Nursing Jobs in Lake Balboa, CA

Epic Healthcare Los Angeles, CA

LVN Resident Care Coordinator (RCC)

Anchor Health Los Angeles, CA

RN Admission Nurse

Description Are you looking for a work place where you can make a genuine difference? Company Culture that feels supportive, genuine and appreciative of all? Anchor Health is committed to the communities of which we serve, the patients and families we have the honor of caring for and the EMPLOYEES who have chosen us as their work family. The registered nurse plans, organizes and directs hospice care services specific to each patient/family which includes instruction and evaluation in the home. The professional nurse is accountable to the Director of Patient Care Services for implementing the patient plan of care and communicating each patient needs to the Interdisciplinary team. The professional nurse is also responsible for communication and collaboration with community physicians as well as family members regarding individual patient care. Anchor Health offers competitive salaries, great benefits and a compassionate work environment. PRIMARY FUNCTION The Admissions Registered Nurse is an Interdisciplinary Team member whose primary responsibility is to present ANCHOR HEALTH services and philosophy to patients and families in a manner that results in the admission of appropriate patients. JOB RESPONSIBILITIES FOR THE ADMISSIONS REGISTERED NURSE 1. Admissions Registered Nurse participates in the information gathering, analysis, education, and form completion aspects of the admissions process 2. Admissions Registered Nurse evaluates patients for hospice appropriateness, e.g. medical records review as requested. 3. Admissions Registered Nurse Obtains agreement for admission of referred patients and families who meet admission criteria. 4. Admissions Registered Nurse analyzes data collected by the admission staff or ANCHOR HEALTH clinicians to facilitate/obtain admission orders 5. Admissions Registered Nurse builds effective referral source relationships to support the high quality and responsiveness expectations associated with ANCHOR HEALTH. 6. Admissions Registered Nurse maintains clinical and professional competence. 7. Admissions Registered Nurse takes the initiative in developing effective relationships internally with the appropriate admissions and patient care resource persons. 8. Admissions Registered Nurse utilizes interpersonal skills to help appropriately educate and address any questions the patient and/or patients’ family has concerning hospice and palliative care. 9. Other duties and responsibilities as assigned JOB REQUIREMENTS FOR THE ADMISSIONS REGISTERED NURSE 1. Admissions Registered Nurse has knowledge of the principles of the intake, admission, and transition to care process with the ability to further develop skills in these competency areas. 2. Admissions Registered Nurse has the ability to communicate effectively with patients and families, physicians, referral sources and colleagues. 3. Admissions Registered Nurse has the knowledge of clinical manifestations of diseases and ability to develop ANCHOR HEALTH specific clinical knowledge. 4. Admissions Registered Nurse has the ability to use the ANCHOR HEALTH information system and mobile technology platforms. 5. Admissions Registered Nurse has reliable means of transportation. ESSENTIAL FUNCTIONS/PHYSICAL DEMANDS The physical demands of the Admissions Registered Nurse are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of the Admissions Registered Nurse, the employee is regularly required to: 1. Assist in lifting and transferring patients, as required. 2. Lift objects in excess of 20 pounds 3. Stand or walk in excess of one hour per day The Admissions Registered Nurse will be required to sit and stoop, kneel, and crouch. DIRECTION RECEIVED The Admissions Registered Nurse reports to the Admissions Manager designated in the location. In the event the location does not have an Admissions Manager, the Admissions Registered Nurse will receive direction from the Patient Care Administrator or program designee QUALIFICATIONS FOR THE ADMISSIONS REGISTERED NURSE 1. Graduate of a National League of Nursing accredited school of nursing. 2. Current licensure in State of CA and CPR certification. 3. Registered nurses shall have a minimum of one (1) year of experience as a professional nurse within the last three (3) years; OR have a baccalaureate degree in nursing from a program accredited by the National League of Nursing and a current RN license. Minimum of two (2) years’ experience, at least one of which is in the area of public health, home care, or hospice nursing is preferred. 4. Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist. Admissions Registered Nurse is expected to have strong presentation skills. 5. Prolonged or considerable walking or standing. Able to lift, position and/or transfer patients. Able to lift supplies and equipment. Considerable reaching, stooping bending, kneeling and/or crouching. 6. Must be a licensed driver with an automobile that is insured in accordance with state/or organization requirements and is in good working order. Benefits Include: Competitive compensation Health, dental, vision, life and disability insurance Life insurance 401(k) plan with numerous investment options and generous company match Paid Time Off Many of our positions offer the opportunity to work day or night shifts, weekdays or weekends.

