MLK Community Health is an employer of choice for healthcare professionals in Los Angeles.
Our commitment to the community, and to our employees, make us a great place to work.
*We’re seeking an experienced Care/Case Manager for a per diem role during the day on weekends.
Join us!*
*Qualifications/Requirements:*
* Associates degree in Nursing required
* BSN preferred
* Prior case management experience
* Case Management certification highly desirable
* Minimum of one (1) to three (3) years of hospital inpatient case management experience required.
* Ability to navigate and connect successfully with outside provider networks (Health Plans, IPA’s, and FQHC’s).
* Current CA RN license
* Bilingual Spanish language skills preferred
* Current BLS
*About this opportunity:*
Case Managers at MLKCH provide key support to the physicians and interdisciplinary teams in facilitating patient care, working to enhance the quality of clinical outcomes and patient satisfaction while managing cost-of-care and working closely with payors.
This role integrates and coordinates the functions of utilization management, care progression and care transition.
It’s a wonderful opportunity to support our patient population and community.
* Facilitation of precertification and payor authorization processes
* Facilitation of the collaborative management of patient care across the continuum ensuring timely and efficient care delivery and reimbursement
* Application of process improvement methodologies in evaluating outcomes of care
* Coordinating communication with physicians
* Includes admission, continued, extended and discharge reviews in all reimbursement categories to determine medical necessity, assure high quality of care and efficient utilization of resources
* Includes patient assessment, discharge planning, implementation of progression care activities, interacts with family, providers and patient to ensure clarity of communication related to clinical status
* Demonstrates an understanding of the patient’s clinical condition, social, and financial resources to determine the most appropriate care setting, practice standards for evaluation, treatment delivery options (Home, SAR, SNF, LTACH, Acute Rehabilitation, Assisted Living, Board/Care, Recuperative Care, Shelter), and resources required to support safe transition of care.
* Develops and evaluates case management plans and protocols in collaboration with the interdisciplinary team.
* Evaluates actions taken to assure cost-effective care including physician length of stay, diagnostic related groups cost reporting, morbidity and mortality reports and monitoring of readmissions.
* Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues.
Job Type: Full-time
Pay: $50.
24 - $72.
84 per hour
Schedule:
* Day shift
* Weekends as needed
Education:
* Bachelor's (Preferred)
Experience:
* Hospital inpatient case management: 1 year (Preferred)
License/Certification:
* California RN License (Preferred)
Work Location: In person
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