Senior Care Management Nurse — Hybrid Leader

Blue Shield of CA; Washington (District of Columbia); Hybrid; USD 110,000 - 140,000; Full time

Benefits offered by this job

Hybrid Virtual Work

Job summary

Blue Shield of California seeks a Care Management Nurse, Senior to perform case management, determine and implement care plans, and collaborate with members and clinicians. You will assess needs, coordinate with nurses and treating MDs, and apply clinical judgment for complex cases including chronic conditions and poly-pharmacy.

The role requires a CA RN license, a BSN or higher preferred, CCM certification or progress, and 5+ years in nursing with 3+ years in managed care.

Qualifications

• CA RN license required and must be in good standing.
• CCM certification preferred or in progress.
• Minimum 5 years in nursing, healthcare, or related field.
• At least 3 years in managed care preferred.
• Proficient with Microsoft Office 365 applications.

Responsibilities

• Determine, develop and implement the plan of care based on assessment and treatment plan.
• Collaborate with members, nurses, and treating MDs to support member care.
• Assess, evaluate and interpret clinical information for care planning.
• Apply evidence-based guidelines to promote quality and cost-effective care.

Skills

CA RN License

Bachelors in Nursing

CCM Certification

Clinical assessment

Managed care experience

Critical thinking

MS Office 365

Education

BSN or higher

Tools

Word

Excel

Outlook

Teams

Job description

Blue Shield of California seeks a Care Management Nurse, Senior to perform case management, determine and implement care plans, and collaborate with members and clinicians. You will assess needs, coordinate with nurses and treating MDs, and apply clinical judgment for complex cases including chronic conditions and poly-pharmacy.

The role requires a CA RN license, a BSN or higher preferred, CCM certification or progress, and 5+ years in nursing with 3+ years in managed care.