Travel LPN for Texas (FREE HOUSING)

Promed Staffing Resources Los Angeles, CA

Great opportunity! Join ProMed Staffing as a Full-Time Travel LPN on a 9/10/13-Week Assignment. Discover a fulfilling career with these competitive benefits: Tax-free stipends Relocation reimbursement Bonuses for referred partners/friends Free online training Assistance with transferring your nursing license Housing provided All positions are at nursing home facilities, with multiple locations available for you to choose from. Find the location that's best for you! You must have an active LPN license and reliable transportation. Prior experience as a travel LPN is preferred, but not required. Earn top pay!!

Director of Nursing

Anchor Health Los Angeles, CA

Director of Nursing

Director of Nursing (Hospice) Job Type: Full-time | Work Setting: In-person Schedule: Monday to Friday Pay: Competitive salary, based on experience About Anchor Health Anchor Health has proudly served Northern California communities for years, offering compassionate and high-quality hospice and pediatric care. Our mission is to support not only our patients and families but also the dedicated professionals who make our work possible. Position Overview We are seeking a compassionate and experienced Director of Nursing to lead our hospice clinical operations. This key leadership role is ideal for a Registered Nurse with strong hospice or palliative care experience and a heart for end-of-life care. The DPCS ensures exceptional care quality, regulatory compliance, and team coordination while supporting patients, families, and staff in a meaningful way. Key Responsibilities Clinical Leadership: Direct the delivery of hospice services in compliance with state, federal, and internal standards. Team Management: Recruit, train, supervise, and mentor clinical staff including RNs, LVNs, social workers, and home health aides. Care Coordination: Guide the interdisciplinary team in developing and executing personalized care plans. Regulatory Compliance: Ensure adherence to Medicare/Medicaid requirements and accreditation standards; manage audits and documentation. Quality Improvement: Drive initiatives to enhance patient outcomes and care quality. Budget Oversight: Manage clinical budgets and monitor resource utilization effectively. Family Support: Serve as a compassionate liaison for patients’ families, offering clear communication and emotional support. Cross-Department Collaboration: Partner with social services, spiritual care, and admin teams to provide holistic care. After-Hours Protocol: Develop and maintain readiness protocols for emergencies and after-hours needs. Qualifications Education: BSN required; MSN or advanced degree preferred. Licensure: Active Registered Nurse (RN) license in the state of California (required) . Experience: Minimum of 2 years in hospice or palliative care leadership. Key Skills Strong clinical leadership and staff development abilities Deep knowledge of hospice regulations and standards Excellent communication with patients, families, and interdisciplinary teams Strategic thinker with a collaborative, empathetic approach Physical & Travel Requirements Must be able to travel to patient homes, nursing facilities, and hospitals. Comfortable working in varied patient care settings. Benefits Medical: Health, dental, and vision insurance Financial: 401(k) retirement plan Time Off: Paid time off (PTO) Supportive, mission-driven team environment Medical Specialty Geriatrics Hospice & Palliative Care If you're a passionate leader looking to make a meaningful difference in end-of-life care, we invite you to apply and join the Anchor Health family.

Director of Nursing

$55.67 - $75.63 / hour

Overview California Rehabilitation Institute *A Joint Venture with Cedars, UCLA, and Select Medical* Century City - Los Angeles, CA Registered Nurse (RN) / Full Time – Day Shift 7:00am -7:30pm Pay Rate $55.67 - 75.63 **$7,500 Sign on Bonus** Competitive shift differentials for weekends Why work for California Rehab? We are committed to your growth and success! Clinical Ladder Program (varies per location) Tuition Reimbursement Student Debt Benefit Program Extensive and thorough orientation program Team oriented environment Health, Dental, and Vision insurance; Life insurance; Prescription coverage Paid Time Off (PTO) and Extended Illness Days (EID) A 401(k) retirement plan with company match Short and Long Term Disability Personal and Family Medical Leave Here, you will provide advanced treatment and comprehensive care to best address the medical, physical, emotional and vocational challenges for individuals with brain injuries, spinal cord injuries, neurological disorders, orthopedic issues, amputation, and multiples traumas. Responsibilities On each shift, you will partner with a Nursing Assistant partner and handle a manageable case load. Together, you will help our patients achieve outlined goals and milestones on their individual patient care plan. Receiving admissions and/or transfers. Initial and ongoing systematic patient assessment. Timely and accurate documentation using EPIC Interpreting assessment/diagnostic data including labs and telemetry. Ensuring medical orders are transcribed and processed accurately. Promoting continuous quality improvement. Instructing and counseling patients/families. Qualifications Minimum requirements: Valid State RN License is required. BLS is required at hire. Preferred qualifications that will make you successful: BSN or enrollment in a BSN program is preferred. Clinical experience is preferred. *Post offer employment testing (POETs) are completed as part of the onboarding process and are to be completed before an employee's first day of work.* Additional Data Equal Opportunity Employer, including Disabled/Veterans .

