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enrollment rn manager

myPlace Health

<div>
 
 About MyPlace Health
 
 
 
 myPlace Health was founded in 2021 by mission-aligned healthcare leaders and organizations that are committed to drastically improving health outcomes, quality and experience for vulnerable older adults and frail seniors. We specialize in providing value-based, comprehensive care and coverage for older adults with significant needs so they can thrive in the homes they love and in the communities they cherish.
 
 
 Our mission is simple: to enable older adults to live the independent lives they deserve. We pursue this mission through our myPlace PACE (Program of All-Inclusive Care for the Elderly) model, which provides seamless primary care, integrated health plan coverage, personalized social engagement, and customized services delivered in the participant&rsquo;s preferred place.
 
 
 myPlace Health is building a mission-driven team that shares our passion for redefining the way older adults experience care as they &ldquo;age in place&rdquo; in the community. This is a unique opportunity to take on one of our country&rsquo;s most challenging healthcare problems and join a fast-growing, dynamic team as we prepare to scale our mission to serve more markets.
 
 
 
 About This Role
 
 
 
 As our Enrollment RN Manager, you&rsquo;ll be the clinical leader at the front door of our PACE program&mdash;guiding how frail older adults and their families first experience myPlace Health. You&rsquo;ll lead and develop the enrollment clinical team across both our Greater LA and South LA sites, coaching Enrollment RN Supervisors, RNs, and LVNs while ensuring consistent standards, workflows, and a warm, person-centered experience.
 
 
 You&rsquo;ll oversee NFLOC and other level-of-care assessments, keep enrollment documentation audit-ready, and serve as a go-to expert on PACE eligibility and regulatory requirements. In this hybrid role, you&rsquo;ll split your time between the center, the community, and working from home; partnering closely with Outreach, Center Operations, Finance, and Compliance to align enrollment with program capacity, growth, and quality goals.
 
 
 
 What Does Success Look Like As Our First Enrollment RN Manager?
 
 
 
 <ul>
 <li>
 Lead and develop the enrollment clinical team across all sites: Coach, mentor, and support Enrollment RN Supervisors, RNs, and LVNs at each PACE center, providing regular feedback, performance management, and growth opportunities while ensuring consistent standards, workflows, and participant experience across locations.
 </li>
 <li>
 Own the clinical side of enrollment: Oversee NFLOC and other Level of Care assessments, home safety evaluations, and enrollment-related clinical documentation to ensure completeness, accuracy, and timeliness.
 </li>
 <li>
 Keep us audit-ready and compliant: Maintain high standards of documentation in the EHR and CRM. Lead preparation for DHCS, CMS, and other regulatory audits, ensuring all enrollment activities meet PACE and state/federal requirements.
 </li>
 <li>
 Be the internal expert on PACE eligibility: Serve as a go-to resource on PACE eligibility criteria, enrollment rules, and NFLOC guidelines. Provide guidance to leaders and staff when questions or complex cases arise.
 </li>
 <li>
 Drive collaboration across teams: Partner with Outreach, Center Leadership, Finance, Compliance, and Center Operations to align enrollment workflows with program capacity and strategic growth goals.
 </li>
 <li>
 Use data to improve how we work: Track key enrollment metrics such as pipeline status, RN productivity, documentation timelines, and audit findings. Use insights to refine processes and support decision-making.
 </li>
 <li>
 Lead clinical eligibility reviews: Facilitate clinical eligibility meetings, helping present and review nursing recommendations for potential participants and supporting clear, informed decisions.
 </li>
 <li>
 Provide hands-on support when needed: Step in to complete home-based assessments and NFLOC evaluations when needed to maintain timelines and continuity of operations.
 </li>
 <li>
 Optimize our systems and tools: Help implement or refine EHR and CRM workflows that support enrollment, reduce administrative burden, and strengthen reporting and audit capabilities.
 </li>
 <li>
 Identify and escalate risks: Spot clinical, operational, or regulatory risks that could impact eligibility, enrollment timing, or compliance, and partner with leadership to address them.
 </li>
 <li>
 Step in where it makes sense: Take on additional projects and responsibilities as needed to support enrollment operations and participant care, within the scope of your RN licensure, training, and organizational needs.
 
 
 </li>
 </ul>
 
 What Does An Ideal Profile Look Like?
 
