Senior Complex Case Manager (RN) - D-SNP (Temporary)

Central California Alliance for Health; California; In loco; USD 90.000 - 120.000; Tempo pieno

Descrizione del lavoro

Central California Alliance for Health is seeking a Senior Complex Case Manager (RN) for the D-SNP program. This temporary, full-time role supports Medicare Dual Eligible members by developing individualized care plans and coordinating across providers, families, and community agencies.

The position emphasizes quality improvement, program oversight, and effective collaboration to promote cost-efficient, high-quality outcomes for members.

Competenze

• Must hold a valid RN license and be eligible to work in California.
• Experience with Medicare D-SNP or managed care preferred.
• Strong assessment, planning, and communication skills.
• Ability to work across disciplines and with external agencies.

Mansioni

• Develops and manages an individualized care plan for D-SNP members.
• Educates members, families, providers, and agencies on the D-SNP program.
• Participates in Quality Improvement studies to evaluate program effectiveness.
• Performs D-SNP program oversight and support activities.
• Acts as a liaison between the D-SNP program and providers/community agencies.

Conoscenze

Clinical nursing

Case management

Motivational interviewing

Care coordination

Geriatric care

Social determinants

EHR proficiency

Formazione

RN license

Descrizione del lavoro

Senior Complex Case Manager (RN) - D-SNP (Temporary)

OUR COMMITMENT TO A HUMAN HIRING PROCESS

We believe every candidate deserves thoughtful consideration.That’swhy we do not use AI or automated systems toreview applications . Every application is reviewed bya real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer — and we genuinely appreciate your patience as we work through applications carefully and respectfully.

SERVICE AREA PREFERENCE

While we encourage all interested applicants to apply, we do give priority to those who live in , or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa . Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment.

ABOUT THIS TEMP POSITION

This is a temporary position. The length of the assignment is estimated to go from November 2, 2026 to December 31, 2026, but this is always dependent on business need, and these dates may change. While the assignment would be at the Alliance, you would be an employee of a temporary employment agency that we would connect you with if hired for this position.This is a full-time (40 hours/week) temporary assignment.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Complex Case Management Supervisor - Adult (RN), this position:

• Develops and manages an individualized comprehensive plan of care for Medicare Dual Eligible Special Needs Plan (D-SNP) members referred into the Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner
• Works with and educates members, families, providers, external agencies, and internal departments on the D-SNP Case Management Program
• Participates in Quality Improvement studies, to continually evaluate the program’s effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for members
• Performs D-SNP Program oversight and support activities
• Acts as a liaison between the D-SNP Program and providers and community agencies to promote effective implementation of program objectives and requirements

WHAT YOU'LL NEED TO BE SUCCESSFUL

• Knowledge of:
• The principles and practices of clinical nursing
• The principles and practices of case management, including motivational interviewing and evidence-based guidelines
• Care management and coordination
• Complex chronic conditions, geriatric care, and psychosocial factors impacting health outcomes
• The principles and practices of developing and implementing health improvement strategies to address social determinants of health
• Evidence-based practice guidelines in the development of care plans
• Electronic health record and/or care management platforms
• Ability to:
  • Assess member risk, define problems, develop care plans, and collaborate across disciplines
  • Demonstrate strong critical thinking and problem-solving skills
  • Interpret and apply policies and regulations