Looking for a Licensed RN for a Case Manager Opportunity with a Hospital in Century City, CA!

Onsite M-F first shift

Pay: $48-$52/HR

Location: Century City, CA

Must have:

• RN License or LCSW

• EPIC experience

• Hospital

Preferred

• 1-3 years of Case Management experience

• CCM (Case Manager Cert)

Description

• responsible for developing and maintaining working relationships with clinical treatment team members, i.e.: medical, psychology, nursing, therapy, therapeutic recreation, vocational and dietary, in order to assure clinical outcomes that are appropriate, cost-effective, and beneficial to the patient

• Coordinates with Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., to assure positive fiscal management outcomes for the patient

• Develops and maintains updated departmental materials and patient education materials

• Conducts chart audits on a regular basis to maintain compliance

-Handles payer responsibilities and referral sources

• Overseeing negotiations of continued stay rationale, length of stays, and appeals process

• Initiates activities to develop positive business relationships with payers and referral sources in order to promote repeat business

• Assures responsiveness to payer systems by maintaining ongoing communication and serving as the primary contact for all external payer sources, in turn generating revenue, enhancing reimbursement, minimizing financial risk and assuring payment for the hospital

• Maintains a thorough understanding of insurance coverage and benefits, providing interpretation to patients/families of their insurance and providing patient advocacy

· Responsible for functioning as the liaison among all parties involved with the patient

Participates as part of the interdisciplinary team developing, implementing, reviewing and revising the interdisciplinary plan of care.

• Maintain ongoing communication and serving as the primary contact for all external payer sources, enhancing reimbursement, minimizing financial risk and assuring payment for the hospital = collections.

• Understanding of insurance coverage and benefits, providing interpretation to patients/families of their insurance

• Payer/Referral Management: fulfills the requirements and needs of payer and referral sources and appeals process.

• Assist in patient caseload – 15 – 20 cases

• Coordinates with other departments, i.e.: Pre-Admissions, Admissions, Patient Accounts, Utilization Review, PPS Coordinator, etc., - patient financial responsibility

Additional Skills & Qualifications

· Current licensure (RN, LCSW preferred).

· Previous experience in Case Management and Discharge Planning preferred.

· CCM Certification Preferred.

Experience Level

Intermediate Level

Pay and Benefits

The pay range for this position is $52.00 - $52.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision• Critical Illness, Accident, and Hospital• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available• Life Insurance (Voluntary Life & AD&D for the employee and dependents)• Short and long-term disability• Health Spending Account (HSA)• Transportation benefits• Employee Assistance Program• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Los Angeles,CA.

Application Deadline

This position is anticipated to close on Feb 11, 2025.

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.