REMOTE UM Case Manager

A leading nationwide care company is looking for a Remote UM Case Manager to join their team!! With immense opportunity for growth, this facility is looking for someone who is eager to expand on their skillset AS SOON AS POSSIBLE!

If this sounds like something that you are interested in, please email me directly at olpeterson@actalentservices .com.

What's In It For You?

• Remote!! (Considered hybrid but at the moment, no office days are required)
• Working with a nationwide industry leader in care coordination.

MUST HAVE:

• Current California RN License
• Local to San Jose or Ventura County
• Case Management experience.
• Experience working with Medicare/Medi-caid.
• Telephonic or remote experience.

Pay: $47/hr

Placement: Contract (3 months)

Job Description:

• Monday - Friday, 8am - 5pm PST.
• Develop, assess and adjust, as necessary, the care plan and promote desired outcome
• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
• Actively participate in integrated team care management rounds
•  Identify related risk management quality concerns and report these scenarios to the appropriate resources
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systemsals, treatment and provider options
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Assisting with Backlog-referrals from CA-members sending referrals to case managers
  • Will be Assigned 5-10 referrals daily.
  • Ability to work in Fast paced environment.
  • Case Management experience required.
  • At least 4 hours a day is spent on outbound phone calls-reaching out to members.
  • Calls are recorded-will have audio audits.
  • Data entry-tracking data.
  • Case load requirement is 75-(will be ramped up to this amt)
  • Excel (data entry-basic knowledge)
  • True Care medical records system

Pay and Benefits

The pay range for this position is $47.00 - $47.00

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 remote position.

Application Deadline

This position will be accepting applications until Feb 1, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

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

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $47