RN Care Manager Lead: Care Coordination & Outcomes

Community Health Plan of Imperial Valley; Imperial (CA); On-site; USD 85,000 - 125,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Paid time off

401k with match

Chance to make a real difference in a:

Job summary

Community Health Plan of Imperial Valley (CHPIV) seeks a Care Manager to lead a team of Care Coordinators responsible for case management, health management, and transition of care activities for Imperial Valley members.

The role requires an active California RN license, 3+ years leading care teams, and strong knowledge of managed care principles. Proficiency with Outlook, Word, Excel, and case management software is essential.)

Qualifications

• Active California RN license without restriction.
• 3+ years leading Care Coordinators.
• 3+ years in management/case/disease management in medical or behavioral health.
• Knowledge of managed care principles with emphasis in care management.
• Clinical knowledge to assess whole-person care needs for effective plans.
• Proficient with Outlook, Word, Excel and case management programs.
• Experience partnering with healthcare team members.

Responsibilities

• Provide direction to care coordination team to implement model of care and regulatory requirements.
• Manage caseloads for the team considering medical/psychosocial complexity.
• Maintain electronic case management documentation in HIPAA-compliant systems.
• Complete trainings and implement changes as required.
• Promote multidisciplinary collaboration with providers, members, and families.
• Audit assessments and care plans for completeness and timeliness per state rules.
• Monitor TOC assessments and timing per TOC protocols.
• Participate in audits, remote or onsite as required.
• Create business requirements docs, user training materials, and related docs.
• Assist with care coordination for resources and services.

Skills

Leadership of care teams

Case management oversight

Regulatory compliance

Clinical assessment

Communication with providers

Education

CA RN license

Tools

Outlook

Word

Excel

case management software

Job description

Community Health Plan of Imperial Valley (CHPIV) seeks a Care Manager to lead a team of Care Coordinators responsible for case management, health management, and transition of care activities for Imperial Valley members.

The role requires an active California RN license, 3+ years leading care teams, and strong knowledge of managed care principles. Proficiency with Outlook, Word, Excel, and case management software is essential.)