Manager/Supervisor

L.A. Care Health Plan Los Angeles, CA

Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical)

Salary Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.) ** Please note the following details for this role before applying: The candidate selected for this role MUST have recent experience with healthcare/managed care grievances The candidate selected for this role must live in California or be willing to relocate Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Manager, Appeals & Grievances (A&G) & General Operations (Clinical) is responsible for the daily oversight of clinical appeals and grievances functions within the Appeals & Grievances Department to ensure clinical grievances, complaints, appeals and complex issues are investigated and resolved using regulatory guidance across all lines of business. Provides direct supervision to the A&G clinical team and the unit that supports them in order to assure operational effectiveness which includes the implementation and adherence to L.A. Care's Policies & Procedures that meet Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), the California Department of Managed Health Care (DMHC), the Managed Risk Medical Insurance Board (MRMIB), National Committee for Quality Assurance (NCQA) and other rules/ regulations/ standards. The Manager is responsible for establishing and monitoring processes to oversee and coordinate the identification, documentation, reporting, investigation and resolution of all member appeals and grievances in a timely and culturally-appropriate manner. Coordinates, tracks, and resolves internal and external appeal and grievance complaints for L.A. Care Plan Partners, including identifying opportunities for improvement. This position will be a role model for integrity and will establish and maintain effective professional work relationships, working collaboratively with all levels of management and business owners to help guide the discipline of planning, organizing, securing, managing, leading, and controlling resources to achieve specific goals. Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports. Duties Manage and oversee the handling of clinical grievances and appeals, for L.A. Care and Plan Partner members. Establishes and oversees processes and all relevant member correspondence for accuracy, clarity, and cultural appropriateness and sensitivity. Review and monitor procedures for identifying quality of care issues and work collaboratively with cross-functional departments to appropriately address and resolve member grievances. Serve as the Key Contact for State Fair Hearings, internal and external audits, DMHC and DHCS inquiries. Review and monitor procedures for identifying quality of care issues and work collaboratively with cross-functional departments to appropriately address and resolve member and provider grievances. Responsible for timely daily operations in the A&G Clinical Services Unit and other general operations units. Ensures timely appeal and grievance reporting to regulatory agencies, internal Regulatory Affairs and Compliance Department, internal Quality Oversight Committee, etc. Collaborates with cross-functional departments to ensure the use of appropriate appeal and grievance issue codes, timely resolution, and refers to community partners as appropriate. Lead, participate and provide representation of the A&G Team at Internal and External meetings/workgroups and acts as the point person for A&G Programs especially the Clinical Programs. Develop and execute on strategic opportunities to improve the overall appeals & grievance process. Create a best in clinical appeals process that is efficient and effective in managing member appeals. Work cross functionally and collaboratively within Appeals and Grievances with key internal partners to build a high functioning, results oriented environment and organization. Duties Continued Partner with internal and external stakeholders to build and maintain collaborative relationships and partnerships. Identify areas of connection to leverage and create added value for L.A. Care. Provide input into the development of automation to guide the team to process efficiencies for all lines of business while maintaining compliance and manageable workloads for staff. Responsible for maintaining and updating on an annual basis, or as necessary, appeal and grievance policies and procedures, member correspondence, etc., consistent with regulatory changes. Develop and maintain inventory reports for the appeals process ensuring appropriate productivity, compliance, and inventory management. Identify and implement continuous business process improvement recommendations to leverage organizational added value to the Appeals and Grievances Department. Develop and implement short and long-term strategies to improve team results, reducing administrative expenses. Manage staff, including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others. Supervision of the Clinical Services unit and general operations within Appeals and Grievances. Maintain a team of top talent, providing a culture of teamwork and collaboration. Perform other duties as assigned Education Required Bachelor's Degree in Nursing Education Preferred Experience Required: 6 years of clinical acute care experience with at least 3 years of experience with health care grievance and/or appeals issues, preferably in a managed care or Medicaid Health Plan environment and/or public services or public benefits programs. At least 3 years of management level operations leadership experience. Experience working with firm deadlines, regulators, detail oriented with the ability to interpret and apply regulations Experience building relationships with organizations and business partners. Equivalency: Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement. Preferred: Managed care experience. Skills Required: Excellent analytical, problem solving, planning and implementation skills. Demonstrated strong writing and communication skills. Demonstrates excellent leadership, communication, and negotiation skills with the ability to interact and influence all levels of the organization including executive management and key decision -makers. Demonstrates professional judgement, and critical thinking, to promote the delivery of quality, cost-effective care. Time management and priority setting skills. Excellent understanding of NCQA, DMHC, DOI, DHCS, and CMS regulatory requirements. Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization, level of care and length of stay criteria sets. Able to work effectively with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies. Able to operate PC-based software programs including proficiency in Word, Excel and PowerPoint presentations. Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call. This position requires handling various caseloads and flexibility to adapt to changing priorities which may include but not limited to redistributed work assignments, team projects, and other priorities as assigned Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO)