 
 
 <ul>
 <li>
 You are a licensed RN in California: You hold an active, unrestricted Registered Nurse (RN) license in the state of California.
 </li>
 <li>
 You are clinically seasoned: You bring at least 5 years of nursing experience, ideally in geriatrics, case management, managed care, or community and home-based care.
 </li>
 <li>
 You are a proven people leader: You have a minimum of 2 years of leadership or supervisory experience, including performance management, clinical oversight, and team development.
 </li>
 <li>
 You care deeply about older adults: You have experience working with older adults and frail populations and are committed to dignity, safety, and person-centered care.
 </li>
 <li>
 You are educated and growth-minded: You have an Associate&rsquo;s degree in Nursing, and a BSN is strongly preferred.
 </li>
 <li>
 You understand enrollment and compliance: You are familiar with enrollment processes, care coordination, and regulatory requirements; experience with PACE, Medi-Cal, or value-based care models is a plus.
 </li>
 <li>
 You are tech-comfortable and data-aware: You are comfortable using Electronic Health Record (EHR) and Customer Relationship Management (CRM) systems for documentation, workflow management, and performance reporting.
 </li>
 <li>
 You are a strong communicator and collaborator: You bring excellent communication, interpersonal, organizational, and problem-solving skills and can build trust across disciplines and levels.
 </li>
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 You are field-ready when needed: You have a valid California driver&rsquo;s license and reliable transportation to travel within the service area for home visits and assessments.
 </li>
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 You prioritize safety and readiness: You have current CPR certification or are willing to obtain it within 60 days of hire.
 </li>
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 You bring the power of language: You may offer bilingual skills, such as Spanish, Cantonese, Mandarin, or Vietnamese, which are highly preferred.
 </li>
 <li>
 You are mission-driven at your core: Above all, you are passionate about helping frail older adults live safely and independently at home and want your work to reflect that purpose every day.
 
 
 </li>
 </ul>
 
 The Fine Print:
 
 
 
 <ul>
 <li>
 Set your weekly rhythm &ndash; You&rsquo;ll work Monday through Friday, with the flexibility to support occasional weekend needs when participant care or operations require it.
 </li>
 <li>
 Blend office, home, and community &ndash; This is a hybrid role, combining time in the field across our Greater LA and South LA service areas, time at the center, and time working from home when appropriate.
 </li>
 <li>
 Meet people where they are &ndash; You&rsquo;re comfortable being out in the community, connecting with participants and team members in real-world settings, and traveling to our centers as needed for collaboration, meetings, and on-site support.
 
 
 </li>
 </ul>
 
 The Physical Requirements Of The Role:
 
 
 
 <ul>
 <li>
 Ability to sit for extended periods while working on a computer, reviewing charts, and participating in meetings.
 </li>
 <li>
 Ability to stand, walk, and move throughout the Center, clinic, and office spaces for portions of the day.
 </li>
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 Ability to drive and travel within the service area for home visits and assessments, including entering and navigating a variety of home environments that may include stairs, tight spaces, or uneven surfaces.
 </li>
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 Ability to occasionally lift, carry, push, or pull materials and equipment (such as a laptop, charts, or small medical equipment), generally up to 25 pounds.
 </li>
 <li>
 Ability to bend, reach, kneel, and stretch as needed during home safety evaluations or when reviewing participant environments.
 </li>
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 Sufficient vision and hearing to assess participant conditions, review documentation, and communicate clearly in person, by phone, and via video.
 </li>
 <li>
 Ability to perform repetitive hand and wrist motions associated with computer use and documentation.
 </li>
 <li>
 Ability to move quickly and adapt in a dynamic clinical and operational environment.
 </li>
 <li>
 Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of this role.
 
 
 </li>
 </ul>
 
 The Work Environment:
 
 
 
 <ul>
 <li>
 Make the PACE Center your home base: You&rsquo;ll spend part of your time in a combined clinic and administrative office setting, working side by side with nurses, social workers, therapists, physicians, and operations teammates.
 </li>
 <li>
 Take your impact into the community: You&rsquo;ll regularly travel within our Greater LA and South LA service areas to support home-based assessments, NFLOC evaluations, and other enrollment activities in participants&rsquo; homes and neighborhood settings.
 </li>
 <li>
 Enjoy true hybrid flexibility: You&rsquo;ll also work from home for focused time on documentation, chart review, virtual meetings, planning, and data or workflow review, while staying closely connected to your team.
 </li>
 <li>
 Thrive in a fast-moving, team-first environment: You&rsquo;ll collaborate closely with Outreach, Finance, Compliance, and Center Operations to meet enrollment timelines, manage the pipeline, and support program growth.
 </li>
 <li>
 Balance screen time and face time: Your days will blend computer and phone work, virtual meetings, in-person huddles, and time spent moving between clinic, office, and community settings.
 </li>
 <li>
 Work safely in a healthcare setting: At the center and in the field, you may encounter infectious diseases and body fluids; we provide training and PPE, and you&rsquo;ll follow standard infection control practices.
 </li>
 <li>
 Stay flexible in a lively space: Noise levels are typically moderate but can increase during peak clinic hours or group activities, keeping the environment active and engaging.
 
 
 </li>
 </ul>
 
 Lead the Front Door of Care &ndash; Become Our Enrollment RN Manager
 
 
 
 If you&rsquo;re an RN leader who loves building strong teams, improving how work gets done, and making a real difference for frail older adults, we&rsquo;d be excited to connect with you. Join us in shaping a thoughtful, person-centered enrollment experience that helps more seniors stay safely at home, surrounded by the care and community they deserve.
 
 
 
 Your Application
 
 
 
 Please submit your resume/CV.
 
 
 
 Our Commitment to Diversity, Equity and Inclusion
 
 
 
 At myPlace Health, we value the diversity of our team members, and we are committed to building a culture of inclusion and belonging. We pride ourselves to be an equal opportunity employer. People seeking employment at myPlace Health are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
 
 
 
 COVID-19 Vaccination Policy
 
 
 
 At myPlace Health, we provide safe and high-quality care to our participants. To achieve this, we have a policy that strongly recommends Covid-19 vaccination to keep both our team members and participants safe. Medical and religious exemptions can be granted based upon review of proper documentation. We adhere to all federal, state, and local regulations by obtaining necessary proof of vaccination prior to employment.
 
 
 
 Beware of Scams and Fraud
 
 
 
 Please beware of scams that solicit interviews or promote jobs for opportunities that are not listed on our website or are not directly related to a job you applied for yourself. Please be advised that myPlace Health will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the &lsquo;Rip-offs and Imposter Scams&rsquo; option: https://reportfraud.ftc.gov/#/
 
 
 We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
 
 
 
 What&rsquo;s In It for You?
 
 
 
 At myPlace Health, we believe that when we take exceptional care of our people, they can take exceptional care of our participants. That&rsquo;s why we&rsquo;ve built a comprehensive, people-first rewards package designed to support your well-being&mdash;professionally, financially, and personally.
 
 
 Here&rsquo;s a snapshot of what you can look forward to:
 
 
 
 Competitive Pay &amp; Total Rewards
 
 
 
 We offer a strong base salary along with a total rewards package that reflects your experience, education, certifications, and the location of your role. For onsite roles, we adjust pay based on local markets; remote roles are aligned to national pay benchmarks.
 
 
 
 Performance-Based Incentives
 
 
 
 Our productivity-driven incentive plan recognizes your individual and team contributions and rewards you for meeting and exceeding agreed-upon productivity and quality goals.
 
 
 
 Ongoing Growth &amp; Feedback
 
 
 
 You&rsquo;ll receive two performance reviews per year (when applicable), giving you the chance to grow, reflect, and celebrate your achievements.
 
 
 
 Plan for Your Future
 
 
 
 Take advantage of our 401(k) plan with an employer match&mdash;because your future matters.
 
 
 
 Health Coverage that Fits Your Life
 
 
 
 Choose from six medical plans, with up to 80% of premiums covered for employees and 75% for dependents.
 
 
 
 More Than Just Medical
 
 
 
 We&rsquo;ve got you covered with dental and vision insurance, FSA/HSA options, short- and long-term disability, basic life insurance, and additional benefits like accident, critical illness, and hospital indemnity coverage.
 
 
 
 Generous Time Off
 
 
 
 Recharge with 20 days of PTO to start, 12 paid holidays, and 2 floating holidays each year.
 
