RedlandsRecruiter Since 2001
the smart solution for Redlands jobs

Care Manager II

Company: Centene Corporation
Location: Redlands
Posted on: August 21, 2019

Job Description:

Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.

  • 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
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • 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
  • 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
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as neededEducation/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.Licenses/Certifications: Current state's RN license

Keywords: Centene Corporation, Redlands , Care Manager II, Executive , Redlands, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


RN Clinical Manager - Home Health $5,000 Sign On Bonus
Description: Overview Brookdale Home Health is seeking an RN Clinical Manager for our 5 Star Medicare Home Health Agency in Placentia, CA. 5,000 Sign on Bonus Every day is an opportunity for our associates to deeply (more...)
Company: Brookdale Senior Living
Location: Santa Ana
Posted on: 09/16/2019

Technical Account Manager
Description: Moogsoft is the creator of Moogsoft AIOps - a next generation approach to IT Operations and Analytics driven by real-time machine learning. Moogsoft AIOps helps Enterprises Service Providers deliver (more...)
Company: Moogsoft
Location: Los Angeles
Posted on: 09/16/2019

HR Senior Manager, Frito-Lay
Description: Job Description Auto req ID: 189145BR Job Description We are PepsiCo, one of the most iconic and recognized consumer brands around the globe With net revenues of over 65 billion and almost 300,000 (more...)
Company: PepsiCo
Location: Rancho Cucamonga
Posted on: 09/16/2019


Assistant Housekeeping Manager (NE) - Renaissance Newport Beach - Marriott Hotels - (19090170)
Description: You were always one of those curious kids who opened every cabinet, peeked behind every door, and never ceased to ask why when given an explanation. Today, you bring your personal style to every experience. (more...)
Company: Marriott International, Inc.
Location: Los Angeles
Posted on: 09/16/2019

LVN Med Care Manager - Santa Ana
Description: Overview br It makes me feel good knowing that we make the residents' lives better. We laugh with them, cry with them, sing and dance with them - we brighten their day. Working here is an unbelievable (more...)
Company: Sunrise Senior Living
Location: Santa Ana
Posted on: 09/16/2019

Medical Sciences Medical Director - Early Development - Cardio-metabol
Description: Amgen is a leading global biotechnology company, with a mission to serve patients around the world. As a science based, patient focused organization, we discover and develop innovative therapies to treat (more...)
Company: Amgen
Location: Newbury Park
Posted on: 09/16/2019

Perioperative Nurse Manager Eye Center
Description: This popular Los Angeles Area hospital is actively interviewing for a Nurse Manager to oversee its Ophthalmology Surgical Services line. Join this trusted community health system, and get the opportunity (more...)
Company: Nurse Management
Location: Inglewood
Posted on: 09/16/2019

Corporate Operations Director - Fitness
Description: WTS International, the world's leading spa consulting and management firm is seeking a Fitness focused Corporate Operations Director
Company: WTS International
Location: Long Beach
Posted on: 09/16/2019

Market Manager - Southern California
Description: OBJECTIVE To oversee the successful sale and distribution of products in the St. Killian Importing portfolio, with heavy emphasis on Spirits portfolio in assigned territory. This individual will act as (more...)
Company: Sheehan Family Companies
Location: Los Angeles
Posted on: 09/16/2019

RN OR SURGERY MANAGER
Description: RN OR SURGERY MANAGER FULL TIME DAYS 20K SIGN ON BONUS Location: United States - California - Fountain Valley DESCRIPTION Industry: Healthcare / Health Services Job Category: Medical / Health - Nurse (more...)
Company: WPA Staffing Solutions, LLC
Location: Fountain Valley
Posted on: 09/16/2019

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Redlands RSS job feeds