CNA

Prime Healthcare Inglewood, CA

Certified Nurse Assistant, CNA- Physical Rehab (4W)

Overview Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for nearly 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, robotics surgery program, inpatient and outpatient rehab programs, labor and delivery, and more. Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Why Prime Healthcare? Centinela Hospital Medical Center; a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Celebrating Our Centinela Hospital Heroes Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2022) for hospital safety from The Leapfrog Group. For more information, visit www.centinelamed.com. Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to: Paid Time Off 401K retirement plan Outstanding Medical Dental Vision Coverage Tuition Reimbursement Many more Voluntary Benefit Options! Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. Responsibilities Assists with activities of daily living, provides basic nursing care to acute rehabilitation patients and assists in maintenance of a safe environment under the direction and supervision of the Registered nurse in charge of the team and / or unit. Qualifications EDUCATION, EXPERIENCE, TRAINING Certification for nursing assistant required Ability to read, write, speak and understand English. Knowledge of Medical Terminology. Previous experience in an acute care hospital or physician’s office. Current BCLS required. Pay Transparency Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The current compensation range for this role is $25.70 to $25.70. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure. Employment Status Full Time Shift Days Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

Certified Nurse Assistant, CNA - Med/Surg (8E)

Prime Healthcare Inglewood, CA

Overview Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for nearly 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, robotics surgery program, inpatient and outpatient rehab programs, labor and delivery, and more. Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Why Prime Healthcare? Centinela Hospital Medical Center; a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Celebrating Our Centinela Hospital Heroes Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2022) for hospital safety from The Leapfrog Group. For more information, visit www.centinelamed.com. Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to: Paid Time Off 401K retirement plan Outstanding Medical Dental Vision Coverage Tuition Reimbursement Many more Voluntary Benefit Options! Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. Responsibilities Assists with activities of daily living, provides basic nursing care to non critical patients and assists in maintenance of a safe environment under the direction and supervision of the Registered nurse in charge of the team and / or unit. Qualifications EDUCATION, EXPERIENCE, TRAINING Certification for Certified Nursing Attendant required. Ability to read, write, speak and understand English. Knowledge of Medical Terminology, preferred. Previous experience in an acute care hospital or physician’s office. BCLS upon hire. Pay Transparency Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The current compensation range for this role is $25.70 to $25.70. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure. Employment Status Full Time Shift Nights Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

CNA

Prime Healthcare Inglewood, CA

Certified Nurse Assistant, CNA - Physical Rehab (4W)

Overview Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for nearly 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, robotics surgery program, inpatient and outpatient rehab programs, labor and delivery, and more. Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Why Prime Healthcare? Centinela Hospital Medical Center; a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Celebrating Our Centinela Hospital Heroes Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2022) for hospital safety from The Leapfrog Group. For more information, visit www.centinelamed.com. Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to: Paid Time Off 401K retirement plan Outstanding Medical Dental Vision Coverage Tuition Reimbursement Many more Voluntary Benefit Options! Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. Responsibilities Assists with activities of daily living, provides basic nursing care to acute rehabilitation patients and assists in maintenance of a safe environment under the direction and supervision of the Registered nurse in charge of the team and / or unit. Qualifications EDUCATION, EXPERIENCE, TRAINING Certification for nursing assistant required Ability to read, write, speak and understand English. Knowledge of Medical Terminology. Previous experience in an acute care hospital or physician’s office. Current BCLS required. Pay Transparency Centinela Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The current compensation range for this role is $25.70 to $25.70. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure. Employment Status Full Time Shift Nights Equal Employment Opportunity Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