 
 
 Support for Your Learning
 
 
 
 We prioritize your professional development with a generous CME/CEU budget, dedicated time off for learning, and ongoing growth opportunities.
 
 
 
 Family Comes First
 
 
 
 Our family-friendly culture includes paid parental leave and a child care stipend to help support you at home.
</div>

Enrollment RN Manager

TEEMA

<div><h4 class="jobSectionHeader">Make a Difference in the Lives of Families Affected by Autism</h4>
We&rsquo;re looking for a dedicated Autism Services Navigator (ASN) to support families enrolled in the Autism Care Demonstration (ACD). In this role, you&rsquo;ll be a trusted advocate, guiding beneficiaries diagnosed with autism spectrum disorder (ASD) through the care process. You&rsquo;ll coordinate services, provide crucial resources, and help families overcome barriers to ensure they receive the highest quality of care in a cost-effective manner. If you have a passion for helping others and expertise in care management, this is the role for you!<h4 class="jobSectionHeader">
What You&rsquo;ll Do</h4><ul><li>
Apply knowledge of HIPAA privacy regulations and accreditation standards to ensure compliance in all interactions.</li><li>
Assess beneficiary needs against ACD program criteria to determine eligibility and identify high-risk individuals needing enhanced support.</li><li>
Educate families on ACD benefits and available services to ensure they receive the best possible care.</li><li>
Make timely enrollment decisions and communicate approvals efficiently.</li><li>
Conduct comprehensive case management assessments and collaborate with families and providers to create individualized Comprehensive Care Plans (CCPs).</li><li>
Ensure continuity of care by sharing CCPs with beneficiaries, primary care managers (PCMs), and relevant providers while updating them as needed.</li><li>
Obtain necessary agreements for sharing protected health information to coordinate care effectively.</li><li>
Continuously monitor and adjust CCPs to reflect evolving needs, treatments, and available funding options.</li><li>
Document all actions, updates, and changes related to the beneficiary&rsquo;s care journey.</li></ul><h4 class="jobSectionHeader">
What You Bring</h4><ul><li>
Current, unrestricted licensure as a Licensed Clinical Social Worker (LCSW), Registered Nurse (RN), or another licensed mental health professional with a Case Management Certification (CCM). Ideally licenses will be current in CA</li><li>
At least three years of full-time clinical experience providing direct care.</li><li>
Experience in pediatrics, behavioral health, ASD, healthcare environments, and care management.</li><li>
Ability to obtain an industry-recognized case management certification within four years of hire.</li><li>
Must pass a Department of Defense (DoD) background investigation.</li><li>
U.S. Citizenship required.</li></ul><h4 class="jobSectionHeader">
Preferred Qualifications</h4><ul><li>
Two years of experience working with individuals diagnosed with ASD and/or the TRICARE ACD program.</li><li>
Two years of case management experience.</li><li>
Industry-recognized case manager certification.</li></ul>
Join us in making a real impact&mdash;apply today and help families access the care and support they deserve!
#Workwolf #BCDC_Consulting</div>

RN Case Manager - Autism Services Navigator California

TEEMA Group

<div>Job Title: Registered Nurse (RN) Disease Manager
Job Overview: 
The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or complex health conditions. This role involves assessing, monitoring, educating, and supporting patients in managing their diseases to improve overall health and quality of life while reducing unnecessary hospitalizations and emergency care.
Key Responsibilities:<ul><li>
Patient Assessment: Conduct comprehensive assessments of patients&rsquo; physical, emotional, and psychosocial needs related to their chronic conditions.</li><li>
Care Coordination: Work closely with interdisciplinary teams, including physicians, case managers, social workers, and other healthcare professionals, to develop and implement individualized care plans for patients.</li><li>
Disease Education: Provide education to patients and their families regarding their diagnoses, treatment plans, and self-management techniques to improve disease outcomes.</li><li>
Case Management: Monitor patient progress and adjust care plans as necessary. Ensure that patients are following their prescribed treatment and managing their conditions effectively.</li><li>
Data Management and Reporting: Track patient outcomes and document interactions accurately. Utilize health information technology to document care, track patient progress, and report to appropriate stakeholders.</li><li>
Advocacy: Advocate for the patient&rsquo;s needs, including obtaining necessary resources or services that will improve their health outcomes.</li><li>
Prevention and Health Promotion: Promote preventive care, including vaccinations, screenings, and lifestyle modifications to reduce the impact of chronic conditions.</li><li>
Collaboration with Providers: Maintain communication with healthcare providers to ensure continuity of care, timely follow-ups, and updates on patient status.</li></ul>
Qualifications:<ul><li>
Education: Bachelor&rsquo;s Degree in Nursing (BSN) or an Associate's Degree in Nursing (ADN) with appropriate certifications.</li><li>
Licensure: Current Registered Nurse (RN) license in the state of employment.</li><li>
Experience: 3-5 years of clinical nursing experience, preferably in disease management, case management, or a related field.</li><li>
Certifications: Certification in Disease Management (CDM), Case Management (CCM), or other relevant certifications preferred.</li><li>
Skills: Strong communication, problem-solving, and critical thinking skills. Ability to work independently and as part of a team. Proficiency with electronic health records (EHR) and other healthcare technology.</li></ul>
#Workwolf</div>

