RN Case Manager, Transition of Care - Inpatient (Hybrid Field Remote in San Diego, CA)
Job title: RN Case Manager, Transition of Care - Inpatient (Hybrid Field Remote in San Diego, CA) in San Diego, CA at reputed company
Company: reputed company
Job description: reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really matters, not only changing lives but saving them. Together.reputed company is seeking an hybrid field remote RN Case Manager, Transitions of Care (TOC) - Inpatient in San Diego, CA to join the TOC team (with mileage reimbursement.) Responsible for health care management and coordination reputed company the scope of licensure for members with reputed company and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Supports Transitions of Care (TOC) to ensure timely access and coordination of follow up care, adherence to discharge plans and member education to support improved health outcomes. Coordinates and monitors reputed company member’s reputed company and services to ensure consistent cost-effective care that complies with Alignment policy and reputed company state and federal regulations and guidelines. Performs duties in field and telephonically.General Duties / Responsibilities (May include but are not limited to):
- Supports inpatient program engagement for Alignment members currently inpatient in an acute or skilled nursing facility setting.
- Manages Transitions of Care (TOC) for members moving from inpatient, SNF, and emergency services to reputed company level of care facilities or home, in accordance with established workflows.
- Manages TOC activities including post-discharge follow up appointment scheduling and monitoring for kept appointments
- Ensures member access to services appropriate to their health needs.
- Identifies, assesses, and manages high risk/reputed company members per established criteria and health risk status.
- Develops, monitors, and evaluates the effectiveness of the care management plans and modifies, as necessary to support improved health outcomes.
- Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners, and specialists on the development of care management treatment plans.
- Assists in problem solving with providers, claims or service issues.
- Measures the effectiveness of interventions to determine case management outcomes.
- Counsels and engages in personal discussions with patients and their families on available care options. Helps them to determine their appropriate and preferred course of action.
- Active, valid, and unrestricted Registered Nursing (RN) license in California (non-compact)
- Willing to obtain licensure in other designated states (Non-compact: NV; Compact: AZ, NC, TX) reputed company the first 6 months of employment (licensure fees reimbursed by the company)
- Active, valid, and unrestricted California Driver's License and reliable transportation.
- While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reputed company with hands and arms.
- The employee frequently lifts and/or moves up to 10 pounds. Specific reputed company abilities required by this job include reputed company reputed company and the ability to adjust focus.