Senior Care Coordination RN - FEP Triage (Hybrid)

Blue Shield of CA; Oakland (CA); Hybrid; USD 85,000 - 115,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Blue Shield of CA's Federal Employee Program team seeks a Complex Care Coordination Triage Registered Nurse Case Manager. You will assess members, develop care plans, and coordinate with clinicians to ensure appropriate care.

The role requires CA RN license, 5+ years in nursing or healthcare, and knowledge of case management principles. The position supports hybrid/virtual work with periodic office visits as needed.

Qualifications

• Associate Degree in Nursing required
• CA RN license active/unrestricted required
• Minimum 5 years of nursing/healthcare experience
• CCM Certification preferred
• Knowledge of NCQA and federal regulatory requirements

Responsibilities

• Determine, develop, and implement a plan of care based on comprehensive assessment
• Coordinate with members, nurses, and treating physicians to ensure appropriate care
• Demonstrate clinical judgment and independent analysis in case management and disease management
• Lead and participate in discharge planning and utilization management
• Contribute to program evaluation and leadership initiatives

Skills

Supervisory skills

Communication skills

Negotiation skills

Abstracting skills

MS Word

MS Excel

Education

Associate Degree in Nursing

Bachelor of Science in Nursing or advanced degree

RN license in CA

Tools

MS Word

MS Excel

Job description

Blue Shield of CA's Federal Employee Program team seeks a Complex Care Coordination Triage Registered Nurse Case Manager. You will assess members, develop care plans, and coordinate with clinicians to ensure appropriate care.

The role requires CA RN license, 5+ years in nursing or healthcare, and knowledge of case management principles. The position supports hybrid/virtual work with periodic office visits as needed.