Remote Social care Worker Needed - Pasadena, CA

Plans, develops, assesses, and evaluates care provided to members.

In conjunction with primary care and specialist physicians, evaluates and develops baseline medical and psychosocial evaluations and individualized patient care/treatment plans.

Recommends alternative levels of care and ensures compliance with federal, state, and local requirements.

Makes assessments of physiological and or functional status utilizing protocols.

Initiates appropriate diagnostic testing/screening and interventions.

Develops individualized patient/family education plan focused on self-management; delivers patient/family education specific to a disease state.

Implements strategies to target/assess risk factors and achieve and ensure patient follow-up according to clinical and strategic measures/outcomes.

Produces population-based reports on outcomes specific to defined patient populations.

Participates with healthcare team/providers in actualizing outcomes by planning, evaluating, and implementing decisions and strategies to achieve predetermined cost, clinical, quality, utilization, and service outcomes.

Develops and maintains case management policies and procedures.

Coordinates care/services with utilization and/or quality reviewers and monitors level and quality of care.