RN Job

Manager, Outpatient Case Management RN

Full Time
Req #UHM-1026
Northridge, 91325

Manager of Outpatient Case Management is responsible for management and oversight of Regal Outpatient Care Management Programs.  The Program and Department coordinate and manage care of enrollees designated at high risk for progression of disease, clinical decline, and in need of urgent or emergent care.  Directly responsible for daily operations of the Program and Department and for operational partnership with concurrent review team managing inpatient and SNF admissions, home health care services, home visit program staff, hospice agencies, and preauthorization department.  

Cooperation and problem solving with Network Management, Finance, and Claims is also expected. Responsible for processes to oversee ambulatory case management including standardized documentation and auditing, programs that maximize quality, programs to ensure appropriate resource utilization within members benefit plan and established contracts.

Qualifications
  • Previous management experience required.
  • Must have experience in managing high risk cases.
  • High level knowledge of Case Management processes and principles
  • Prior experience in MSO environment preferred.Ability to work with all levels of management.
  • Must have excellent verbal and written communications skills.
  • Must have excellent organizational skills.
  • Must have prior experience with project development and implementation.
  • Must have working knowledge of MS Office environment.
  • Requires current CA driver’s license and car insurance.
  • Requires active CA RN license, CCM certification preferred.
About the Hospital

As one of the largest physician-led networks in Southern California, we have thousands of physicians and hundreds of hospitals committed to providing quality healthcare to all of the communities we serve.

Every day, our employees are inspired to make a difference in the lives of others as well as transform their own experiences to achieve a higher sense of fulfillment. Our employees become a part of an extraordinary team of people dedicated to health, wellness, and happiness for themselves and others. There is no greater reward than contributing to a positive work environment where compassion, understanding, care and attention are encouraged and valued.

View Job

 

Additional Jobs at Regal Medical Group

Posted within the last 49 days (7 jobs)

Nurse Practitioner / Physician Assistant – Primary Care – $15K Sign On Bonus

Full Time
Req #w97-1407
Northridge, CA, 91325

Obtains complete medical history and physical data on patients Reviews...

View Job

RN – PACU

Part Time, Per Diem
Req #UVJ-1014
Northridge, 91325

Assists the PACU Charge Nurse in the daily clinical operations of the PACU in...

View Job

Nurse Auditors LVN/RN with CQM Experience

Full Time
Req #UHM-1156
Northridge, 91325

The CQM auditor performs Quality Monitoring to assure the regulatory compliance...

View Job

Inpatient Case Manager RN

Part Time, Per Diem
Req #WDL-987
Northridge, 91325

The Inpatient Case Manager is responsible for the assessment, treatment...

View Job

Nurse Practitioner / Physician Assistant – Primary Care

Full Time
Req #W97-968
North Hollywood, 91607

Provides primary health care and performs selective medical services under the...

View Job

Operating Room RN

Full Time
Req #UVJ-1103
Glendale, 91202

Assists clinical director in organization and daily function of the operating...

View Job

SNF Placement Case Manager

Full Time
Req #UHM-773
Covina, 91723

The Case Manager, SNF Placement RN performs triage functions by providing...

View Job

Hiring Now

Experience the Digital Flip Mag

Flip through the pages of the latest Working Nurse magazine on your device.