RN, Case Managers
Join a company that was ranked among the TOP 25 companies to work for in Los Angeles!
Join AltaMed’s team of multicultural health care professionals in serving more than 150,000 families a year. Our integrated system emphasizes prevention and healthy living to reduce health care disparities in multi-ethnic communities and avoid unnecessary trips to the emergency room or other more costly forms of care.
AltaMed is the largest independent Federally Qualified Community Health Center in the U.S., with more than 930,000 annual patient visits. Our culturally competent physicians and health care professionals provide integrated primary care services, senior care programs, and health and human services at 43 accredited sites in Los Angeles and Orange Counties. Established in 1970, AltaMed is proud to be a national model for the delivery of quality, patient centered care to underserved communities. We currently have excellent opportunities for the following:
RN, Case Managers
Children’s Hospital Los Angeles, Boyle Heights, Commerce, West Covina
The Nurse Case Manager will provide daily care coordination, case management, coaching, consultation, and intervention to patients with one or more chronic diseases.
• Identify patients with chronic diseases via provider/clinic referral, utilization management referral, disease registry reporting mechanisms, and patient self-referral.
• Provide case management to patients who are admitted to the hospital and to patients who need to be enrolled in ambulatory case management.
• Identify CCS cases; handle transfers and retro reviews.
• Perform concurrent reviews, retro reviews and discharge planning.
• Participate in developing all program materials, policies and procedures related to the nurse case management program.
• Work with hospital discharge planners and assist in the coordination of support services.
• Conduct intakes and comprehensive assessments.
• Identify needs and develop individualized care service plans on behalf of clients.
• Review and process referral authorizations in accordance with TAT standards.
• Monitor ongoing services and their cost effectiveness.
• Provide disease specific educational support and in-services to clinic staff.
• Use clinical evidence-based criteria, including Milliman, Interqual, CMS, and National Recognized American Academy of Specific Specialty.
• Assist with composing Medical Director denials.
• Perform and document patient risk assessments as needed.
• Graduation from an accredited nursing program.
• Current valid RN license through the California Board of Registered Nursing.
• Bachelor’s degree in Social Work, Nursing, or other health or human services field and appropriate licensure preferred.
• Experience working as part of multi-disciplinary team.
• Experience with physically or mentally impaired adults and/or geriatric population.
• 3 years’ experience in public health nursing, acute care, case management, and/or in-home health care.
• Minimum 2 years’ managed care experience in case management with focus in inpatient and/or outpatient ambulatory care preferred.
• Bilingual English/Spanish preferred.
• Knowledge of the Case Management Process, Chronic Care Model and Patient-Centered Medical Home Model (PCMH).
• Excellent customer service skills and ability to resolve complex issues.
• Effective communication skills and understanding of medical terminology.
• Computer literacy.
• Knowledge of regulatory requirements, health plan contracts, government benefits, and community resources.
AltaMed offers extensive opportunities for professional development, as well as competitive salaries and excellent benefits. Our team members enjoy medical, dental and vision plans, retirement plan with matching employer contributions, tuition reimbursement, continuing education programs, and much more. We invite you to join us in making a difference in our communities and in the lives of others.
For immediate consideration, please apply online at AltaMed.org.
AltaMed is fully committed to Equal Employment Opportunity and to attracting, retaining, developing, and promoting the most qualified employees without regard to their race, gender, color, religion, age, or any other characteristic prohibited by state or local law. We are dedicated to providing a work environment free from discrimination and harassment, and where employees are treated with respect and dignity.
View a full list of open positions and apply online at AltaMed.org.
AltaMed is accredited by The Joint Commission. EOE M/F/D/V