Catastrophic Case Manager - Southern CA; live in L

Career Opportunities with SCM Associates

Current job opportunities are posted here as they become available.

Summary
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. The case manager typically works from their home office, and attends several patient appointments in person per week.

Local/Regional driving is required.

Responsibilities and Duties
Processes the case utilizing client's outcome management model and tools

Obtains written authorization for case management services as well as release of information

Assesses the client/family to identify their strengths and resources; problems; psychosocial, financial, and medical history; current status; diagnosis; prognosis; functional status; goals; current treatment plan; and needs

Develops a plan of care with client’s model through interdisciplinary collab-oration, which identifies realistic short- and long-term goals

Identifies, secures, and coordinates the services and resources to implement the plan

Monitors services being provided for continued appropriateness and reports to client and carrier

Evaluates the client’s progress, the plan, and the appropriateness of the services provided, with modifications as necessary

Provides ongoing instruction to the client and family regarding the injury/dis-ease process, treatment options, and present care

Promotes the client’s/family’s self-advocacy skills to achieve maximum self-sufficiency

Has knowledge of the benefit package as well as all available funding sources and systems of care and coordinates with the payer for authorization of payment

Provides for in-depth reporting of outcomes encompassing clinical, functional,
financial, and customer satisfaction areas

Demonstrates effective, accurate, and timely verbal and written communication
in all work situations

Identifies and discloses all situations which might result in exposure to legal liability
and/or are indicative of poor-quality care negatively affecting the client

Frequently requires travel to patient appointments.

Performs other related duties as assigned in accordance with the necessary job
function

Supervisory Responsibilities
This position has no supervisory responsibilities.

People Contact
This position requires regular contact both within the company and outside the company
in order to carry out company policies and procedures. Requires abilities of persuasion
and cooperation. Often deals with persons of equal or higher rank.

Decision Making
This position requires frequent decision making and the ability to plan and perform unusual
or difficult work with general operation methods/procedures.

Supervision Received
This position exercises considerable latitude in determining objectives and approach to
assignments. Completed work is reviewed from a long-term perspective for desired results.

Minimum Position Qualifications
To perform this job successfully, an individual must be able to perform each essential
duty satisfactorily. The requirements listed below are representative of the knowledge,
skill, and/or ability required. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.

Education and/or

Experience:

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

Language

Skills:

Ability to…