Hybrid Senior Transplant Nurse, Case Management Lead

Blue Shield of CA; Denver (CO); Hybride; USD 85 000 - 120 000; Plein temps

Résumé du poste

Blue Shield of CA is seeking a Senior Case Management Nurse to join our Case Management team. You will determine, develop, and implement plans of care based on assessments for members with complex needs, chronic conditions, and high ER utilization, collaborating with clinicians and care teams.

The role requires an active CA RN license (or compact state), an Associate's Degree in Nursing (Bachelor's preferred), CCM certification or in progress, and at least 5 years of nursing or healthcare

Qualifications

• Requires CA RN license or valid RN license from another state; compact state preferred
• Associate's Degree in Nursing required
• Bachelor's degree preferred for advancement
• CCM certification or in progress when eligible
• Minimum 5 years nursing/healthcare experience
• Prior transplant experience required
• Managed care experience preferred (3 years)
• Proficient with MS Office apps (Word/Excel/Outlook/Teams)

Responsabilités

• Define and implement care plans based on member assessments
• Collaborate with members, nurses, treating physicians and care teams
• Apply evidence-based guidelines to determine medical necessity and appropriate levels of care

Connaissances

Clinical judgment

Independent analysis

CCM certification

Care planning

Team collaboration

Formation

Associate's Degree in Nursing

Bachelor of Science in Nursing (preferred)

Outils

Microsoft Office 365

Description du poste

Blue Shield of CA is seeking a Senior Case Management Nurse to join our Case Management team. You will determine, develop, and implement plans of care based on assessments for members with complex needs, chronic conditions, and high ER utilization, collaborating with clinicians and care teams.

The role requires an active CA RN license (or compact state), an Associate's Degree in Nursing (Bachelor's preferred), CCM certification or in progress, and at least 5 years of nursing or healthcare