The Case Manager identifies, plans, and coordinates care for high-risk patients in an ambulatory setting. They are responsible for developing multidisciplinary treatment plans and ensuring cost-effective outcomes through utilization management.
Requirements summary
Candidates must be a graduate of an accredited LVN program with a current California LVN license. A high school diploma is required, and one to two years of related experience is preferred.
high schoolassociate degreeprofessional certificateCase ManagementPatient MonitoringPatient AssessmentTreatment PlanningPatient Care CoordinationQuality ReportingUtilization ManagementMultidisciplinary CoordinationManaged Care OrientationMedical Eligibility Verification
Job description
Responsibilities
Come and join the RMC Family!
We have been in the community since 1935.
Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region.
Your passion, inspiration, and talents are invaluable to us and our mission to serve others.
Our facility can provide a place for you to thrive and continue your professional development.
Quality Healthcare is our passion, improving lives is our reward.
We are working to change lives and transform the delivery of healthcare.
Riverside Medical Clinic is the best place to work, practice medicine, and receive care.
SUMMARY: Identifies, plans, and coordinates high-risk patient care (frail, chronic disease, catastrophic injury) in an ambulatory setting.
Reviews referrals and applies the UM standards for patient care.
Ensures continuity of care across the continuum.
Promotes and evaluates quality and cost-effective outcomes.
Qualifications
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. HOURS: Monday- Friday 8:30AM- 5:30PM
Qualifications
EDUCATION and/or EXPERIENCE
High School Diploma or GED required. Graduate of an accredited LVN Program. A.A., Diploma preferred. One to two years related experience and/or training; or equivalent combination of education and experience.
Certificates,
Licenses,
AND
REGISTRATIONS: Current California LVN license.
Essential
FUNCTIONS: Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable.
Note
(other duties may be assigned, deleted or changed at any time, at the discretion of management, formally, or informally, either verbally or in writing). 1. Assess available information to determine patient needs. Develop and initiate comprehensive, multidisciplinary treatment plans. 2. Consult and coordinate treatment plans with providers. 3. Establish and implement with patient and health care team measurable goals within the proposed treatment plan. 4. Verify patient and medical group eligibility and benefits. Monitor utilization of resources and readjust treatment plans when appropriate. 5. Monitor patient responses to treatment plans. 6. Monitor patient outcomes to determine patient satisfaction as well as the effectiveness and efficiency of the treatment plans. 7. Orient providers to managed care and RMC goals and philosophies. 8. Initiate required QRM reports per company policy. 9. Utilize established criteria for authorization guidelines. 10. Communicate problems with patients and physicians to resolve issues in a timely manner.
Benefits
Competitive Compensation
Growth And Development Opportunities
This opportunity offers the following: Challenging and rewarding work environment Growth and Development Opportunities within UHS and its Subsidiaries Competitive Compensation About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Avoid and Report Recruitment Scams At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
