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Case Management Intermediate- 26528 WDH

Woodland Hills, California | Contract

Job ID: 55630 Position: Administrative/Clerical/Support Branch: Torrance







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.
Discharge planning for cases that exceed EOA or dx assigned to RN. 
Follow-up with LLC coordination such as SNF, HH, HI, Rehab. 
Referrals to QM, DM, CM and AGD 
IPA oversight, Continuity of Care, Healthy Families activities, OOA/OON cases, invest/exp, POS 
Other CM activities as identified 
Support to senior/lead CMs as needed. 

Ability encompasses broad knowledge of concepts, practices and procedures required within health care field. 
Uses concepts and abilities as well as internal policies and procedures to complete assignments and solve problems.

Requires moderate to thorough experience in nursing, health care or related field. (3-5 years) 
Bachelor’ s degree or equivalent and appropriate licensing.

CA RN License

Rachel Savitt
Staffing Manager

Rachel rejoined the Wollborg Michelson Recruiting team in Torrance as the Staffing Manager. She previously worked for the company from 2006-2009 as a Recruiter for the Temporary division. Rachel brings over 16 years of Staffing Industry experience. She has worked on all sides of the industry as a temporary employee, client, full desk Recruiter as well as corporate for a Staffing Company. Her goal is to change the lives of everyone she works with no matter what their role. In her free time, Rachel enjoys spending time with her friends and family. She is active with multiple non-profit animal rescues and prefers to ask for donations instead of gifts for birthday. She also enjoys kickboxing, Muay Thai and dancing. Rachel always finds a way to connect with people. Her #1 Strength from Strengthfinders is Connectedness.

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