate in integrated team care management rounds

Identify related risk management quality concerns and report these scenarios to the appropriate resources

Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systemsals, treatment and provider options

Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients

Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs

Provide patient and provider education

Facilitate member access to community based services

Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan

Actively participate in integrated team care management rounds

Identify related risk management quality concerns and report these scenarios to the appropriate resources

Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems

Assisting with Backlog-referrals from CA-members sending referrals to case managers

Will be Assigned 5-10 referrals daily.

Ability to work in Fast paced environment.

Case Management experience required.

At least 4 hours a day is spent on outbound phone calls-reaching out to members.

Calls are recorded-will have audio audits.

Data entry-tracking data.

Case load requirement is 75-(will be ramped up to this amt)

Excel (data entry-basic knowledge)

True Care medical records system

About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.Diversity, Equity & Inclusion At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

Hiring diverse talent

Maintaining an inclusive environment through persistent self-reflection

Building a culture of care, engagement, and recognition with clear outcomes

Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.