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Case Management Associate-26532-1 MPK or SD
Monterey Park, California | Contract
EXCITING 3 MONTH CONTRACT FOR COMPLEX CASE MANAGER IN SAN DIEGO OR MONTEREY PARK!
Working with complex cases promotes the delivery of quality; cost-effective health care services based on medical necessity and contractual benefits.
Works with other members of HCS team, provider, hospitals, IPA/MGs, members and their families to plan and review medical necessity, intensity of services, level of care, length of stay and general appropriateness of care.
Provides guidance to the provider network.
Performs effective discharge planning and collaborates with member support system and health care professionals involved in the continuum of care.
May provide case management to member segments with chronic or catastrophic illness.
Pre-admission education for selected surgical and medical admits calls after discharge for same patients and other added medical dxs to cover any missed dsc issues
Referrals to DM, QM, and AGD Ability encompasses some knowledge of fundamental concepts, practices and procedures required within health care field.
Currently in process to develop skills through training and/or additional support to become fully proficient.
Minimal to moderate experience in nursing, health care or related field. (1-2 years)
Bachelor’ s degree or equivalent and appropriate licensing.