Care Management Specialist Job

CARE MANAGEMENT SPECIALIST needed for a CONTRACT TO HIRE opportunity with Yoh's client located in Los Angeles, CA.

TOP SKILLS YOU SHOULD POSSESS:

- Experience in managed care
- Previous clinical experience

WHAT YOU'LL BE DOING:

- Responsible for the overall coordination of the Medicare-SNP program for health plan members
- Day to day referral management requests for the Medicare-SNP program
- Timely and accurate determination and notification of pre-service, concurrent and retrospective referral requests
- Generation of the CMS specific member communications
- Perform telephonic physical, functional and psycho-social assessments
- Assess readiness to change, develop and maintain a member/family specific individualized care plan developed using evidenced based guidelines

WHAT YOU NEED TO BRING TO THE TABLE:

- Associates or Bachelor's Degree in Nursing
- Current California RN license
- Three to five (3-5) years of experience in Utilization Management/Case Management
- HMO managed care (Health Plan or Medical Group) with prior experience in ambulatory case management, disease management, case management, complex case management or catastrophic case management
- Strong clinical skills with a knowledge of behavioral assessment techniques

BONUS POINTS! OTHERWISE KNOWN AS PREFERRED QUALIFICATIONS:

- Master's Degree in Nursing
- Case Management Certification; Public Health Nursing certification; Certified Nurse Practitioner

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER: Jennifer Andersen

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Contact us if you are an individual with a disability and require accommodation in the application process.

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