Los Robles Regional Medical Center Thousand Oaks, CA

RN II Ortho Spine

Description Hourly Wage Estimate: 52.91 - 75.24 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction Do you have the career opportunities as a(an) RN II Ortho Spine you want with your current employer? We have an exciting opportunity for you to join Los Robles Regional Medical Center which is part of the nations leading provider of healthcare services, HCA Healthcare. Benefits Los Robles Regional Medical Center offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan with 10% off HCA Healthcare stock Family support through fertility and family building benefits with Progyny and adoption assistance. Referral services for child, elder and pet care, home and auto repair, event planning and more Consumer discounts through Abenity and Consumer Discounts Retirement readiness, rollover assistance services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. Our teams are a committed, caring group of colleagues. Do you want to work as a(an) RN II Ortho Spine where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise! Job Summary and Qualifications As a Registered Nurse, you will be responsible for delivering high-quality, patient-centered care in line with the requirements of the department and the standards of practice for the relevant state and specialty. Collaborating with medical providers and the care team, you will provide personalized, comprehensive, and compassionate care, following established nursing models such as "Assess, Perform, Teach, and Manage." You will also act as an advocate for patients, families, and caregivers, embodying the organizations vision, mission, and values to ensure an outstanding patient experience and positive clinical outcomes. Performs direct patient care through utilization of the nursing process in accordance with the California Nurse Practice Act, physician orders, hospital policies and procedures, and established professional standards. The RN is responsible and accountable for the delivery of safe, competent care either through direct care or appropriate delegation and for performance improvement and quality initiatives as appropriate. What you will do in this role: Assess the patients condition during admission and each scheduled shift, promptly identifying and reporting any changes in patient status. Perform procedures, monitoring, or other functions as ordered by the medical provider(s), and ensure thorough and timely documentation of care administration in the patients medical record. - Administer prescribed medications, monitor the patient for therapeutic response, and take appropriate action in the event of an unintended response to the medication. Provide exceptional care by responding promptly to patient requests, proactively anticipating patient needs, and resolving them. Educate patients, families, and caregivers about the patients medical condition, treatment plan, medications, possible side effects, and follow-up measures, ensuring complete understanding by translating complex medical terminology. What qualifications you will need: Graduate of an accredited School of Professional Nursing - Required Minimum of one-year experience in specialty unit - Required , ortho neuro or spine experience is preferred. Basic Cardiac Life Support (BLS) - Required (RN) Registered Nurse License with the State of California - Required Los Robles Regional Medical Center is a 380+ bed acute care hospital dedicated to serving the residents of Ventura and Los Angeles Counties along with the Greater Conejo Valley. We are the only Level II Trauma Center in East Ventura County. We are known for providing excellent care with compassion and kindness to each of our patients. In addition, Los Robles Regional Medical Center features a 24-hour emergency department, comprehensive stroke center, ICU/CCU, maternity, Level III NICU, comprehensive cancer center, heart & cardiovascular center, same day surgery, and rehab center. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Bricks and mortar do not make a hospital. People do." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our RN II Ortho Spine opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Los Robles Regional Medical Center Thousand Oaks, CA

Description Hourly Wage Estimate: 51.88 - 77.82 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction Do you have the career opportunities as a(an) RN Med Surg Clinical Nurse Coordinator you want in your current role? We invest in what matters most to nurses like you – at home, at work, and at every stage in your career. We have an exciting opportunity for you to join Los Robles Regional Medical Center which is a part of the nation’s leading provider of healthcare services, HCA Healthcare. Benefits Los Robles Regional Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan with 10% off HCA Healthcare stock Family support through fertility and family building benefits with Progyny and adoption assistance. Referral services for child, elder and pet care, home and auto repair, event planning and more Consumer discounts through Abenity and Consumer Discounts Retirement readiness, rollover assistance services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. Do you want to work where you have a voice? Nurses are at the forefront of our commitment to the care and improvement of human life. At HCA Healthcare, there are many ways for nurses to have a voice through professional practice councils, advisory councils, vital voices surveys, and units of distinction. We learn from our multi-generational nursing family. We partner with our Nurses at Los Robles Regional Medical Center! Job Summary and Qualifications The Clinical Nurse Coordinator (CNC) ensures and delivers high quality, patient-centered care and coordination of all functions in the unit/department during the designated shift. In collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization’s vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance. What you will do in this role: Assists with admission and discharge processes to ensure efficient throughput and high quality, patient-centered care. Participates in the ongoing assessment of the quality of patient care services provided in the unit, in collaboration with other members of the management team. Collaborates with subject matter experts and other managers to create an environment of teamwork that supports improved outcomes and service. Supports a patient-first philosophy and engages in service recovery when necessary. Supports the efforts of the facility to improve engagement by operationalizing current nursing strategies, including employee rounding, hourly rounds, and other initiatives. Provides recommendations related to interviewing, selecting, and training new staff. Recommends and implements courses of action, including training and development, conflict resolution, personnel policy compliance, completion of performance evaluations, and/or disciplinary actions to ensure a competitively better organization. Assists with staff scheduling. Manages all practical aspects of staff labor in accordance with patient care needs and established productivity guidelines. Supports proper inventory control and assists with managing supplies and equipment. What qualifications you will need: Basic Cardiac Life Support must be obtained within 30 days of employment start date Registered Nurse Los Robles Regional Medical Center is a 380+ bed acute care hospital dedicated to serving the residents of Ventura and Los Angeles Counties along with the Greater Conejo Valley. We are the only Level II Trauma Center in East Ventura County. We are known for providing excellent care with compassion and kindness to each of our patients. In addition, Los Robles Regional Medical Center features a 24-hour emergency department, comprehensive stroke center, ICU/CCU, maternity, Level III NICU, comprehensive cancer center, heart & cardiovascular center, same day surgery, and rehab center. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Bricks and mortar do not make a hospital. People do." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If this opportunity is your next step in your career path, we encourage you to apply for our RN Med Surg Clinical Nurse Coordinator opening. We review all applications. Qualified candidates will be contacted by a member of our team. We are interviewing apply today! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

L.A. Care Health Plan Los Angeles, CA

Payment Integrity Nurse Coder RN III

Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Duties Performs Quality Audits to include validation of accuracy and completeness of ICD, Rev Code, CPT, HCPCs, APR, DRG, POA, and all relevant coding elements. Audits can include inpatient, outpatient, and professional claims. Serves cross functionally with Utilization Management, Medical Directors, and other internal teams to assist in identification of overpayments as well as other projects. Serves as SME for all Payment Integrity functions to include both Retrospective Data Mining as well as Pre-Payment Cost Avoidance. Identifies trends and patterns with overall program and individual provider coding practices. Responsible for training and mentoring Payment Integrity Nurse Coder, RN staff. Supports the creation and execution of strategies that determine impact of opportunity and recover overpayments as well as prospective internal controls preventing future overpayments of each applicable pipeline opportunity. Works with both internal and external groups to define and develop cost avoidance measures to ensure continued success. Identifies and defines Payment Integrity issues and reviews and analyzes evidence, utilizes data for the purpose of verifying errors and identifying systemic errors, works as an active team member during scheduled engagements and work collaboratively to achieve the goals of the team, and provides feedback to the team lead on any issues identified during research or claims review. Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed. Performs other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 8 years of clinical RN experience. At least 3 years of experience in utilization management or clinical coding. Investigation and/or auditing experience. Skills Required: Knowledge in CPT, HCPCS, ICD-9, ICD-10, Medicare, and Medicaid rules and regulations. Knowledge of healthcare reimbursement concepts, health insurance business, industry terminology, and regulatory guidelines. Working knowledge of claims coding and medical terminology. Solid understanding of standard claims processing systems and claims data analysis. Strong project leadership and management skills required; ability to prioritize, plan, and handle multiple tasks/demands simultaneously. Excellent interpersonal, verbal, and written communication skills required with excellent analytical and problem-solving skills. Detail oriented and ability to thrive in fast-paced work environment. Must be collaborative and have the ability to establish credibility quickly with all levels of management across multiple functional areas and be able to present findings across all departments. Must be familiar with coordinating benefits between health plan payers. Advanced knowledge of Microsoft Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Certified Professional Coder (CPC) designation by the American Academy of Professional Coders and/or Certified Coding Specialist (CCS) designation by the American Health Information Management Association (AHIMA). Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO)

