Chronic Disease Management Nurse (RN-Remote CA, AZ, NV, TX, NM)

SCAN Health Plan; Long Beach (CA); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading health plan seeks a Disease Management Nurse to assess, plan, and evaluate members' health needs, targeting chronic condition management. This role offers a collaborative environment with various healthcare professionals, ensuring quality care delivery while supporting member engagement and education.

Benefits

Annual employee bonus program

Generous paid-time-off (PTO)

401(k) Retirement Saving Plan with employer match & contribution

Robust Wellness Program

Employee recognition program

Qualifications

• 1-2 Years of Disease Management Experience required.
• At least 1 year of direct patient care nursing experience required.
• 3+ years clinical experience with geriatric population preferred.

Responsibilities

• Help identify and execute interventions and overall plan of care.
• Provide education and coaching surrounding disease management.
• Ensure and evaluate clinical appropriateness of care plan.

Skills

Coaching

Motivational Interviewing

Bilingual (Spanish)

Education

Current & Active CA RN License

BSN preferred

CCM Certification preferred

Job description

The purpose of the Disease Management Nurse is to collaboratively assess, plan, implement, coordinate, monitor, and evaluate the member’s health and psychosocial needs. Disease Management serves a way to prevent further complications of a chronic condition and minimize potential exacerbations by coaching across the continuum of care.

You Will

The Disease Management Nurse would function in the following ways :

• Help identify and execute interventions and overall plan of care for care management and disease management; includes collaborating with interdisciplinary team members, including social workers, community health workers, care coordinators, and pharmacists.
• Ensure and evaluate clinical appropriateness of care plan by incorporating assessment findings against evidence-based guidelines, clinical reasoning, clinical practice guidelines and / or best practices in the community.
• Promotes member activation and engagement to ensure optimal self-management skills and health outcomes.
• Provide education and coaching surrounding disease management by identifying new and preventable exacerbations or worsening chronic conditions
• Create interventions and overall plan of care for disease management pods. Including direction of the Community Health Worker’s field-based interventions.
• Enhance department and organization activities by identifying opportunities for improvement to existing processes
• Participate in activities to support professional growth through education opportunities, reading professional publications, maintain professional networks, and participating in professional organizations.
• Comply with all regulatory and quality agency standards including : Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Services (DHS), and accreditation bodies’ standards such as the National Commission of Quality Assurance (NCQA) as it relates to care management activities.
• Supports SCAN-wide initiatives, such as those related to member education, quality of care, and community engagement.

We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your Qualifications

• Current & Active CA RN License required.
• BSN preferred.
• 1-2 Years of Disease Management Experience required.
• At least 1 year of direct patient care nursing experience required.
• 3+ years clinical experience with geriatric population (Acute, Ambulatory care, SNF and / or LTC) preferred.

2 + years of case management experience in a medical group, IPA and / or HMO setting preferred.

• Medicare / Medi-Cal experience in managed care environment preferred.
• Basic knowledge of related NCQA standards, CMS and DHCS regulations.
• Bilingual / Bicultural (Spanish) preferred. Testing will be administered if applicable.
• CCM Certification preferred.

Coaching, Motivational Interviewing, ability to build a strong rapport.

What's in it for you?

• Base salary range : $ to $per hour
• Remote Work Mode
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• Excellent 401(k) Retirement Saving Plan with employer match & contribution
• Robust employee recognition program
• An opportunity to become part of a team that makes a difference to our members and our community every day!

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Disease Management Nurse • Long Beach, CA , US