Care Manager I - RN (Maryland)

Care Manager I - RN

Job Title: Care Manager

Department: Population Health

Employment Type: Full Time

Location: Monterey Park, CA

Workplace type: Fully remote

Compensation: $78,000 - $91,000 / year

Reporting To: Heather Hartman

What You'll Do

• Develops and initiates the Individual Care Plan, which is client-centered, comprehensive and consistent with program guidelines and policies and procedures
• Identifies, arranges for, and monitors appropriate community services based on a good knowledge of Medicare, Medicaid, and other entitlement programs
• Coordinate and facilitate patient care through assessment, evaluation, planning, and implementation
• Communicate patient needs to a variety of care team members and follow up accordingly
• Manage discharge plans upon completion of treatment
• Work collaboratively with patients, families, physicians, and nurses to ensure high quality care
• Act as the patient's advocate as it relates to insurance coverage and financial assistance
• Maintain the patient's comprehensive clinical record through detailed documentation
• Coordinate an interdisciplinary approach to support timely access to appropriate care, facilitate continuity of care among providers and improve utilization of appropriate resources
• Apply established principles of care transition and follow member through continuum of care as well as coordinate a warm hand-off to the appropriate provider and/or health plan for necessary involvement of continuation of care and services
• Assists UM Manager and participates in all internal and external audits
• Primary liaison with all contracted health plans for case management activities
• Ensure the privacy and security of PHI (Protected Health Information) as outlined in Medical Group/ MSO policies and procedures related to HIPAA compliance
• Other duties and special projects as assigned

Qualifications

• Registered Nurse, Licensed Vocational Nurse, or Medical Assistant required
• Bachelor's degree in nursing and or a related health services field is preferred
• At least two (2) years' experience in utilization management including experience applying evidenced based clinical criteria and benefit plans is required
• At least three (3) years' of clinical experience preferably in case management or related experience is required

You're great for the role if:

• Have a certification as Certified Case Management (CCM)
• Are fluent in Tagalog or Ilocano

Environmental Job Requirements and Working Conditions

• This is a remote position. The home office is located at 1600 Corporate Center Dr., Monterey Park, CA 91754.
• The total compensation target pay range for this role is: $78,000 - $91,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

About Astrana Health, Inc.

Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.