Medical Case Manager - Pediatrics
Medical Case Manager - Pediatrics
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5years
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Medical Case Manager Pediatrics
Company Overview: Our client is a leading healthcare located in Orange CA seeking a medical case manager who will facilitate communication and coordination among all participants of the health care team and the member to ensure the services provided promote quality and costeffective outcomes for all members along with focus on members under 21 years of age.
Position Summary: The successful candidate should hold a current unrestricted registered nurse (RN) license to practice in the state of California holds a bachelor s degree in nursing and has 3 years of clinical experience dealing with pediatric patients.
Work Duration: Up to 6 months
Work hours: 8 am 5 pm MF
Position Responsibilities:
- Assesses member needs using a standardized health needs assessment or health risk assessment.
- Conduct postdischarge assessments to identify and address member needs including physical functional social and psychological aspects as well as cultural linguistic and caregiver support.
- Develop and implement personalized care plans with SMART goals updating them regularly based on the member s condition and progress.
- Schedule followups to monitor progress identify obstacles and ensure quality of care according to department standards.
- Coordinate with members families providers and community resources to align care and services including referrals to behavioral health and LTSS as needed.
- Communicate with physicians specialists and other agencies to ensure seamless care coordination.
- Facilitate and participate in interdisciplinary meetings collaborating with internal teams for case resolution.
Identify cases requiring further review routing them to the appropriate authority and closing them in accordance with procedures.
- Advocate for members best interests in securing necessary resources treatment options and timely care adjustments.
- Complete additional assignments and projects as assigned.
Experience & Education:
Current unrestricted RN license to practice in the state of California required.
Bachelor s degree in nursing (BSN) required
3 years of clinical experience and/or managed care experience required
2 years of pediatric experience highly preferred
Active Commission for Case Manager (CCM) certification preferred
Necessary Attributes:
- Establish effective relationships with internal and external stakeholders.
- Demonstrate independent judgment and decisionmaking skills.
- Communicate effectively both verbally and in writing.
- Flexible schedule availability for evening and weekend events.
- Strong organizational analytical and problemsolving abilities.
- Proficiency in Microsoft Office (Word Outlook Excel PowerPoint) and jobspecific applications/systems.
Please see HR for information on physical demands and work environment of this job.
Sunshine Enterprise USA is an Equal Opportunity Employer Minorities Females Veterans and Disabled Persons
Bachelor s degree PLUS 2 years of experience in facilities management or property management required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. 2 years of experience as an administrative assistant.
Education
Bachelor s degree PLUS 2 years of experience in facilities management or property management required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. 2 years of experience as an administrative assistant.
Employment Type
Full Time
