Senior RN: Complex Care Manager (Hybrid)

Central California Alliance for Health; Hollister (CA); Hybrid; USD 125,000 - 140,000; Full time

Benefits offered by this job

Medical, Dental and Vision Plans

Ample Paid Time Off

12 Paid Holidays per year

401(a) Retirement Plan

457 Deferred Compensation Plan

Wellness Program

Onsite EV Charging Stations

Job summary

Central California Alliance for Health is seeking a Senior Complex Case Manager (RN) to lead a patient-centered care plan for Medicare Dual Eligible Special Needs Plan members. Reporting to the Medicare Care Management Manager, RN, you will coordinate care, educate members and families, and collaborate with providers and community agencies to achieve cost-effective, high-quality outcomes.

The ideal candidate holds an unrestricted California RN license, an associate degree in nursing, and at

Qualifications

• Current unrestricted license as a Registered Nurse issued by the State of California.
• Associate's degree in Nursing and a minimum of seven years of experience in a patient care setting, including a minimum of one year of case management experience (a Bachelor's degree may substitute for two years of the required experience).
• A minimum of one year of the required patient care experience must be in an acute or outpatient environment, working with adults and/or dual-eligible populations.

Responsibilities

• 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.

Skills

Clinical nursing principles

Case management principles

Care management & coordination

Chronic condition knowledge

Social determinants of health

Evidence-based care planning

Electronic health records

Education

RN license (CA)

Associate's degree in Nursing

Bachelor's degree may substitute for 2 years experience

Tools

Care management platforms

Job description

Central California Alliance for Health is seeking a Senior Complex Case Manager (RN) to lead a patient-centered care plan for Medicare Dual Eligible Special Needs Plan members. Reporting to the Medicare Care Management Manager, RN, you will coordinate care, educate members and families, and collaborate with providers and community agencies to achieve cost-effective, high-quality outcomes.

The ideal candidate holds an unrestricted California RN license, an associate degree in nursing, and at