Hybrid RN Senior Case Manager – D-SNP Care Lead

Central California Alliance for Health; Salinas (CA); Hybrid; USD 120,000 - 140,000; Full time

Benefits offered by this job

Medical, Dental and Vision Plans

Paid Time Off

12 Paid Holidays per year

401(a) Retirement Plan

457 Deferred Compensation Plan

Wellness Program

Onsite EV Charging Stations

Job summary

Central California Alliance for Health is seeking a Senior Complex Case Manager (RN) to lead Medicare D-SNP care coordination and develop individualized care plans for Dual Eligible members. You will educate families, work with providers and internal teams, and support quality improvement efforts.

Hybrid work environment; requires CA RN license and strong experience in case management, geriatrics, and health equity. Employee benefits and collaboration with local communities are emphasized.

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 Bachelor's degree may substitute for two years of the required experience).
• A minimum of one year of the required patient care experience must be 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 with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner.
• 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 continually evaluate the program's effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for members.
• Performs D-SNP Program oversight and support activities.
• Acts as a liaison between the D-SNP Program and providers and community agencies to promote effective implementation of program objectives and requirements.

Skills

Nursing

Case management

Motivational interviewing

Care coordination

Chronic conditions

Geriatric care

Social determinants of health

Evidence-based guidelines

EHR systems

Education

CA RN license

Associate degree in nursing

BSN substitution for experience

Tools

Electronic Health Records

Job description

Central California Alliance for Health is seeking a Senior Complex Case Manager (RN) to lead Medicare D-SNP care coordination and develop individualized care plans for Dual Eligible members. You will educate families, work with providers and internal teams, and support quality improvement efforts.

Hybrid work environment; requires CA RN license and strong experience in case management, geriatrics, and health equity. Employee benefits and collaboration with local communities are emphasized.