1000+ Best rn insurance Jobs in Los Angeles, California (September 2025) - page 16

Beecan Health - CA

Central Case Manager

17 days ago

Glendale

Job Description POSITION SUMMARY The Central Case Manager will be collaborating with the assigned facilities and the Interdisciplinary team to come up with an individualized plan of care, to ensure patients progress and safely discharge the patient back to the community or to a Long Term Care setting. DUTIES AND RESPONSIBILITIES • Demonstrates commitment to company's mission, values and standards of ethical behavior., • Models a positive and professional image that emulates the organization's mission and encourages a spirit of cooperation with co-workers. Provides assistance to co-workers and promotes teamwork by sharing information useful to achieving desired results., • Ensures that all residents are treated fairly, with kindness, dignity, and respect, and their rights are protected at all times., • Respects and upholds all residents' personal and property rights whenever carrying out duties, including knocking before entering a resident's room., • Complies with all company and departmental policies and procedures., • Monitors the care plans to ensure the effectiveness and appropriateness and in patient services; ensure the appropriate care is being provided and meet the needs of the patient until discharge.,, • Meet and Greet with the new admissions patient, • Attends morning Stand-Up meetings and afternoon Stand-Down Meetings., • Monitor patients' progress towards achievement and periodically reassess changes in health status., • Review patients' medications and treatments prior to admissions, to identify high cost medications and treatments., • Respects patient rights and personal property., • Identify and develop new community resources., • Assist with problem solving in coordination with Social Services., • Works closely with the Rehabilitation Team to ensure the patient is getting the services needed., • Collabrates with the DOR in managing patients' minutes as authorized by the HMO plans., • Identifies any barriers during the patient's rehabilitation, and addresses the departments involved, to ensure patient's progress in rehab., • Communicates with the HMO case managers and gives updates on patients' progress in the skilled services provided., • Chart observations - Ensure they are done properly and accurately., • Other data review, related to the clinical data of the patient., • Conducts PPS weekly meetings (HMO), • Attends triple check meetings (HMO), • Conducts care plan meetings (within 72 hours upon admission, weekly, and monthly depending on the patient's case), • Conducts IDT meetings (14 days upon admission), • Conducts RNA meetings with the DOR and RNA staff to identify patients that may need skilled services to improve the quality of life., • Help reduce avoidable hospital admissions and A.M.A. (tracking and identifying the cause of hospital readmissions and A.M.A. in coordination with the DON, • Improve providers and members satisfaction during patient's time in the facility., • Identify the patient's barriers in progress and address the patient's grievances to the departments involved, and collaborate to resolve the issues., • Make sure authorizations for skilled services are in place and updated - the case manager specialist will send clinical notes and requests for extending skilled authorizations as needed, and upload it to PCC, • Follow up for any changes in condition, new medications ordered, and doctor appointments (72 hours post discharge, weekly, and monthly)., • Interprets department policies and procedures to personnel, residents, visitors, family members, etc., as necessary., • May perform day-to-day departmental duties as needed. KNOWLEDGE, SKILLS, ABILITIES & QUALIFICATIONS • At least 2 years of licensed nursing experience in a skilled nursing facility or acute hospital setting., • Case management experience preferred, but not required., • Valid LVN or RN License, • Must possess thorough understanding of healthcare reimbursement programs., • Commitment to the Company mission to consistently deliver high quality, person-centered care with dignity, respect, compassion and integrity, and to enrich every life we touch. Embracing of Company values of care & compassion, community, honesty & integrity, teamwork, innovation and safety, • Ability to represent Company in an ethical and professional manner, and to maintain accountability, • Ability to interact tactfully, effectively, and professionally with other employees, residents, family members, visitors, government agencies/personnel and the general public, as needed, • Must be able to communicate via phone or in person, in a positive and professional manner with patients, staff, and visitors., • Must be able to relate to and work with physically and/or mentally ill, disabled, elderly, emotionally upset, and at times hostile people within facility and treat them with respect and consideration regardless of their cognitive or functional level, • Willingness and ability to function as an effective team member through good communication and cooperation to meet departmental goals, • Must demonstrate flexibility and ability to adapt to change, • Ability to organize, prioritize and meet deadlines, • Ability to maintain confidentiality and be discreet, • Must be able to multitask and handle pressure, • Must be able to follow instructions and to accept feedback, • Must successfully pass background check, health exams, and any other pre-employment requirements, • Willing to work beyond normal working hours, weekends, holidays, and/or on other shifts and in other positions, when necessary, • Must be able to read, write and speak the English language sufficiently and comprehensively enough to perform the essential functions of the job, • Sufficient computer skills including proficiency in Microsoft Office, Outlook, and /or Internet to perform required duties, • Knowledge of standard office practices, • Ability to understand and follow applicable regulations, policies and procedures fully and consistently, • Sound knowledge of basic mathematical concepts and tools, • Must have strong detail orientation and high accuracy level, • Good grammatical, punctuation and spelling skills, • Must be knowledgeable of nursing/medical practices and procedures, and/or terminology, laws, regulations, and the guidelines that pertain to long-term care, • Strong communication skills, both one-on-one and in a group, and ability to listen and respond to questions effectively, • Creative problem solving abilities, • Ability to inspire trust and respect, and mobilize others, • Ability to lead and motivate staff to achieve desired results, • Supervisory skills including ability to delegate, resolve conflict and respect diversity; ability to train and mentor adults, • Ability to exercise discretion and independent judgment, and reach logical, practical decisions, • Ability to think strategically, master change, and maintain future orientation, • Must have a valid driver's license and clear DMV record, and be insurable under Company's insurance policy.

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