Catastrophic Nurse Case Manager - Los Angeles

Catastrophic Nurse Case Manager - Los Angeles

Join to apply for the Catastrophic Nurse Case Manager - Los Angeles role at SCM Associates, Inc.

The Case Manager has the responsibility to identify, assess, plan, coordinate, implement, monitor, and evaluate options and services for individuals requiring case management services. The goal of the case manager is to provide for quality, cost‑effective outcomes for the client through collaboration and communication with the client, the family, the physician, and other members of the health care team.

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• Process the case utilizing client’s outcome management model and tools
• Obtain written authorization for case management services as well as release of information
• Assess the client/family to identify strengths, resources and problems; psychosocial, financial, medical history; current status; diagnosis; prognosis; functional status; goals; current treatment plan; and needs
• Develop a plan of care with client’s model through interdisciplinary collaboration, which identifies realistic short‑ and long‑term goals
• Identify, secure, and coordinate the services and resources to implement the plan
• Monitor services being provided for continued appropriateness and report to client and insurance carrier
• Evaluate the client’s progress, the plan, and the appropriateness of the services provided, with modifications as necessary
• Provide ongoing instruction to the client and family regarding the injury/disease process, treatment options, and present care
• Promote the client’s/family’s self‑advocacy skills to achieve maximum self‑sufficiency
• Have knowledge of the benefit package as well as all available funding sources and systems of care and coordinate with the payer for authorization of payment
• Provide for in‑depth reporting of outcomes encompassing clinical, functional, financial, and customer satisfaction areas
• Demonstrate effective, accurate, and timely verbal and written communication in all work situations
• Identify and disclose all situations which might result in exposure to legal liability and/or indicate poor quality care negatively affecting the client
• Frequently require travel to patient appointments
• Perform other related duties as assigned in accordance with the necessary job function

• BSN preferred
• CCM or equivalent certification
• Three years or more of related experience and/or training or equivalent combination of education and experience

• Seniority level: Mid‑Senior level
• Employment type: Full‑time
• Job function: Health Care Provider
• Industry: Hospitals and Health Care
• Location: Los Angeles, CA
• Salary: $80,000.00 - $90,000.00