RN Case Manager (Managed Care / D-SNP) ** 100% remote for CA residents **

Overview:
Our client, a mutual benefit corporation and health plan provider, seeks an accomplished RN Case Manager (Managed Care / D-SNP).
*** Candidate must be authorized to work in USA without requiring sponsorship ***
**********************************************************************
*** Location: Rancho Cordova, CA (100% Remote for CA residents)
*** Duration: 3 months contract w/ possibility of extension or conversion to FTE role
Notes:
This is a 100% remote position.
Candidates must reside and perform their work within the State of California throughout employment.
Work Hours: 8:00 AM – 5:00 PM Pacific Time.
Description:
Research and design treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type.
Initiate timely individualized care plans (ICP) based on health risk assessment (HRA) completion, participation in and documentation of interdisciplinary meetings (ICT), assisting in transitions of care across all ages.
This role will focus on the population that was unable to be reached or declined to complete an HRA.
Determine appropriateness of referral for CM services, mental health, and social services.
Provide Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD).
Conduct member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases.
Manage member treatment to meet recommended length of stay. Ensure DC planning at levels of care appropriate for the members’ needs and acuity.
Assess members’ health behaviors, cultural influences, and clients belief/value system. Evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers.
Research opportunities for improvement in assessment methodology and actively promote continuous improvement. Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers, and Company.
Determine realistic goals and objectives and provide appropriate alternatives. Actively solicit client’s involvement.
Design appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Adjust plans or create contingency plans, as necessary.
Assess and re-evaluates health and progress due to the dynamic nature of the plan of care required on an ongoing basis.
Initiates and implements appropriate modifications in plan of care to adapt to changes occurring over time and through various settings.
Develop appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes.
Recognize need for contingency plans throughout the healthcare process.
Develop and implement the plan of care based on accurate assessment of the members and current of proposed treatment.
Qualifications:
Must be a California RN.
Managed Care, specifically DSNP.
Software skills: Microsoft Application proficiency, use of medical records over multiple applications.
Excellent organization, documentation.
Nice to Haves:
BSN.
Transitions of Care.
Case Management experience - 3+ years.
*********************************************************************
I'd love to talk to you if you think this position is right up your alley, and assure a prompt communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.
Satwinder “Sat” Singh
Lead Technical Recruiter
Company Overview:
Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally, as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients’ businesses forward.
Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Applicants, with criminal histories, are considered in a manner that is consistent with local, state, and federal laws.

Work arrangement
Yes