Case Manager LPN Or RN

Fundamental Administrative Services, LLC Las Vegas , NV 89134

Posted 8 months ago

Job Description:

Spanish Hills Wellness Suites
5351 Montessouri St.|Las Vegas, NV 89113

P: 702.251-2200|F: 702.251-2201

www.SpanishHillsWellness.com

Full Time: Days

About the Position:

Case management is a collaborative and truly holistic process. Case Managers work diligently alongside doctors, nurses, social workers, and many other medical and non-medical personnel to meet the complex needs of patients. They ensure that the care and discharge plans meet the physical, social, and emotional needs of the patient. If you are an LPN or RN with excellent communication, superior organization skills - apply today!

Position Summary:

Responsible for effective benefit management, utilization of services and resources. Reviews to determine appropriateness and medical necessity, continued stay and the use of ancillary services using concurrent review process. Works effectively developing, enhancing and maintaining relationships with third party payers. They also function as a liaison between facility and managed care/ insurance company.

Qualifications:

  • Must have a current, unencumbered LPN or RN License valid to practice in the state of Nevada

  • 2+ years of Case Management Experience preferred

  • Bachelor's degree (in a health-related field is preferred) a plus

  • Case Management Certification preferred

Benefits:

All of our employees are valued and receive a competitive hourly rate; our full time team members are also offered a robust and comprehensive benefit package which includes:

  • Comprehensive Medical, Dental and Vision Insurance/ Flexible Spending Accounts

  • Life Insurance Coverage

  • Short and Long-Term Disability Options

  • Tuition Reimbursement & Nursing Loan Repayment Programs

  • 401 (k) Savings Plan

  • Paid Time Off

  • DailyPay option available! Get your pay, when you need it.

  • MetLife Auto and Home Insurance - employee discount available

  • Helping Friends Foundation

  • Employee Assistance Plan

  • Tickets at Work - entertainment ticket discounts

  • Purchasing Power - online purchase/payroll deduction

  • In-facility education programs and more!

  • Equal Opportunity Employer. M/F/Vets/Disabled. Drug-free/Smoke-free work environment.

Req. ID:008538 | 90427 - Spanish Hills Wellness Suites


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Onsite RN Case Manager Telecommute In Las Vegas NV

Unitedhealth Group Inc.

Posted 2 days ago

VIEW JOBS 11/20/2019 12:00:00 AM 2020-02-18T00:00 Are you ready for your next challenge? Discover it here at UnitedHealth Group and help us reinvent the health system. We're going beyond basic care, providing integrated health programs with a member-centric focus. The challenge is ensuring we deliver the right care at the right time. When you join us as an On-Site RN Case Manager, you'll be making a difference in peoples' lives and will be responsible for discharge planning, improved transitions of care, and utilization management of hospitalized health plan members. You will ensure patients receive quality medical care in the most appropriate setting. What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. Here, we're working to help others live healthier lives while providing an opportunity for you to do your life's best work.(sm) Candidates must be willing to travel to and work onsite at various LTACHs, skilled nursing and acute rehab facilities within the Las Vegas and Henderson area. Ability to telecommute after orientation. Performs the following case management skills on a daily basis: * Perform patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial) * Develop individualized discharge plans that involve provider, patient, and caregiver goals for successful transitions of care * Implement discharge plan involving health care resources across the continuum * Monitor and report variances that may challenge timely quality care Primary Responsibilities: * Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care * Utilize both company and community based resources to establish a safe and effective case management plan for hospitalized members * Collaborate with patient, family, and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge plan * Communicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized members * Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team * Utilize approved clinical criteria to assess and determine appropriate level of care for hospitalized members * Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan * Accountable to understand role and how it affects utilization management benchmarks and quality outcomes * Provides health education and coaches consumers on treatment alternatives to assist them in best decision making * Supports consumers in selection of best physician and facility to maximize access, quality, and to manage heath care cost * Coordinates services and referrals to health programs * Prepares individuals for physician visits * Assesses and triages immediate health concerns * Manages utilization through education * Identifies problems or gaps in care offering opportunity for intervention * Assists members in sorting through their benefits and making choices * Takes in-bound calls and places out-bound calls as dictated by consumer and business needs * Special projects, initiatives, and other job duties as assigned * Work completed in Sub - Acute facilities or Acute Hospital settings * Occasional driving up to one (1) hour daily for regular employees per diem employees will drive less than one hour daily and are not subject to the driving requirements You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Registered Nurse with active, unrestricted license in the State of Nevada * 3 years of adult clinical experience in a hospital setting * Intermediate level of proficiency using a PC in a Windows environment, including MS Word and Excel Preferred Qualifications: * Bachelor's degree * Acute hospital experience in one or more of the following areas: LTACH, med-surg, ER, psychiatric, ICU or IMC * Rehab facility experience in one or more of the following areas: skilled nursing or acute inpatient rehab * CCM certification or ability to obtain within 2 years of employment * Case management/utilization review experience * Knowledge of Interqual or MCG * Experience in a managed care organization Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm) * All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: RN, Nurse, Case Manager, Acute Rehab, LTACH, skilled nursing, ER, IMC, Med-surg, ICU, Claims, MCG, Milliman, Appeals, Grievances, CCM, Medicaid , Public Health, Care Coordination, Case Management, Utilization Review, Prior Authorization, Discharge Planning, Medical Adjudication, Managed Care, Las Vegas, NV, Nevada, UHG, UnitedHealth Group, UHC, UnitedHealthcare Unitedhealth Group Inc. Las Vegas NV

Case Manager LPN Or RN

Fundamental Administrative Services, LLC