About This Position
Case Manager – RN / Clinical Liaison
Hours: 9 am to 530pm
Start date: ASAP
Pay rate: $65,000 to $70,000
Position: Remote – Home Base
Clinical Liaison / Case Manager Position:
Work closely with the Director of Nursing and Executive Director of Case Management and other Clinicians
Assist with managing the day-to-day operations of the Assisted Living Waiver Program (ALW) and other Medi-Cal specialty programs as determined.
Coordinate with the facility, members, and their families on current health status, resource utilization, past and present treatment plans and services, prognosis, short-term and long-term goals, treatment, and provider options.
Ensure urgency with SNF/Hospital transitions/placements.
Determination of eligibility for enrollment in the assisted living waiver program and other Medi-Cal-funded programs
Conducting an initial and ongoing assessment using the ALW Assessment Tool
Determining each beneficiary’s level of care (i.e., tier changes)
Developing the Individualized Service Plan (ISP)
Monitor service delivery by the RCFE/ALF and other providers.
Maintain progress notes and case records for each enrolled beneficiary.
Receiving, reviewing, and responding to concerns/complaints from clients, families, or POA and forwarding all concerns/complaints to DHCS
Reporting all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or neglect occurs in an RCFE) or DHCS and APS (if abuse or neglect occurs).
Facilitate member access to community-based services.
Monitor referrals 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.
Oversee all case managers' and social workers' cases for accuracy
Work closely with compliance on monthly file audits
Work directly with clients/family members/facilities
Worked closely with Star Nursing field Case Managers (CM)
Coordinate with facility, members, and family on long-term goals, resource utilization, discharge, transition, and admissions to an approved facility.
Identify related risk management quality concerns and report these scenarios to the appropriate resources.
Enter, review, and maintain assessments, authorizations, and pertinent clinical information into MedCompass management systems.
Responsible for submitting documentation to vendors
Review all initial tier changes, changes in CCAs, or any other submission to DHCS to ensure 100% file compliance before submitting to DHCS.
Participate in case management committees and work on special projects related to case management as needed.
Staff Development
Participate in developing, planning, conducting, and scheduling in-service/online training classes.
Participate in company committees and act as a resource to junior social workers.
Care Plan and Assessment Functions
Review care plans routinely to ensure that appropriate care is being received.
Ensure that monthly visit notes reflect that the care plan is being followed by the facility and caregivers.
Review patient care plans for appropriate goals, problems, approaches, and revisions based on patient-centered needs.
Patient Rights
Maintain the confidentiality of all patient care information.
Monitor care to ensure that all patients are treated fairly, and with kindness, dignity, and respect.
Report and investigate all allegations of patient abuse and/or misappropriation of property.
Working Conditions
Works in office area(s) as well as in care homes and larger assisted living facilities
Sits, stands, bends, lifts, and moves intermittently during working hours.
Is subject to frequent interruptions.
Is involved with patients, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances
Is subject to hostile and emotionally upset patients, family members, personnel, and visitors
Communicates with the medical staff, nursing personnel, and other department supervisors.
Attends and participates in continuing educational program
Maintains a liaison with the patients, their families, support departments, etc., to adequately plan for the patient's needs.
Qualifications:
Previous experience in social work, counseling, or other related fields
Compassionate and caring demeanor
Ability to build rapport with clients
Strong leadership qualities
Excellent written and verbal communication skills
Education/ Experience
Bachelor’s or master’s degree in nursing, social work, Psychology, counseling, rehabilitation, gerontology, or sociology.
Must possess, as a minimum, 1 year of recent related work experience
Experience working with government programs is a plus
Specific Requirements
Must possess a current, unencumbered, active license to practice as a Registered Nurse in the State of California
Strong knowledge and understanding of Title 2
Familiarity with medical software, microsoft office suites/excel/word
Must possess the ability to make independent decisions when circumstances warrant such action.
Must possess the ability to deal tactfully with personnel, patients, family members, visitors, government agencies/personnel, and the general public.
Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to community health care.
Must possess leadership and supervisory ability and the willingness to work harmoniously with professional and non-professional personnel.
Must have patience, tact, a cheerful disposition, and enthusiasm, as well as the willingness to handle difficult patients.
Additional Information:
The Clinical Liaison/Case Manager is responsible for educating Medi-Cal Members and their families about the requirements of the ALWP. The Assisted Living Waiver program is designed to assist low-income seniors or adults aged 21 with a disability, providing an alternative to living at home or in a skilled nursing facility. By providing funding to move into the RCFE/ALF care setting. The Clinical Liaison/Case Manager is responsible for multiple tasks throughout the workday. This position requires a licensed RN with a minimum of one year of current experience in management, long-term care, skilled nursing, sub-acute care, post-acute care, assisted living, and hospital settings. Experience working with discharge planners and social services departments would be helpful. This Clinical Liaison/Case Manager will work directly with case managers and discharge planners to process Assisted Living Waiver referrals, Health plans, and other specialty programs in a timely and efficient manner. Must have experience with a high-volume workload. This is a work-from-home position with the flexibility to do monthly visits with a caseload of residents residing in ALF/RCFEs.
