Medicare Care Management Manager (RN)

Central California Alliance for Health; Santa Cruz (CA); Hybrid; USD 123,000 - 198,000; Full time

Job summary

Join a leading healthcare organization as the Medicare Care Management Manager (RN) to lead a dedicated team in providing effective care management. You will oversee operations, mentor staff, and collaborate on projects to enhance community health. This role offers a hybrid work environment and a competitive salary based on qualifications.

Benefits

Medical, Dental, Vision

Paid Time Off and Holidays

Retirement Plans (401(a), 457)

Health and Wellness Programs

Onsite EV Charging

Qualifications

• Six years in a health plan or patient care, including two years supervising a multidisciplinary team.
• One year in case management and some care management experience.

Responsibilities

• Leading and managing the Care Management Medicare team.
• Overseeing departmental operations and program effectiveness evaluations.
• Mentoring, supervising, and training 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

Education

Bachelor's degree in Nursing

Current California RN license

Job description

Medicare Care Management Manager (RN)

Location: Mariposa County, Merced County, Monterey County, San Benito County, 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

• Leading and managing the Care Management Medicare team, providing subject matter expertise and guidance on care management activities.
• Overseeing departmental operations and program effectiveness evaluations.
• Mentoring, supervising, and training staff.
• Collaborating on special projects with various Alliance teams.

About the Team

Our mission is to coordinate care and empower members to achieve their 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 prepaid healthcare guidelines
• Ability to:
  • Analyze legal, regulatory, and contractual language and policies
  • 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:
  • Current California RN license
  • Bachelor's degree in Nursing
  • Six years in a health plan or patient care, including two years supervising a multidisciplinary team, one year in case management, and some care management experience (Master's may substitute for two years)

Other Information

• Hybrid work environment with remote interviews via Microsoft Teams.
• Attendance at quarterly events or meetings may be required.
• In-office presence may be necessary based on business needs.

Compensation

Range varies by location, with Zone 1 (Monterey, San Benito, Santa Cruz): $123,399 - $197,454 USD, and Zone 2 (Mariposa, Merced): $112,289 - $179,670 USD. Actual salary depends on qualifications and other factors.

Benefits

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

About Us

We are a dedicated team of over 500 employees committed to accessible, quality healthcare. Join us at Central California Alliance for Health and be part of a respectful, diverse, and professional culture. We serve multiple counties and are committed to community impact.

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