Case Management - Nurse, Senior- Pregnancy and Postpartum

Your Role

The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members' care including clinical nurses and treating physicians.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Current CA RN License required
• Bachelor of Science in Nursing or advanced degree preferred.
• Requires 5 years' experience in nursing, health care or related field.
• 3 years managed care experience preferred.
• Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements.

• At least 2 years within Health Plan / Managed Care Plan, specific to Medi-Cal line of business preferred

• At least 2 years of experience in maternity, labor and delivery, or post-partum preferred

• Transitions of care experience desired
• Excellent communications skills

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come into the office based on business need.