Care Manager I (RN)

Spectraforce Technologies

United States, California, Los Angeles

May 16, 2024

Job Title: Care Manager I (RN

Duration: 3 months

Location: Remote (Fully remote- must be able to work PST hours listed)

must have a CA RN license

Shift: M-F 8-5

Must have a private space/work area due to sensitive information.
Must be comfortable to be on phones at home
Training is about 3-4 weeks and then they will work with Senior Case Managers to start ramping up

Experience Working with Medicare/Medi-caid
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 exp 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 active cases-(will be ramped up to this amt) Cases are 90 days.
Excel (data entry-basic knowledge)
True Care medical records system
Must be able to navigate multiple systems.
Pharmacy system, eligibility system, Workforce management

* 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

Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience in an clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.

Licenses/Certifications: Current state's RN license.

Internal/External Groups with which the Candidate will interface:
Required Skills/Experience:		Preferred Skills/ Experience:
1.	Experience with Medicare/Medicare required	1.	Psych/Behavioral Health Background/Experience
2.	Case management experience	2.	Bilingual in Spanish
3.		3.
Education Requirement:	CA RN license	Education Preferred:
Software Skills Required:	MS Office
Required Certifications:		Required Testing:

CPRA: The Company is committed to complying with the California Privacy Rights Act ("CPRA") effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting .