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Bilingual in Spanish Case Management Coordinator/UM Nurse

Company: Yoh
Location: Santa Barbara
Posted on: March 12, 2019

Job Description:

PEDIATRIC CASE MANAGEMENT COORDINATOR/UTILIZATION MANAGEMENT REGISTERED NURSE needed for a FULL-TIME, DIRECT HIRE opportunity with Yoh's client located in the SANTA BARBARA, CA AREA.

Position Overview: Must be bilingual in Spanish. This is a blended role that incorporates the responsibilities of Case Management and Utilization Management activities. Assist specific members under the age of 21 (who qualify for the program) with care coordination which includes processing medically necessary service requests, facilitating care transitions, and communicating with members and providers to assure the medical needs of the member are met.

TOP SKILLS YOU SHOULD POSSESS:

* Registered Nurse (RN) in state of California

* Minimum of two-three (2-3) years' of case management experience

* Certified Case Manager (CCM) preferred

* Pediatric Case Management experience required

* Must be bilingual in Spanish

WHAT YOU'LL BE DOING:

* Coordinate and manage specific members (includes complex care members) for defined periods of time and/or post discharge transition from an inpatient setting (ie acute care hospital, skilled or long-term care facility) to ensure that member's outpatient care is being coordinated and all medically necessary services are being provided in a timely manner

* Review prospective and retrospective requests for authorization and referrals, perform concurrent inpatient review, coordinate inpatient transfers and care transition activities (assist with discharge planning)

* Process service requests and specialty referrals

* Collaborate with the member, the member's family or caretaker, primary care provider, and other health care providers

* Coordinate timely care transition from one level of care to another, such as acute to SNF or SNF to home or other living arrangement as the member's care needs change

WHAT YOU NEED TO BRING TO THE TABLE:

* Excellent organizational and time-management skills

* Demonstrate ability to critically think, problem solve, and make independent decisions supporting the case management process

* Experience working with Medi-Cal patients

* Computer savvy

WHAT'S IN IT FOR YOU*

* Competitive pay with opportunities for advancement

* Stable, long-term company that offers a pension plan, professional development and wellness benefits, alternative transportation incentives, and comprehensive medical, dental, vision, and life insurance

*ASK ME ABOUT OUR REFERRAL BONUS PROGRAM!*

WE HAVE MULTIPLE OPENINGS SO HELP US SPREAD THE WORD!

RECRUITER: Hana Brown

PHONE: 818.587.4475

EMAIL: Hana.Brown@yoh.com

Keywords: Yoh, Santa Barbara , Bilingual in Spanish Case Management Coordinator/UM Nurse, Other , Santa Barbara, California

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