You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a dedicated Registered Nurse Case Manager to manage and coordinate care for a caseload of high-complexity members. The primary responsibilities include overseeing care management activities, ensuring compliance with contractual requirements, and developing individualized care plans. This role requires a strong commitment to improving the health outcomes of enrollees through effective case management and coordination with multidisciplinary teams.

Key Responsibilities

• Manage a caseload compliant with CASSIP and Care Management Leadership.
• Maintain compliance with contractual and care management requirements.
• Assist in research and implementation of disease management/population health programs.
• Conduct outreach and face-to-face visits as necessary.
• Assess enrollees and close gaps in care based on individual needs.
• Monitor utilization and take action according to policy.
• Gather comprehensive health information and update care plans.
• Complete routine coordination activities with adherence to quality and standards.
• Consult with Supervisory Care Manager on case priorities and utilization concerns.
• Document enrollee interactions accurately and timely.
• Participate in disposition and discharge planning activities.
• Communicate clearly and effectively, both verbally and in writing.
• Empower enrollees and caregivers to be active in their care.
• Schedule and monitor compliance with health appointments.
• Apply advanced care management knowledge to assigned enrollees.
• Attend multidisciplinary meetings as necessary.
• Facilitate coordination of follow-up care based on visit reports.
• Assist in transitions of care and enter authorizations as needed.
• Present accurate information about organization consistently.

Qualifications

• DC RN License
• At least an Associates Degree
• Proficient in Microsoft Office

Experience

• Ideally have 2 years of Case Management experience
• Experience with Medicaid Members is preferred
• Health plan experience is preferred
• Pediatric experience is preferred

Schedule/Shift

• M-F 8 am - 5 pm
• Typically 3 field visits a week (Can schedule these how they would like to)
• in the field or in the office 4 days a week 

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Medix is committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is Medix's intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, sexual orientation, sexual preference, gender identity, disability, veteran or military status, marital status, partnership status, caregiver status, familial status, status as a victim of domestic violence or any other characteristic protected by law.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.