What are the responsibilities and job description for the Case Manager II (67519-1) position at Professional Management Enterprises?
Case Manager I(RN) reviewing Hospice related documentation including but not limited to physician orders, Hospice election form and certifications to coordinate care including loading pseudo authorizations into systems. This position is FULLY remote but
- MUST be a licensed CA RN residing in the state of CA . The work schedule will be M-F 8 : 00am-5 : 00pm PST.
Day to Day Responsibilities :
Roles will review Hospice documentation including physician orders, Member hospice election form, and certifications. Roles will also contact Hospice providers and members on behalf of the CA Health Plan. If documentation is accurate, the roles will load a pseudo authorization in the CA Health Plan's system. If documentation does not support, Reviewing documentation, contacting hospices and members. Loading pseudo authorizations.
Required Education / Experience :
Hospice background strongly
Health Plan experience
CA licensed, CA based, Registered nurse.
Must have a minimum of 3 years Hospice experience
Managed Care and Case Management experience
Required License
Licensure required is a CA State License Registered Nurse - RN license
Case Manager I(RN) reviewing Hospice related documentation including but not limited to physician orders, Hospice election form and certifications to coordinate care including loading pseudo authorizations into systems. This position is FULLY remote but
Day to Day Responsibilities :
Roles will review Hospice documentation including physician orders, Member hospice election form, and certifications. Roles will also contact Hospice providers and members on behalf of the CA Health Plan. If documentation is accurate, the roles will load a pseudo authorization in the CA Health Plan's system. If documentation does not support, Reviewing documentation, contacting hospices and members. Loading pseudo authorizations.
Required Education / Experience :
Hospice background strongly
Health Plan experience
CA licensed, CA based, Registered nurse.
Must have a minimum of 3 years Hospice experience
Managed Care and Case Management experience
Required License
Licensure required is a CA State License Registered Nurse - RN license
