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Desert Oasis Healthcare
Palm Springs, CA | Full Time
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Desert Oasis Healthcare
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Complex Case Manager
Desert Oasis Healthcare Palm Springs, CA
$77k-93k (estimate)
Full Time | Ambulatory Healthcare Services 11 Months Ago
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Desert Oasis Healthcare is Hiring a Complex Case Manager Near Palm Springs, CA

The Complex Case Manager is responsible for helping members with multiple or complex conditions regain optimum health or improved functional capability in a cost-effective manner. Complete assessments to determine available benefits and needed resources to assist in the development of an individualized care plan with focus on performance, goals, monitoring and follow up. The complex case manager is a Registered Nurse who operates in accordance with the NCQA, CMS, health plan and company requirements for Complex Case Management.
  • Actively seek supervisory assistance following the established chain of command.
  • Telephonically monitor 50-60 members by managing their healthcare conditions. Prioritize their healthcare needs to prevent complications and avoid utilizations.
  • Document in member electronic medical record (EHR) in accordance with the current documentation methodology using the Problem Intervention Plan (PIP) format, nursing standards, and company policies and procedure. Documentation must comply with the requirements mandated by health plans in order to meet routine audits.
  • Develop an individualized plan of care with goals that are Specific, Measurable, Attainable, Realistic, Time Bound (SMART) which address the qualifying complex case management diagnosis. Plan of care must be completed after assessment and with the member's input and agreement, this must be done within 30 days of the case open date.
  • Develop an individualized plan of care that identifies continued self-management SMART goals for the member. Plan of care must be completed after assessment and with the member's input and agreement, this must be done within 30 days of the case open date. Goals must be re-evaluated annually or sooner with a change in condition.
  • Complete the Clinical Social Assessment within 30 days of enrollment in Complex Case Management, then annually throughout the member's enrollment in Complex Case Management.
  • Review POLSTS, DPOAs, Serious Illness and Life Planning discussions with members on a continuous and regular basis. Routinely address the importance of preventative care and proper follow up with the Healthcare Professionals rendering care with focus on needed quality measures.
  • Educate members on the importance of proper follow up with Primary Care Providers (PCP) and other Healthcare Professionals rendering care. Educate members on the use of Immediate Care (IC) facilities and the importance of the use of the Complex Case Manager (CCM TCM) as the single point of contact.
  • Perform other duties as assigned.
(10999)
  • Current California Registered Nurse (RN) License.
  • 3 years of experience in an acute care setting. Complex Case Management experience, preferred.
  • Strong medical knowledge and competence in chronic disease pathophysiology, polypharmacy, clinical assessment, and patient-family education.
  • Basic computer skills. Ability to manage time and prioritize to meet deadlines. Ability to work independently with minimal supervision.
  • Excellent customer service and telephone etiquette skills.
  • Ability to effectively communicate with individuals within all levels of the organization, patients, patient family members and others.
  • Ability to utilize own judgement and critical thinking skills to problem solve.
  • Ability to work with a broad spectrum of healthcare professionals.
  • Bilingual preferred. Ability to speak, read and write in English and Spanish fluently, preferred.
  • At the discretion of DOHC/FHC management, this position has the potential to be a full or hybrid telecommuting position.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Ambulatory Healthcare Services

SALARY

$77k-93k (estimate)

POST DATE

06/23/2023

EXPIRATION DATE

06/06/2024

WEBSITE

mydohc.com

HEADQUARTERS

INDIO, CA

SIZE

200 - 500

FOUNDED

1981

CEO

RANDY VAUGHN

REVENUE

$10M - $50M

INDUSTRY

Ambulatory Healthcare Services

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About Desert Oasis Healthcare

Desert Oasis Healthcare is committed to the provision and facilitation of the highest quality medical care to the residents of the desert communities. We will strive to be an organization which provides excellence in every encounter. As a result, we will be recognized by: Our patients as their care givers of choice; Our employees as their employer of choice; Our provider and health plan partners as their health care network of choice. Desert Oasis Healthcare is a non-discriminate (Religious, Cultural, Sexual, Ethnic) Health Care Provider. In 1981, Desert Medical Group Inc. introduced to the Co ... achella Valley a full service medical facility, providing the community with all their health care needs from newborn to senior care. Today, we are Desert Oasis Healthcare - a team of highly skilled primary care physicians and ancillary providers with services conveniently located throughout the desert communities. Our many locations include Palm Springs, Bermuda Dunes, Indio, Rancho Mirage and Yucca Valley. Desert Oasis Healthcare's services include access to 4 Immediate Care Centers - Indio, Palm Desert, Palm Springs and Yucca Valley. We also offer an award winning Outreach Services Department that is committed to educating individuals on how to apply the principles of preventative health care in their daily lives, resulting in improved health. Desert Oasis Healthcare accepts most HMO's, private insurance, Medicare and private pay patients. We are affiliated with every hospital in the Coachella Valley, which includes Eisenhower Memorial Hospital, Desert Regional Medical Center, John F. Kennedy Memorial Hospital and Hi-Desert Medical Center More
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The following is the career advancement route for Complex Case Manager positions, which can be used as a reference in future career path planning. As a Complex Case Manager, it can be promoted into senior positions as a Case Management Director that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Complex Case Manager. You can explore the career advancement for a Complex Case Manager below and select your interested title to get hiring information.