Posted in General Business 30+ days ago.
Type: Full-Time
Whole Child Model (WCM) Case Manager - Full Time (Remote) - Temporary
We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.
The Whole Child Model Case Manager has accountability for all of the case management accountabilities under the Whole Child Model (SB-586; mandating the transition of many components of the State/County CCS Program to CalOptima and via delegation agreements to Prospect/AMVI. This position reports operationally to the CalOptima Case Management Supervisor and clinically to the California Medical Director. This RN position will play a critical role in implementing and refining the newly defined case management activities for the WCM program to support clinically complex children, adolescents and young adults up to 21 years of age (CCS-eligible medical conditions) and their families. Tasks include but are not limited to the following: complete a comprehensive member assessment (Health Needs Assessment, medical and claims histories, provider information, etc.), develop individual care plans and facilitate interdisciplinary care team meetings as appropriate to members' risk, facilitate the authorization for all CCS specialized services and coordinate all medical care and services with the member/family. Collaborating with the member/family ensure the receipt of needed medical care and support services.
Job Responsibilities/Duties
Minimum Education: High School Diploma required. BA preferred.
Minimum Experience: Clinical experience with complex pediatric patients/members (minimum of 2 years). Familiarity with developing care plans and assessments preferred.
Req. Certification/Licensure: RN unrestricted active license required.
Employee Value Proposition
Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:
How to Apply
To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.
EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm
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