Nurse Case Manager - Van Nuys, CA

TRIUNE Health Group•Van Nuys, CA

About The Position

The Nurse Case Manager coordinates resources and develops flexible, cost-effective options for catastrophically or chronically ill or injured individuals. The role facilitates quality, individualized, holistic treatment goals, including timely return to work when appropriate. The position primarily involves sedentary work, with occasional field visits or meetings and travel as needed; the posting states that travel may comprise 90% of the time. Telephonic case management or modified duties may be available where appropriate. The Nurse Case Manager provides medical case management in coordination with patients, physicians, other health care providers, employers, and referral sources. The role assesses and evaluates treatment plans and progress, facilitates care and services, communicates with patients and families, researches medical and community resources, and prepares timely reports while complying with HIPAA and other applicable requirements.

Requirements

Graduate of an accredited school of nursing.
Current RN licensure in the state of operation.
Fluency in English, including speaking, reading, and writing.
Three or more years of recent clinical experience.
Valid driver’s license and ability to travel 90% of the time.
Proven leadership skills.
Excellent verbal and written communication skills, including effective interaction by phone, email, in person, and formal presentations.
Methodical approach to accomplishing job-related goals.
Strong analytical and organizational skills, multitasking ability, and attention to detail.
In-depth knowledge of multiple software packages, particularly Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and the Internet.
Maintain a friendly, professional attitude; exercise initiative and be solution-oriented; keep management informed of situations or opportunities; demonstrate dependability and adaptability.
Ability to perform the essential duties satisfactorily, with reasonable accommodations available where applicable.
Ability to communicate effectively, maintain sustained concentration, and perform repetitive hand and wrist movements associated with computer and keyboard use.

Nice To Haves

Three or more years of clinical experience in trauma, psychology, emergency, orthopedics, rehabilitation, occupational health, or neurology is preferred.
CCM preferred.
One or more or a combination of certifications listed by the state board: CCM, CRC, CRRN, LPC, COHN, COHN-S, or CDMS.

Responsibilities

Provide medical case management through coordination with patients, physicians, other health care providers, employers, and referral sources.
Use case management steps to assess, plan, implement, and evaluate care and outcomes.
Evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness.
Facilitate care, including negotiating and coordinating durable medical equipment and home health services, and ensuring clear communication.
Assess rehabilitation facilities for appropriateness of care, facilitate transportation, and coordinate home architectural assessments when required.
Communicate medical information clearly and compassionately to patients and families.
Stay current with medical terminology and federal and state laws related to health care, Workers’ Compensation, ADA, HIPAA, FMLA, STD, LTD, SSDI, and SSA.
Use technology to prepare organized, timely reports and comply with safety rules and HIPAA requirements.
Research medical and community resources for individuals with catastrophic or chronic diagnoses and ensure accessibility.
Travel for field visits or other business needs; the posting states the role requires the ability to travel 90% of the time.
Perform other duties as assigned.