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Case Manager II (67519-1)

Professional Management Enterprises
United States, California, Los Angeles
Feb 21, 2025
Case Manager I(RN)reviewing Hospice related documentation including but not limited to physician orders, Hospice election form and certifications to coordinate care including loading pseudo authorizations into systems. This position isFULLY remote but ***MUST be a licensed CA RN residing in the state of CA. The work schedule will be M-F 8:00am-5:00pm PST.

Day to Day Responsibilities:

Roles will review Hospice documentation including physician orders, Member hospice election form, and certifications. Roles will also contact Hospice providers and members on behalf of the CA Health Plan. If documentation is accurate, the roles will load a pseudo authorization in the CA Health Plan's system. If documentation does not support, Reviewing documentation, contacting hospices and members. Loading pseudo authorizations.

Required Education/Experience:

Hospice background strongly

Health Plan experience

CA licensed, CA based, Registered nurse.

Must have a minimum of 3 years Hospice experience

Managed Care and Case Management experience

Required License

Licensure required is a CA State License Registered Nurse - RN license

Case Manager I(RN)reviewing Hospice related documentation including but not limited to physician orders, Hospice election form and certifications to coordinate care including loading pseudo authorizations into systems. This position isFULLY remote but ***MUST be a licensed CA RN residing in the state of CA. The work schedule will be M-F 8:00am-5:00pm PST.

Day to Day Responsibilities:

Roles will review Hospice documentation including physician orders, Member hospice election form, and certifications. Roles will also contact Hospice providers and members on behalf of the CA Health Plan. If documentation is accurate, the roles will load a pseudo authorization in the CA Health Plan's system. If documentation does not support, Reviewing documentation, contacting hospices and members. Loading pseudo authorizations.

Required Education/Experience:

Hospice background strongly

Health Plan experience

CA licensed, CA based, Registered nurse.

Must have a minimum of 3 years Hospice experience

Managed Care and Case Management experience

Required License

Licensure required is a CA State License Registered Nurse - RN license
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