Med-Surg

Part-time

Los Robles Regional Medical Center Thousand Oaks, CA

Resource RN Med Surg

Description Hourly Wage Estimate: 52.91 - 75.24 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction Do you currently have an opportunity to make a real impact with your work? With over 2,000 sites of care and serving over 31.2 million patient interactions every year, nurses at Los Robles Regional Medical Center have the opportunity to make a real impact. As a(an) Resource RN Med Surg you can be a part of change. Benefits Los Robles Regional Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan with 10% off HCA Healthcare stock Family support through fertility and family building benefits with Progyny and adoption assistance. Referral services for child, elder and pet care, home and auto repair, event planning and more Consumer discounts through Abenity and Consumer Discounts Retirement readiness, rollover assistance services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential and see how rewarding it can be to reach your personal and professional goals. Help to advance the practice of nursing and improve positive outcomes for your patients as a (an) Resource RN Med Surg. We want your knowledge and expertise! Job Summary and Qualifications The Resource Registered Nurse servicing the MedSurg departments as a professional practitioner, assumes responsibility and accountability for the application of the nursing process and the delivery of patient care while they are relieving other licensed nurses during break/meal periods. Our team is amazing, we consider ourselves a family who work hard to support each other and we are looking for someone who feels patient care is as meaningful as we do. If that is you, come be a part of what makes us great and apply today! You will be documenting interventions, outcomes, patient care, and patient response You will be acting as a resource to staff by providing information, and problem solving to immediately resolve patient care problems You will be developing, implementing, and modifying the patient’s plan of care according to the patient’s progress You will be demonstrating knowledge of specific disease process treatments, interventions and responses based on age specificity, patient’s needs, condition, impairment, or disability You will be reviewing physician orders and accurately transcribe to MAR You will immediately initiate STAT orders You will be assessing, collaborating, reporting, and coordinating the patient’s transfer or discharge planning needs and readiness for discharge or transfer to another level of care with the other members of the health care team and patient’s family/SO What qualifications you will need: California RN License with the State Board of Nursing - Required Basic Cardiac Life Support - Required Graduate of an accredited school of professional nursing - Required Minimum of one-year experience in acute care setting - Required 2 years of acute care nursing experience - Preferred Los Robles Regional Medical Center is a 380+ bed acute care hospital dedicated to serving the residents of Ventura and Los Angeles Counties along with the Greater Conejo Valley. We are the only Level II Trauma Center in East Ventura County. We are known for providing excellent care with compassion and kindness to each of our patients. In addition, Los Robles Regional Medical Center features a 24-hour emergency department, comprehensive stroke center, ICU/CCU, maternity, Level III NICU, comprehensive cancer center, heart & cardiovascular center, same day surgery, and rehab center. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "There is so much good to do in the world and so many different ways to do it." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our Resource RN Med Surg opening. Submit your application today and help advance the practice of nursing. We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Med-Surg

Los Robles Regional Medical Center Thousand Oaks, CA

RN MedSurg Meal Relief

Description Hourly Wage Estimate: 52.91 - 75.24 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Shift: Full Time Nights, rotating weekends Introduction Do you currently have an opportunity to make a real impact with your work? With over 2,000 sites of care and serving over 31.2 million patient interactions every year, nurses at Los Robles Regional Medical Center have the opportunity to make a real impact. As a(an) RN Med Surg Meal Relief you can be a part of change. Benefits Los Robles Regional Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan with 10% off HCA Healthcare stock Family support through fertility and family building benefits with Progyny and adoption assistance. Referral services for child, elder and pet care, home and auto repair, event planning and more Consumer discounts through Abenity and Consumer Discounts Retirement readiness, rollover assistance services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. It is an exciting time to be a nurse at HCA Healthcare! Come unlock your career potential and see how rewarding it can be to reach your personal and professional goals. Help to advance the practice of nursing and improve positive outcomes for your patients as a (an) RN MedSurg Meal Relief. We want your knowledge and expertise! Job Summary and Qualifications Performs direct patient care through utilization of the nursing process in accordance with the California Nurse Practice Act, physician orders, hospital policies and procedures, and established professional standards. The RN is responsible and accountable for the delivery of safe, competent care either through direct care or appropriate delegation and for performance improvement and quality initiatives as appropriate. What you will do in this role: Assess the patients condition during admission and each scheduled shift, promptly identifying and reporting any changes in patient status. Perform procedures, monitoring, or other functions as ordered by the medical provider(s), and ensure thorough and timely documentation of care administration in the patients medical record. - Administer prescribed medications, monitor the patient for therapeutic response, and take appropriate action in the event of an unintended response to the medication. Provide exceptional care by responding promptly to patient requests, proactively anticipating patient needs, and resolving them. Educate patients, families, and caregivers about the patients medical condition, treatment plan, medications, possible side effects, and follow-up measures, ensuring complete understanding by translating complex medical terminology. What qualifications you will need: California RN License with the State Board of Nursing - Required Basic Cardiac Life Support - Required Graduate of an accredited school of professional nursing - Required Minimum of one-year experience in acute care setting - Required 2 years of acute care nursing experience - Preferred Los Robles Regional Medical Center is a 380+ bed acute care hospital dedicated to serving the residents of Ventura and Los Angeles Counties along with the Greater Conejo Valley. We are the only Level II Trauma Center in East Ventura County. We are known for providing excellent care with compassion and kindness to each of our patients. In addition, Los Robles Regional Medical Center features a 24-hour emergency department, comprehensive stroke center, ICU/CCU, maternity, Level III NICU, comprehensive cancer center, heart & cardiovascular center, same day surgery, and rehab center. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "There is so much good to do in the world and so many different ways to do it." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our RN MedSurg Meal Relief opening. Submit your application today and help advance the practice of nursing. We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Contract

