Senior Complex Case Manager (RN) – D-SNP Care

Central California Alliance For Health; Philippines; Hybrid; PHP 120,000 - 140,000; Full time

Job summary

Central California Alliance for Health in Santa Cruz, Philippines, is seeking a Senior Complex Case Manager (RN) for our D-SNP program. This full-time role reports to the Medicare Care Management Manager (RN) and focuses on developing individualized care plans for Dual Eligible Special Needs Plan members, coordinating with families, providers, and agencies.

The successful candidate will have a California RN license, a nursing degree, and several years in patient care and case management, with

Qualifications

• Current unrestricted license as a Registered Nurse issued by the State of California
• Associate’s degree in Nursing and a minimum of seven years of experience in a patient care setting, including a minimum of one year of case management experience
• A minimum of one year of patient care experience in an acute or outpatient environment, working with adults and/or dual-eligible populations

Responsibilities

• Develops and manages an individualized comprehensive plan of care for Medicare Dual Eligible Special Needs Plan (D-SNP) members referred into the Case Management Program
• Works with and educates members, families, providers, external agencies, and internal departments on the D-SNP Case Management Program
• Participates in Quality Improvement studies to evaluate the program’s effectiveness and outcomes
• Performs D-SNP Program oversight and support activities
• Acts as a liaison between the D-SNP Program and providers and community agencies

Skills

Clinical nursing

Case management

Motivational interviewing

Care coordination

D-SNP knowledge

Communication

Education

Registered Nurse license (CA)

Associate's degree in Nursing

Tools

EHR systems

Job description

Central California Alliance for Health in Santa Cruz, Philippines, is seeking a Senior Complex Case Manager (RN) for our D-SNP program. This full-time role reports to the Medicare Care Management Manager (RN) and focuses on developing individualized care plans for Dual Eligible Special Needs Plan members, coordinating with families, providers, and agencies.

The successful candidate will have a California RN license, a nursing degree, and several years in patient care and case management, with