RN Health Plan Care Manager: Care Coordination & Utilization

Adventist Health; Antelope (CA); In loco; USD 90.000 - 120.000; Tempo pieno

Descrizione del lavoro

Adventist Health Roseville is seeking a Registered Nurse Care Manager to lead and coordinate care management initiatives for our member population. This role emphasizes continuity of care, cost effectiveness, and collaborative practice with physicians, claims, and analytics teams.

The ideal candidate will hold an active RN license in California, prefer a BSN, and have CCM certification or experience. This is a patient-centered position focused on high-quality, efficient care delivery.

Competenze

• Bachelor’s Degree in Nursing (BSN): Preferred
• Nursing experience: Preferred
• Certified Case Manager (CCM): Preferred
• Registered Nurse (RN) licensure in the state of practice: Required

Mansioni

• Partners with physician advisors, claims, data management and analytics to ensure safe outcomes for the Health Plan’s member population.
• Performs preventative care, wellness, and nutritional counseling for Members.
• Develops and maintains positive relationships with customers internal and external.
• Collaborates on quality and performance improvement for efficient care delivery and cost reduction.
• Manages discharge planning and ensures medical necessity criteria are met.

Conoscenze

Care coordination

Stakeholder collaboration

Patient advocacy

Formazione

Bachelor of Science in Nursing (BSN)

Registered Nurse (RN) licensure in CA

Certified Case Manager (CCM) preferred

Descrizione del lavoro

Adventist Health Roseville is seeking a Registered Nurse Care Manager to lead and coordinate care management initiatives for our member population. This role emphasizes continuity of care, cost effectiveness, and collaborative practice with physicians, claims, and analytics teams.

The ideal candidate will hold an active RN license in California, prefer a BSN, and have CCM certification or experience. This is a patient-centered position focused on high-quality, efficient care delivery.