RN Case Manager – Managed Care REMOTE

Wyndy

<div>
 
 Pay:
 
 $17 - $33 per hour
 
 
 
 Start Date:
 
 In 5-7 Days
 
 
 
 Location:
 
 Los Angeles, CA
 
 
 
 Job Description
 
 
 
 Seeking part-time nanny/house manager for 2 school-aged siblings. Must be located near UCLA.
 
 
 
 Parent / Family Information
 
 
 
 Location: Los Angeles, CA 90025
 
 
 Seeking: Los Angeles Nanny
 
 
 Education: Attending/Graduated College
 
 
 Time Needed: Part-Time
 
 
 
 Nanny Job Requirements
 
 
 
 Experienced Nanny: Yes
 
 
 Background Checked: Yes
 
 
 Verified College Enrollment: Yes
 
 
 
 Qualifications
 
 
 
 <ul>
 <li>
 </li>
 <li>
 A love of working with children
 </li>
 <li>
 </li>
 <li>
 Excellent communication skills
 </li>
 <li>
 </li>
 <li>
 Ability to follow directions
 </li>
 <li>
 </li>
 <li>
 Passion for helping others
 
 
 </li>
 </ul>
 
 Benefits
 
 
 
 <ul>
 <li>
 </li>
 <li>
 Build a strong profile with positive reviews from families
 </li>
 <li>
 </li>
 <li>
 Earn more by taking on last-minute or high-demand jobs
 </li>
 <li>
 </li>
 <li>
 Earn extra money by working on weekends or during school breaks
 
 
 </li>
 </ul>
 
 Application Process
 
 
 
 <ul>
 <li>
 </li>
 <li>
 Upon submission, your application will be reviewed to ensure quality before becoming active.
 </li>
 <li>
 </li>
 <li>
 You'll receive an initial response within 48 hours of submission.
 </li>
 </ul>
</div>

Seeking part-time nanny/house manager near UCLA for 2 school-aged siblings

UCLA Health

<div><div>Description
The Nurse Practitioner (NP) in the Division of Clinical Genetics provides advanced clinical support and expertise across inpatient and outpatient settings for patients and families with complex genetic and metabolic conditions, including lysosomal storage disorders and autism. A primary focus of this role is serving as a key clinical leader within the Newborn Screening (NBS) Program and functioning as the Specialty Services Coordinator (SSC). In this capacity, the NP oversees the evaluation, triage, and coordination of care for infants identified through newborn screening, ensuring timely follow‑up, diagnostic workup, family education, and seamless transition into specialty care when indicated.

The NP participates in an interdependent role that includes performing medical examinations, managing and diagnosing genetic conditions, and participating in specialized therapeutic and diagnostic procedures. Core responsibilities include obtaining medical histories, conducting physical examinations, communicating treatment plans, ordering and interpreting laboratory and genetic tests, and supporting comprehensive patient care as defined by standardized procedures (SPs) or NP licensure. The NP practices independently in patient management decisions and collaboratively with attending physicians and interdisciplinary team members to address the health care needs of Clinical Genetics patients.

As an expert clinical resource, interdisciplinary consultant, and patient advocate, the NP may also provide care within the gene therapy infusion center. The NP demonstrates a strong commitment to a patient‑ and family‑centered model of care and plays an active role in trainee education, including medical students, residents, and genetic counseling students. The NP participates in interdisciplinary and clinical rounds, provides education and support to families and staff, coordinates appropriate referrals, and ensures accurate and timely documentation of services.

Through the implementation of Standardized Procedures, the NP adjusts treatment regimens based on clinical assessment, including signs and symptoms of illness, treatment response, behavior, and physical findings, in accordance with the California Nursing Practice Act (subsection (b) of Section 2725). The NP promotes safe continuity of care, leads patient and family education efforts, and supports the operational and clinical functions of both the Newborn Screening Program and SSC coordination.
Salary range: $93.81- $133.97/hourly</div><div> 
Qualifications<div><ul><li>
CA RN and CA NP License-required</li><li>
MSN or DNP in Nursing-required</li><li>
State of CA NP Furnishing with Schedule II, NPI#, DEA#, Enrollment in PECOS and in CURES-required</li><li>
BLS Certification from AHA or ARC-required</li><li>
PALS and NRP Certification from AHA- required</li><li>
National NP Board certification in a relevant specialty (e.g., Family NP, Pediatric NP. Neonatal NP-required</li><li>
Minimum of 1&ndash;2 years of NP experience in pediatrics, genetics, metabolic disorders, neonatology, or a related specialty-required</li><li>
Experience working with infants, children, and families in acute, outpatient, or specialty care settings-required</li><li>
Ability to utilize excel, word and other software programs-required</li><li>
Ability to establish and maintain cooperative and collaborative working relationships with administrative, clinical and academic personnel-required</li><li>
Skill in working independently and following through with minimum direction-required</li><li>
Ability to set priorities-required</li><li>
Demonstrate writing skills to compose logical, detailed and grammatically correct correspondence-required</li><li>
Prior involvement in newborn screening follow up, metabolic/genetic clinics, or care coordination preferred</li><li>
Experience interpreting laboratory results, genetic testing, and metabolic evaluations strongly preferred</li></ul></div></div></div>

