California RN license or equivalent social work license., 2-4 years of clinical and case management experience., Strong nursing assessment and case management skills., Bachelor's degree in Nursing, Social Work, or related field..
Key responsibilities:
Coordinate and monitor care plans for members with complex conditions.
Conduct assessments and develop individualized care plans.
Collaborate with healthcare professionals and members to ensure effective care.
Maintain documentation and participate in team meetings.
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Saviance Technologies is a US Healthcare IT Service provider focusing on Patient Engagement with Innovative Products and Solutions like Patient Intake Tablet, iHealthConnect Wellness Portal, Mobile Applications, Actionable Analytics and ICD-10 Testing Services. Incorporated in 1999 in New Jersey, with over 15 years of excellent industry track record, Saviance offers services & solutions that enable enterprises to achieve critical objectives.
Saviance is a Gold Category Corporate Member with Healthcare Information Management Systems Society (HIMSS), member of mHealth Alliance and Corporate member of NJ-HITEC. We are awarded by INC. 5000 as one of the fastest growing privately held companies in North America. Saviance is also ranked among the Fast 50 Asian American Businesses in the United States by USPAACC (US Pan Asian American Chamber of Commerce) and selected as a 2014 "Top Business" recipient byDiversityBusiness.com.
A certified Minority Business Enterprise recognized by NMSDC, Saviance is also partner with leading global brands such as Microsoft, Amazon Web Services, Apple, Samsung and Red Hat.
100% REMOTE POSITION - MUST BE LOCATED WITHIN ONE OF THE 15 APPROVED STATES
MUST HAVE A CALIFORNIA RN LICENSE
MONDAY TO FRIDAY 9AM TO 5PM
NEEDS TO HAVE AT LEAST 2-4 YEARS OF EXPERIENCE IN NURSING FIELD
BILINGUAL IN SPANISH IS A PLUS BUT NOT REQUIRED
WILL NEED LAPTOP, TWO MONITORS, DOCKING STATION
NEEDS TO HAVE STRONG NURSING ASSESSMENT AND CASE MANAGEMENT SKILLS
Summary: Responsible for health care management and coordination of Molina Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors Molina members progress and services to ensure consistent cost effective care that complies with Molina policy and all state and federal regulations and guidelines. Essential Functions: Provides case management services to members with chronic or complex conditions including: o Proactively identifies members that may qualify for potential case management services. o Conducts assessment of member needs by collecting in-depth information from Molinas information system, the member, members family/caregiver, hospital staff, physicians and other providers. o Identifies, assesses and manages members per established criteria. o Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs. o Performs ongoing monitoring of the plan of care to evaluate effectiveness. o Documents care plan progress in Molinas information system. o Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes. o Measures the effectiveness of interventions to determine case management outcomes. Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for Molina members. Conducts face to face or home visits as required. Maintains department productivity and quality measures. Manages and completes assigned work plan objectives and projects in a timely manner. Demonstrates dependability and reliability. Maintains effective team member relations. Adheres to all documentation guidelines. Attends regular staff meetings. Participates in Interdisciplinary Care Team (ICT) meetings. Assists orientation and mentoring of new team members as appropriate. Maintains professional relationships with provider community and internal and external customers. Conducts self in a professional manner at all times. Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct. Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth. Complies with required workplace safety standards. Knowledge/Skills/Abilities: Demonstrated ability to communicate, problem solve, and work effectively with people. Excellent organizational skill with the ability to manage multiple priorities. Work independently and handle multiple projects simultaneously. Strong analytical skills. Knowledge of applicable state, and federal regulations. Knowledge of ICD-9, CPT coding and HCPC. SSI, Coordination of benefits, and Third Party Liability programs and integration. Familiarity with NCQA standards, state/federal regulations and measurement techniques. In depth knowledge of CCA and/or other Case Management tools. Ability to take initiative and see tasks to completion. Computer skills and experience with Microsoft Office Products. Excellent verbal and written communication skills. Ability to abide by Molinas policies. Able to maintain regular attendance based upon agreed schedule. Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers. Required Education: Bachelors degree in Nursing or Masters degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree). Required Experience: 2-4 years of clinical experience with case management experience. Required Licensure/Certification: Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing. A combination of experience and education will be considered in lieu of LCSW or APSW. Must have valid drivers license with good driving record and be able to drive locally.
Required profile
Experience
Level of experience:Mid-level (2-5 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.