Pay: $68,000.00 - $70,000.00 per year
Benefits:
401(k)
401(k) matching
Health insurance
Life insurance
Paid time off
Wellness program
Work Location: Remote
Hours: 9 am to 530pm
Start date: ASAP
Pay rate: $65,000 to $70,000
Position: Remote – Home Base
Clinical Liaison / Case Manager Position:
Work closely with the Director of Nursing and Executive Director of Case Management and other Clinicians
Assist with managing the day-to-day operations of the Assisted Living Waiver Program (ALW) and other Medi-Cal specialty programs as determined.
Coordinate with the facility, members, and their families on current health status, resource utilization, past and present treatment plans and services, prognosis, short-term and long-term goals, treatment, and provider options.
Ensure urgency with SNF/Hospital transitions/placements.
Determination of eligibility for enrollment in the assisted living waiver program and other Medi-Cal-funded programs
Conducting an initial and ongoing assessment using the ALW Assessment Tool
Determining each beneficiary’s level of care (i.e., tier changes)
Developing the Individualized Service Plan (ISP)
Monitor service delivery by the RCFE/ALF and other providers.
Maintain progress notes and case records for each enrolled beneficiary.
Receiving, reviewing, and responding to concerns/complaints from clients, families, or POA and forwarding all concerns/complaints to DHCS
Reporting all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or neglect occurs in an RCFE) or DHCS and APS (if abuse or neglect occurs).
Facilitate member access to community-based services.
Monitor referrals 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.
Oversee all case managers' and social workers' cases for accuracy
Work closely with compliance on monthly file audits
Work directly with clients/family members/facilities
Worked closely with Star Nursing field Case Managers (CM)
Coordinate with facility, members, and family on long-term goals, resource utilization, discharge, transition, and admissions to an approved facility.
Identify related risk management quality concerns and report these scenarios to the appropriate resources.
Enter, review, and maintain assessments, authorizations, and pertinent clinical information into MedCompass management systems.
Responsible for submitting documentation to vendors
Review all initial tier changes, changes in CCAs, or any other submission to DHCS to ensure 100% file compliance before submitting to DHCS.
Participate in case management committees and work on special projects related to case management as needed.
Staff Development
Participate in developing, planning, conducting, and scheduling in-service/online training classes.
Participate in company committees and act as a resource to junior social workers.
Care Plan and Assessment Functions
Review care plans routinely to ensure that appropriate care is being received.
Ensure that monthly visit notes reflect that the care plan is being followed by the facility and caregivers.
Review patient care plans for appropriate goals, problems, approaches, and revisions based on patient-centered needs.
Patient Rights
Maintain the confidentiality of all patient care information.
Monitor care to ensure that all patients are treated fairly, and with kindness, dignity, and respect.
Report and investigate all allegations of patient abuse and/or misappropriation of property.
Working Conditions
Works in office area(s) as well as in care homes and larger assisted living facilities
Sits, stands, bends, lifts, and moves intermittently during working hours.
Is subject to frequent interruptions.
Is involved with patients, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances
Is subject to hostile and emotionally upset patients, family members, personnel, and visitors
Communicates with the medical staff, nursing personnel, and other department supervisors.
Attends and participates in continuing educational program
Maintains a liaison with the patients, their families, support departments, etc., to adequately plan for the patient's needs.
Qualifications:
Previous experience in social work, counseling, or other related fields
Compassionate and caring demeanor
Ability to build rapport with clients
Strong leadership qualities
Excellent written and verbal communication skills
Education/ Experience
Bachelor’s or master’s degree in nursing, social work, Psychology, counseling, rehabilitation, gerontology, or sociology.
Must possess, as a minimum, 1 year of recent related work experience
Experience working with government programs is a plus
Specific Requirements
Must possess a current, unencumbered, active license to practice as a Registered Nurse in the State of California
Strong knowledge and understanding of Title 2
Familiarity with medical software, microsoft office suites/excel/word
Must possess the ability to make independent decisions when circumstances warrant such action.
Must possess the ability to deal tactfully with personnel, patients, family members, visitors, government agencies/personnel, and the general public.
Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to community health care.
Must possess leadership and supervisory ability and the willingness to work harmoniously with professional and non-professional personnel.
Must have patience, tact, a cheerful disposition, and enthusiasm, as well as the willingness to handle difficult patients.
Additional Information:
The Clinical Liaison/Case Manager is responsible for educating Medi-Cal Members and their families about the requirements of the ALWP. The Assisted Living Waiver program is designed to assist low-income seniors or adults aged 21 with a disability, providing an alternative to living at home or in a skilled nursing facility. By providing funding to move into the RCFE/ALF care setting. The Clinical Liaison/Case Manager is responsible for multiple tasks throughout the workday. This position requires a licensed RN with a minimum of one year of current experience in management, long-term care, skilled nursing, sub-acute care, post-acute care, assisted living, and hospital settings. Experience working with discharge planners and social services departments would be helpful. This Clinical Liaison/Case Manager will work directly with case managers and discharge planners to process Assisted Living Waiver referrals, Health plans, and other specialty programs in a timely and efficient manner. Must have experience with a high-volume workload. This is a work-from-home position with the flexibility to do monthly visits with a caseload of residents residing in ALF/RCFEs.
Pay: $68,000.00 - $70,000.00 per year
Benefits:
401(k)
401(k) matching
Health insurance
Life insurance
Paid time off
Wellness program
Work Location: Remote