Nurse Practitioner - Clinical Genetics

MLK Community Healthcare

<div><div><div>Pay Rate Type</div>
Yearly</div>
<div><div>Salary Range (Depending on Experience)</div>
$125,179.12 - $194,027.64</div> 
<div><div>If you are interested apply online and send your resume to yadeleon@mlkch.org.
POSITION SUMMARY
The Manager of Care Management will supervise and direct all levels of Care Management team that includes RN Care Managers, Lead Care Management RN, Care Management Coordinators, Discharge Planners (DCP), Care Coordinators, and Care Management Educator. This position may also be asked to supervise and cover supervision for other management in the CM Department. These services include assessment of patients for level of care, appropriateness for admission or observation, HLOC transfers, discharge assistance, and follow up care as appropriate in collaboration with the ED care management team and Social Work Department. Care Management policies for this work initiated, reviewed and implemented by the Manager as needed.
This Manager role will also provide clinical supervision for scheduling, Kronos payroll, coaching/corrective action, and educational needs to ensure that the care management policies and processes are carried out for the organization. This role will oversee the electronic referral system, currently Ensocare, documentation of care management through Cerner Healthcare EMR including working with Clinical informatics (CIT), to develop or improve care management documentation, as well as handoff processes.
This position is responsible for overseeing post-acute providers, facilities and other types of community service providers as directed by the Director of Care Management. The Manager will assist with overseeing compliance policies and plan related to vendor networks to maintain a working relationship between MLK and individual network providers. Manager will identify opportunities to improve post discharge services to reduce readmissions and improve community health in collaboration.
Works collaboratively with other colleagues within the Population Health Program to support the entire Care Management Department. This role is expected to share in Care Management Leadership Call on a rotation basis as assigned by the Director for Care Management 
ESSENTIAL DUTIES AND RESPONSIBILITIES<ul><li>
Manages and supervises the IP Care Management RNs, Care Management Coordinators, Care Coordinators, 
Discharge Planners, and Care Management Educator to support the MLKCH Care Management services includes but not limited to assessments, transfers to higher levels of care, inpatient discharge needs, and follow up care by DCP team according to Care Management Department policies and procedures.</li><li>
Works in collaboration with the Director of Social Work Services and Street Medicine to support the Care Management Program as well as in support of the Population Health Program at MLKCH.
</li><li>Oversight of MLKCH compliance policies related to discharge planning and use of letters of agreement (LOA) with current/planned scope of post-acute partner networks including:<ul><li>
MLK-LA Skilled Nursing Facilities (SNF)</li><li>
MLK-LA Home Health Professional Network (planning)</li><li>
MLK-LA Palliative and Hospice Network (planning)</li></ul></li><li>
Have oversight of assessing need for additional provider networks in collaboration with management given new clinical/social needs and ongoing revisions to the Population Health Strategy.
</li><li>Identify and vet potential post-acute service providers
</li><li>Participates in hospital committees and unit specific multidisciplinary conferences as well as staff meetings for the Care Management Department
</li><li>Models leadership and promotes professionalism to assist staff in developing priority setting, team work, and flexibility in support of the Care Management team and in community health activities.
</li><li>Holds clinical and non-clinical staff accountable for the performing initial assessments, identifying and documenting a discharge plan, and collaborating with the work team to ensure a safe patient discharge under the scope and standards for ACMA &amp; CMSA standards.</li><li>
Responsible for the hiring process and identifying and recommending staffing needs with skill mix as appropriate to meet needs of the population.
</li><li>Manages payroll in Kronos; monitors overtime as well as attendance related to HR policy for time &amp; attendance.
</li><li>Oversee a mix of clinical, operational and business projects including but not limited to ones used reduce readmissions, improve transportation services such as ambulance services, and other clinical services
</li><li>Work closely with and in partnership with ED Care Coordinators, ED Care Managers, Social Work, Transitional Care Navigator staff, and clinical staff to ensure that patients care transitions from MLK entities to post-acute network providers are seamless.</li><li>
Establish and monitor management metrics: quality, outcomes, productivity of staff work, financial, case volume/mix and provides scheduled reporting to the Director of Care Management.
</li><li>Design and coordinate formal and informal training for staff and providers regarding post-acute services care management services, and oversees the clinical education program executed by the Care Management Educator.
</li><li>Systematically and continuously evaluate and address internal and external customer concerns/ grievances</li><li>
Collaborates and coordinates services and joint meetings with Los Angeles County Department of Health Services Outpatient Clinic staff</li><li>
Collaborates and coordinates functional programs with MLKCH outpatient clinics to ensure smooth transitions to community healthcare for MLKCH patients.
</li><li>Collaborates with other Care Management Leadership to ensure adequate staffing and scheduling to support the functions of the transitional care team.</li></ul> 
</div></div><div><div>POSITION REQUIREMENTS
A. Education<ul><li>
Bachelor degree in nursing required or Master&rsquo;s Degree in Social Worker with LCSW required.
</li></ul>B. Qualifications/Experience<ul><li>
RN Candidates must have five (5) years acute care hospital, health plan, and/or ancillary services required.</li><li>
Candidate&rsquo;s with LCSW, must have 7 years of experience in acute care hospital, health plan, and/or ancillary services required.
</li><li>Prior Supervisory or Management Experience in a clinical role required.
</li><li>RN license required or LCSW required</li><li>
CCM or ACM certification required within 2 years of hire.
</li><li>Basic Life Support (BLS) certification
</li><li>Workplace violence prevention annually.
</li><li>Direct patient care or care coordination, utilization, case/disease management experience a plus</li><li>
Experience with Medicaid/ Medi-Cal patients and government programs preferred</li><li>
Experience in clinical health informatics is preferred.</li></ul> 
C. Special Skills/Knowledge<ul><li>
Significant knowledge regarding health care provider organizations &ndash; acute and post-acute care facilities and providers</li><li>
Working knowledge of health plans and typical UM and medical management functions</li><li>
Able to navigate communication and decision-making across disciplines and provider types</li><li>
Clinical knowledge and the ability to assess situations in collaboration with multiple disciplines in order to arrive at a decision often in pressurized situations</li></ul><div>
#LI-YD1</div></div></div></div>
 <div><div><div>Know someone at MLK Community Healthcare? 
<div></div>
 
</div><div></div> 
<div><div>Equal Rights Employer 
 
Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, national origin, age, disability, genetic information, citizenship status, military service, or any other status protected by federal, state, or local laws. This application is intended for use in evaluating your application for employment. 
 
 
MLK Community Healthcare 
1680 E 120th Street 
Los Angeles, CA 90059 
Tel: 424-338-8000 
Email: info@mlkch.org 
www.mlkch.org</div></div></div></div>

Manager Care Management

Crawford & Company

<div>Now Hiring: RN Case Manager &ndash; Los Angeles, CA Region
 Work from home + local field travel 
 Salary: $87,000 &ndash; $101,000 annually 
 Quarterly Bonus Opportunities 
 Free CEUs for licenses &amp; certificates 
 License &amp; Certification Reimbursement
We&rsquo;re looking for an RN with a passion for case management to join our team! 
✨ RN degree required 
✨ National Certification preferred (CCM, CRC, COHN, CRRN) 
✨ Workers&rsquo; Comp Case Management experience a plus
 Location Requirement 
Candidates must be based in one of these California areas: 
San Fernando, Van Nuys, Santa Clarita, Granada Hills, Panorama, Valencia, Oxnard, Westlake Village, Palmdale, or Chatsworth.
✅ Your Impact: You&rsquo;ll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You&rsquo;ll support patients/employees receiving benefits under insurance lines including Workers&rsquo; Compensation, Group Health, Liability, Disability, and Care Management.
This is your chance to grow your career, earn great rewards, and enjoy true work-life balance.
 Apply today and make an impact in the community!<ul>
<li>Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services.</li>
<li>Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW.</li>
<li>Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention.</li>
<li>May perform job site evaluations/summaries to facilitate case management process.</li>
<li>Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians.</li>
<li>Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual.</li>
<li>May obtain records from the branch claims office.</li>
<li>May review files for claims adjusters and supervisors for appropriate referral for case management services.</li>
<li>May meet with employers to review active files.</li>
<li>Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians.</li>
<li>Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly.</li>
<li>May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases.</li>
<li>Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product.</li>
<li>Reviews cases with supervisor monthly to evaluate files and obtain directions.</li>
<li>Upholds the Crawford and Company Code of Business Conduct at all times.</li>
<li>Demonstrates excellent customer service, and respect for customers, co-workers, and management.</li>
<li>Independently approaches problem solving by appropriate use of research and resources.</li>
<li>May perform other related duties as assigned.</li>
</ul><ul><li>Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred.</li>
<li>Minimum of 1-3 years diverse clinical experience and one of the below:</li>
<li>Certification as a case manager from the URAC-approved list of certifications (preferred);</li>
<li>A registered nurse (RN) license.</li>
<li>Must be compliant with state requirements regarding national certifications.</li>
<li>General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services.</li>
<li>Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation.</li>
<li>Excellent analytical and customer service skills to facilitate the resolution of case management problems.</li>
<li>Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes.</li>
<li>Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees.</li>
<li>Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes.</li>
<li>Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously.</li>
<li>Demonstrated leadership ability with a basic understanding of supervisory and management principles.</li>
<li>Based on federal, state, or local law, this position may require you to be fully vaccinated for COVID-19.</li>
<li>Active RN home state licensure in good standing without restrictions with the State Board of Nursing.</li>
<li>Must meet specific requirements to provide medical case management services.</li>
<li>Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months.</li>
<li>National certification must be obtained in order to reach Senior Medical Case Management status.</li>
<li>Travel may entail approximately 70% of work time.</li>
<li>Must maintain a valid driver's license in state of residence.</li>
</ul>
#LI-RG1
Why Crawford?
 
 
Because a claim is more than a number &mdash; it&rsquo;s a person, a child, a friend. It&rsquo;s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community &ndash; one claim at a time.
 
 
At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We&rsquo;re looking for the next generation of leaders to take this journey with us.
 
 
We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com.
 
 
When you accept a job with Crawford, you become a part of the One Crawford family.
 
 
Our total compensation plans provide each of our employees with far more than just a great salary
 
<ul><li>Pay and incentive plans that recognize performance excellence</li>
<li>Benefit programs that empower financial, physical, and mental wellness</li>
<li>Training programs that promote continuous learning and career progression while enhancing job performance</li>
<li>Sustainability programs that give back to the communities in which we live and work</li>
<li>A culture of respect, collaboration, entrepreneurial spirit and inclusion</li>
</ul>Crawford &amp; Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford &amp; Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.</div>

Medical Case Manager- CA

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