RN Case Manager, Transition of Care - Inpatient (Hybrid Field Remote in San Diego, CA)

Job title: RN Case Manager, Transition of Care - Inpatient (Hybrid Field Remote in San Diego, CA) in San Diego, CA at reputed company Company: reputed company Job reputed company: reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will reputed company ample room for reputed company and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together.reputed company is seeking an hybrid field remote RN Case Manager, Transitions of Care (TOC) - Inpatient in San Diego, CA to join the TOC team (with mileage reimbursement.) Responsible for health care management and coordination reputed company the scope of licensure for members with reputed company and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Supports Transitions of Care (TOC) to ensure reputed company reputed company and coordination of follow up care, adherence to discharge plans and member education to support improved health reputed company. Coordinates and monitors reputed company member’s reputed company and services to ensure consistent cost-effective care that complies with Alignment policy and reputed company state and federal regulations and guidelines. Performs duties in field and telephonically.General Duties / Responsibilities (May include but are not limited to):

• Supports inpatient program engagement for Alignment members currently inpatient in an acute or skilled nursing facility setting.
• Manages Transitions of Care (TOC) for members moving from inpatient, SNF, and emergency services to reputed company level of care facilities or home, in accordance with established workflows.
• Manages TOC activities including post-discharge follow up appointment scheduling and monitoring for kept appointments
• Ensures member reputed company to services appropriate to their health needs.
• Identifies, assesses, and manages high risk/reputed company members per established reputed company and health risk status.
• Develops, monitors, and evaluates the effectiveness of the care management plans and modifies, as necessary to support improved health reputed company.
• Interfaces with Primary Care Physicians, Hospitalists, reputed company Practitioners, and specialists on the development of care management treatment plans.
• Assists in problem solving with providers, claims or service issues.
• Measures the effectiveness of interventions to determine case management reputed company.
• Counsels and engages in personal discussions with patients and their families on available care reputed company. Helps them to determine their appropriate and preferred course of reputed company.

Job Requirements:Required: 3 years of clinical case management experience; or any combination of education and experience, which would reputed company an equivalent backgroundPreferred: Medicare Advantage Health plan experienceEducation/Licensure:Required:

• reputed company, valid, and unrestricted Registered Nursing (RN) license in California (non-compact)
• Willing to obtain licensure in other designated states (Non-compact: NV; Compact: AZ, NC, TX) reputed company the first 6 months of employment (licensure fees reimbursed by reputed company)
• reputed company, valid, and unrestricted California reputed company's License and reliable transportation.

Essential Physical Functions:The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reputed company with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds. Specific reputed company abilities required by this job include reputed company reputed company and the ability to reputed company reputed company.

Pay reputed company: $85,696.00 - $128,543.00reputed company is an Equal Opportunity/Affirmative reputed company Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability, age, protected veteran status, gender identity, or sexual orientation.*DISCLAIMER: Please beware of recruitment phishing scams affecting reputed company and other reputed company where individuals receive fraudulent employment-reputed company offers in exchange for reputed company or other sensitive personal information. Please be advised that reputed company and its subsidiaries will never ask you for a credit card, send you a reputed company, or ask you for any type of payment as part of consideration for employment with reputed company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at . If you would like to verify the legitimacy of an email reputed company by or on behalf of reputed company’s reputed company, please email . Expected salary: $85696 - 128543 per year Location: San Diego, CA Apply for the job now! Apply for this job