RN Case Manager – Transition of Care (Outpatient, Bilingual Spanish or Vietnamese) – Remote
Job title: RN Case Manager – Transition of Care (Outpatient, Bilingual Spanish or Vietnamese) – Remote in USA 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 a remote, bilingual Spanish or Vietnamese, RN Case Manager, TOC (Transition of Care) to join the case management team (Must have California RN License). The Case Manager – Transitions of Care (Outpatient) ensures a smooth transition for members after a hospital or Skilled nursing facility discharge by coordinating care, providing resources, and educating members/families about the post discharge care plan to support optimal health outcomes.Responsibilities include reputed company aspects and activities responsible for monitoring the delivery of care to reputed company members. Performs duties mostly telephonically.Schedule: Must be willing to work Mon - Fri, reputed company - 5pm Pacific TimeJob Duties/Responsibilities:reputed company and implement individualized discharge plans in collaboration with the interdisciplinary team, patients, and families.Coordinate with healthcare providers, home health agencies, rehabilitation facilities, and community resources to ensure continuity of care.Facilitate timely referrals to necessary services, including home health, physical therapy, occupational therapy, and social support.Monitor patient reputed company and adjust discharge plans as needed.Provide comprehensive education to patients and families regarding their medical condition, treatment plan, medications, and post-discharge care instructions.Answer questions and address concerns reputed company to discharge planning and post-discharge care.reputed company patients and families to actively participate in their care and self-management.Identify and access appropriate resources and services for patients and families, including financial assistance, transportation, and community support programs.reputed company for patients' needs and ensure access to necessary resources.Maintain accurate and up-to-date patient records and documentation reputed company to discharge planning and post-discharge care.Communicate effectively with reputed company members of the interdisciplinary team, patients, and families.Participate in care conferences and team meetings to ensure effective communication and coordination of care.Participate in quality improvement activities to identify areas for improvement in discharge planning and post-discharge care.Stay reputed company with best practices and trends in care management and discharge planning.Job Requirements:To reputed company this job successfully, an individual must be able to reputed company each essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company the essential functions.Experience:
- Required: 2-3 years of clinical care management experience; or any combination of education and experience, which would provide an equivalent background.
- Preferred: 3-5 years of clinical care management experience; or any combination of education and experience, which would provide an equivalent background.
- Required: