CASE Manager Job in Woodland Hills, California US
CASE Manager
Kelly Healthcare Resources Kelly Healthcare Resources (KHR) is a specialty service of Kelly Services, Inc., a leader in providing workforce solutions. Launched in 1999, KHR services all levels of healthcare specialists and professionals in the following disciplines: medical laboratory, medical device, pharmacy and pharmacology, dental, nursing, allied health, behavioral health, healthcare billing/coding, utilization, case management, occupational health, special education, and physical therapy. Visit www.kellyhealthcare.com . Current Needs: Currently seeking for an experienced Case Manager RN in San Fernando Valley, CA. Qualified candidate will be responsible for the coordination of services and cost effective management of health care resources to meet individual members health care needs and promote positive health outcomes. Acts as a member advocate and a liaison between providers, members to seamlessly integrate complex services. Case Management services are generally focused on members who fall into one or more high risk or high cost groups and require significant clinical judgment, independent analysis, critical-thinking, detailed knowledge of departmental procedures, clinical guidelines, community resources, contracting and community standards of care. Case Management includes assessment, coordination, planning, monitoring and evaluation of multiple environments. This is a long term assignment. Work schedules: Monday ? Friday; 8:00am ? 5:00pm. Duties: Participates in programs to proactively identify members at risk who are appropriate for case management services. Reviews, screens and prioritizes cases for possible case management services. Expedites access to appropriate care for members with urgent or immediate needs using expedited review process. Acquires appropriate clinical records, clinical guidelines, policies, EOC, Benefit Policy and coding guidelines. Assesses the member's current health status, resource utilization, past and present treatment plan and services; prognosis, short and long term goals, treatment and provider options. Develops plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs. Works with the member/family, provider(s), and other members of the health care team to develop a plan of care that enhances the clinical outcome while maximizing the member's benefits. License: Active, valid and unrestricted California Registered Nurse is a MUST Experience/Qulalifications: Minimum three years clinical experience required. One to three years Case Management experience required. Health Plan experience preferred. Demonstrated ability for assessment, evaluation and interpretation of medical information, and care planning. Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs. Extensive knowledge of the management of chronic conditions. Experience using standardized clinical guidelines required. Able to operate PC-based software programs including proficiency in Word, Excel, PowerPoint, Access and Project. Other Qualifications: Bilingual English/Spanish preferred. Application Contact Info: For immediate consideration, click the ?Apply Now!? button, or refer a friend by clicking the ?E-mail this job? link provided. About Kelly Services Kelly Services, Inc. (NASDAQ: KELYA, KELYB ) is a leader in providing workforce solutions. Kelly ® offers a comprehensive array of outsourcing and consulting services as well as world-class staffing on a temporary, temporary-to-hire and direct-hire basis. Serving clients around the globe, Kelly provides employment to more than 530,000 employees annually. Revenue in 2010 was $5 billion. Visit www.kellyservices.com and connect with us on Facebook, LinkedIn, Twitter . Kelly Services?Celebrating 64 Years Kelly Services is an Equal Opportunity Employer.