L.A. Care Health Plan Los Angeles, CA

Care Management Specialist II, D-SNP Team (12 month Assignment)

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Care Management Specialist II utilizes clinical skills and training to perform essential functions of care management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines. Manages a specified caseload across the entire continuum of programmatic levels including those within National Committee for Quality Assurance (NCQA) scope or otherwise Complex/Catastrophic cases, which are those with the severest acuities or care needs and requiring the highest clinical skills and judgement. Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating member access to care in a timely and cost-effective manner. Collaborates and communicates with member, family, and interdisciplinary health team to promote wellness and member empowerment, while ensuring access to appropriate services across the healthcare continuum and maximizing member benefit: Serves as clinical advocate for members, active interdisciplinary team member, liaison with other departments and external health care team. Provides direction and assistance to Care Coordinators and to Community Health Workers (CHW) of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document contacts, and track member progress. Duties Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs. Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives; reviewing member claims histories and identifies intervention opportunities through the professional standards of practice; contacting and interviewing members to conduct a baseline assessment, assess self-care ability, assess knowledge and adherence deficits; conducting comprehensive clinical assessments as indicated; developing a member centric plan of care. Maintains assigned care management caseload for with a focus on the most complex, highest-risk members particularly those with advanced chronic conditions, co-occurring mental and/or substance abuse and complex social issues (e.g. homelessness, domestic violence). Collaborates with primary care physician and other treating professionals as appropriate. Authorizes initiation of care management services and specialized program services for members and specific populations, and develops interventions designed to meet member or population desired outcomes. Provides comprehensive education and resources to members about accessing services, in-network use, national guidelines for care, community resources, and self-management skills and strategies. Employs engagement techniques to build relationships with members and their authorized representatives. Encourages participants to participate in their health care decisions and assists member with researching treatment options in order to communicate effectively with providers and to make informed decisions. Notifies Care Coordinators and CHWs of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines. Performs field assessment and care coordination functions in community settings with members, such as at the L.A. Care Community Resource Centers, medical clinics, and member homes. Duties Continued Meets and assesses members at L.A. Care Community Resource Centers, as needed. Provides effective care management for Individualized Care Plan summary and interventions during the Interdisciplinary Care Team meetings based on department guidelines. Facilitates appropriate use of resources and coordinates necessary services to improve health status and impact the cost of care. Identifies member needs for and refers to appropriate internal and external programs, as appropriate. Encourages member and family empowerment through education and use of reliable resources. Monitors and evaluates member progress: evaluates member response to interventions and refines action plan to produce desired outcomes. Identifies complex care management issues and discusses possible solutions with management. Assesses effectiveness of care plan’s goals and interventions on a regular basis. Uses claims and care management software to document interactions and interventions with members, vendors, and providers. Maintains case information in the member's clinical records to promote care coordination. Provides ongoing direction and support to internal customers regarding Care Management programs, processes, and benefit coverage. Responsible for staying current with best practices, identifying areas for personal growth opportunities and works with management to develop a plan for obtaining the necessary training. Performs other duties as assigned. Education Required Associate's Degree in Nursing for Registered Nurses Master's Degree in Social Work for Licensed Clinical Social Workers Education Preferred Bachelor's Degree in Nursing for Registered Nurses Experience Required: Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments. Experience providing care management with complex/catastrophic conditions. Skills Required: Current knowledge of clinical standards of care and disease processes. Critical thinking skill. Excellent customer service skills. Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions. Ability to triage immediate member health and safety risks. Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping. Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders. Ability to use a personal computer, and knowledge of medical information systems. Knowledge of and ability to comply with HIPAA compliance. Ability to interview, assess and coordinate care. Ability to prioritize caseload. Knowledge of community resources. Knowledge of Medi-Cal and Medicare regulations. Ability to work as a part of a diverse team and gain consensus and resolution of problems. Preferred: Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse (RN);current and unrestricted California License OR Licensed Clinical Social Worker; current and unrestricted California License. Licenses/Certifications Preferred Certified Case Manager (CCM) Accredited Case Manager (ACM) Certification Case Management Nurse – Board Certified (CMGT-BC) Required Training Physical Requirements Light Additional Information Required: Travel to offsite locations for work. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. This position is a limited duration position. The term of this position is a minimum one year and maximum of two years from the start date unless terminated earlier by either party. Limited duration positions are full-time positions and are eligible to receive full benefits. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO)