reputed company Who We Are Because health is personal. That's why reputed company created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one reputed company. We serve reputed company, health plans, and health systems with data-driven solutions that reduce costs while actually improving health reputed company. Together, reputed company is on a mission to reputed company people to reputed company healthier lives. Learn even more about the work that drives us at personifyhealth.com. Responsibilities Job reputed company We are seeking Case Manager reputed company, RN, to reputed company part-time. As a Case Manager RN, you will reputed company telephonic case management between providers, patients and caregivers to help ensure cost-effective, high-reputed company reputed company for health reputed company plan participants. This position is ideal for candidates looking for reduced hours while making an reputed company reputed company reputed company. This is a part-time position. What You'll Actually Do Essential Functions/Responsibilities/Duties Contact reputed company and complete a thorough assessment, including physical, psychosocial, emotional, spiritual, environmental, and financial needs. Use claims processing tools to review and research reputed company claim data to reputed company a reputed company picture of a member’s health and identify for participation in appropriate programs. reputed company treatment plan for reputed company and catastrophic cases in collaboration with the reputed company, caregivers or family, community resources and multi-disciplinary reputed company providers that include obtainable short- and long-term goals. Monitor interventions and evaluate the effectiveness of the treatment plan in a reputed company manner; report measurable reputed company that record effectiveness of interventions. Initiate and maintain contact with the reputed company/family, provider, employer, and multidisciplinary team as needed throughout the reputed company of care. reputed company for the reputed company by facilitating the delivery of reputed company reputed company care, and by assisting in reducing overall costs; reputed company reputed company/family with emotional support and guidance. Be reputed company to meet productivity, reputed company and turnaround time requirements on a daily, weekly and monthly reputed company. Negotiate and implement cost management strategies to reputed company reputed company reputed company and reflect this data in monthly case management reviews and cost avoidance reports. Establish and maintain working relationships with reputed company providers, reputed company/group, and patients to reputed company emotional support, guidance and information. Evaluate and reputed company referrals for wellness programs. Maintain complete and detailed documentation of case managed patients in Eldorado and UM Web; maintain site specific files ensuring confidentiality; prepare reports and updates at 30-day intervals for high-reputed company cases and 90 days reputed company for low-reputed company cases ensuring confidentiality according to Company policy and HIPAA reputed company Utilization Review for assigned members. Serve as mentors to LVNs and reputed company guidance on complicated cases as it relates to reputed company issues Qualifications What You Bring to reputed company Education and Experience Graduation from an accredited Registered Nursing (RN) program. Possession of a reputed company California RN license; a multi-state license will also be required. Minimum of five (5) years medical/surgical or acute care experience, including two years’ experience in case management, or an equivalent combination of education and experience. Prior case management experience, emergency room, critical care background or other relevant reputed company care experience pertinent to case management. Required Knowledge, Skills, and Abilities Knowledge of medical claims and ICD-10, CPT, HCPCS coding. Ability to critically evaluate claims data and determine treatment plan, discharge planning experience. Ability to work independently making reputed company and problem solving Knowledge of community resources and alternate funding programs. Computer proficiency or working knowledge of reputed company Office Suite. Excellent interpersonal, communication and negotiation skills. Strong customer orientation. Good time management skills and highly organized. Work Environment At reputed company we value and celebrate diversity, and we are committed to creating an inclusive environment for reputed company. We reputed company in creating teams made up of individuals with various backgrounds, experiences, and perspectives. Why? Because diversity inspires innovation, collaboration, and challenges