RN Health Plan Care Manager - Utilization & Coordination

Talented-Medical-Solutions; Roseville (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Talented Medical Solutions is seeking an RN Health Plan Care Manager in Roseville, CA. This full-time, on-site role requires an RN license and is based in our Roseville office.

The manager will oversee the development, implementation and evaluation of the health plan's care management service lines, supporting continuity of care and cost-effective practices across multiple modalities. Preferred candidates hold a BSN, CCM, and have 5–10 years of acute care and health plan experience.

Qualifications

• RN licensure required; 5-10 years of acute and ancillary experience preferred.
• Certified Case Manager (CCM) preferred; Case management experience in health plans.
• Strong communication skills; ability coach patients through their healthcare journey.

Responsibilities

• Develops, implements and evaluates care management service lines.
• Promotes continuity of care and cost effectiveness through integrated inpatient and outpatient management.
• Collaborates with physicians, claims, data management and analytics to ensure outcomes for members.
• Coordinates preventative care, wellness and counseling for Members.
• Manages discharge planning and utilization management communications.
• Works with leadership to improve quality and resource utilization.

Skills

RN licensure

Case management

Communication skills

Patient coaching

Care coordination

Education

BSN degree

Job description

Talented Medical Solutions is seeking an RN Health Plan Care Manager in Roseville, CA. This full-time, on-site role requires an RN license and is based in our Roseville office.

The manager will oversee the development, implementation and evaluation of the health plan's care management service lines, supporting continuity of care and cost-effective practices across multiple modalities. Preferred candidates hold a BSN, CCM, and have 5–10 years of acute care and health plan experience.