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Care Manager, RN - Health Access, ECM - Rancho Cucamonga (Remote)

Inland Empire Health Plans

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Reporting to Health Access Enhanced Care Management Department Leadership, this position is responsible for working effectively with the Health Access Enhanced Care Management (ECM) Care Coordination team, members and families, other professionals, and the designated healthcare care organization (HCO) medical team to provide high quality, effective care management to IEHP members. This position focuses on a person-centered model of care which takes in to account the member’s medical, behavioral, and social needs. This position provides high quality, effective care management to IEHP members ensuring coordinated continuous care.


Care Management is broadly defined, and can include outreach and engagement to members, engaging members in skilled therapeutic interactions to promote health behaviors, other behavioral health interventions within scope, coordination of care, resource linkages, working with other professionals, and organizations in the community to ensure quality of care for members, seamless transitions of care, and facilitating the right care and the right time for the member. As a licensed clinician, this position provides clinical expertise, clinical leadership, and clinical oversight in a variety of ways within the Enhanced Care Management program. This position, like all positions within the HA ECM team, is expected to model behavioral health principles of relationship-based care, as well engage in promoting education and understanding of behavioral health and its importance in whole health, to those within IEHP and in the community.


This is a field-based position in which Care Team Members will meet with our highest risk/high utilizer population face to face, per member's consent. The individual in this position is to utilize their clinical expertise to support and engage members to promote positive health behaviors, assist with coordination of care, provided resource linkages, and collaborate with other Team Members within their care team, as well as external partners, to ensure a seamless transition of care experience.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more

  • Competitive salary
  • State of the art fitness center on-site
  • Medical Insurance with Dental and Vision
  • Life, short-term, and long-term disability options
  • Career advancement opportunities and professional development
  • Wellness programs that promote a healthy work-life balance
  • Flexible Spending Account – Health Care/Childcare
  • CalPERS retirement
  • 457(b) option with a contribution match
  • Paid life insurance for employees
  • Pet care insurance
Education & Requirements
  • Three (3) or more years of care management experience in a health care delivery setting required. Experience working successfully within a team, and experience in developing and maintaining effective relationships with both clients and coworkers is mandatory

  • Experience in a Managed Care setting preferred
  • Minimum of one (1) year clinical experience in an acute care facility, skilled nursing facility, home health or clinic setting preferred
  • Population of Focus Experience:
    1. Adults, unaccompanied youth & children, and families experiencing homelessness
    2. Adults, youth, and children who are at risk for avoidable hospital or ED care
    3. Adults, youth, and children with serious mental health and/or substance use disorder needs
    4. Adults living in the community and at risk for long-term care institutionalization
    5. Adult nursing facility residents transitioning to the community
    6. Children & youth enrolled in CCS or CCS Whole Child Model with additional needs beyond their CCS conditions
    7. Children & youth involved in child welfare (foster care)
    8. Adults & youth who are transitioning from incarceration
    9. Pregnant & postpartum individuals; birth equity population of focus
  • Associate’s degree in Nursing from an accredited institution required
    • Bachelor’s degree in Nursing from an accredited institution preferred
  • Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN required
    • Certified Case Manager (CCM) preferred
Key Qualifications
  • Must have a valid California Driver’s license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
  • Strong knowledge and in-depth understanding of:
    • Skill in evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies
    • Understanding of and sensitivity to multi-cultural community
    • Self-management philosophies and practices, especially as they relate to chronic medical conditions
    • Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both
  • Bilingual (English/ “Target Language”) preferred

  • Highly skilled interpersonally, with excellent relationship skills
  • Highly skilled in interpersonal communication, including resolving conflict with co-workers
  • Skillful in informally and formally sharing expertise
  • Must have skills to tolerate, manage and make effective use of a high level of ambiguity around new team models, new models of care, and new care management practices
Start your journey towards a thriving future with IEHP and apply TODAY!
#J-18808-Ljbffr
Vacancy posted 5 days ago
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