Medicare Care Management Manager (RN)

Central California Alliance for Health; Monterey (CA); Hybrid; USD 112,000 - 198,000; Full time

Job summary

Join a leading company as the Medicare Care Management Manager (RN) in California. You will lead a team, oversee care management activities, and ensure effective program delivery. The role requires strong nursing knowledge and supervisory experience, with a focus on improving member health outcomes.

Benefits

Medical, Dental, Vision

Paid Time Off and Holidays

Retirement Plans (401a, 457)

Health and Wellness Programs

Onsite EV Charging Stations

Qualifications

• Minimum of six years in a health plan or patient care setting.
• Two years supervising a multidisciplinary team.
• One year in case management.

Responsibilities

• Lead and manage the Care Management Medicare team.
• Oversee departmental functions and evaluate program effectiveness.
• Supervise, mentor, and train staff.

Skills

Clinical nursing principles and practices

Case management principles and practices

Supervision and training practices

Care management and coordination

Medi-Cal policies and Title 22 regulations

Medicare D-SNP regulations

Managed care concepts and guidelines

Education

California RN license

Bachelor’s degree in Nursing

Job description

Medicare Care Management Manager (RN)

Location: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California

Join the Alliance as the Medicare Care Management Manager (RN) in the Care Management Department.

WHAT YOU'LL BE RESPONSIBLE FOR

• Lead and manage the Care Management Medicare team, acting as a subject matter expert and providing guidance on care management activities.
• Oversee departmental functions and evaluate program effectiveness.
• Supervise, mentor, and train staff.
• Collaborate on special projects with various Alliance departments.

ABOUT THE TEAM

Our mission is to coordinate care and empower members to achieve health and wellness goals through collaboration and community provider engagement.

WHAT YOU'LL NEED TO BE SUCCESSFUL

For the full position description and requirements, click here.

• Knowledge of:
  • Clinical nursing principles and practices
  • Case management principles and practices
  • Supervision and training practices
  • Care management and coordination
  • Medi-Cal policies and Title 22 regulations
  • Medicare D-SNP regulations
  • Managed care concepts and guidelines
• Ability to:
  • Analyze legal, regulatory, and contractual language and directives
  • Train, mentor, supervise, and motivate staff
  • Explain regulations, processes, and programs clearly
  • Organize, prioritize, delegate, and follow up on work
  • Lead meetings and data collection activities
  • Present data effectively using visual aids
• Education and Experience:
  • California RN license
  • Bachelor’s degree in Nursing
  • Minimum of six years in a health plan or patient care setting, including two years supervising a multidisciplinary team, one year in case management, and some care management experience. A Master’s degree may substitute for two years of experience.

OTHER INFORMATION

• Hybrid work environment; remote interviews via Microsoft Teams.
• Attendance at quarterly events or meetings may be required.
• In-office or community presence may be needed, depending on business needs.

COMPENSATION

The full range varies by location:

• Zone 1 (Monterey, San Benito, Santa Cruz): $123,399 - $197,454
• Zone 2 (Mariposa, Merced): $112,289 - $179,670

OUR BENEFITS

• Medical, Dental, Vision
• Paid Time Off and Holidays
• Retirement Plans (401a, 457)
• Health and Wellness Programs
• Onsite EV Charging Stations

ABOUT US

We are committed to accessible, quality healthcare, guided by local innovation. Join our diverse and respectful culture at Central California Alliance for Health. Learn more through our Fact Sheet.

We are an equal opportunity employer and participate in E-Verify. Currently, we do not sponsor employment visas. Applicants must be authorized to work in the U.S. full-time without sponsorship.