Care Management Nurse Senior

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 Care Management - Nurse, Senior will report to the Manager of Care Management. In this role you will play a pivotal role in assessing member needs, providing clinical education, as well as care coordination with providers, medical groups, and community resources. You will be responsible for managing and coordinating patient care, ensuring that our members receive the highest quality of care and services. Care Managers perform 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

Requires an active, unrestricted CA RN License or active, unrestricted RN license(s) from other state(s). Preferred licensure from a compact state. If assigned to another state, must maintain an active, unrestricted RN license in assigned state(s) or the ability to obtain required RN license (in addition to primary state license) within 90 days of hire
Requires 5 years of experience in nursing, healthcare, or related field
Requires a Certified Case Manager (CCM) certification or obtained within 18 months of hire
Bachelor of Science in Nursing or advanced degree is preferred
Managed care experience of 3 years is preferred
Health insurance experience is preferred
Transitions of care experience is preferred
Strong knowledge of healthcare delivery systems, managed care principles, and care coordination
Excellent communication skills
Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

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