Care Manager, RN – Health Access, ECM

🕒 Outubro 1

🏄 California – Remoto

🏄 California – Remote

💵 $91.249 - $120.910 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 8%

O que significa: a chance de ninguém estar realmente contratando para esta vaga.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Por que essa pontuação:

• Aberta há 42 dias.
• As vagas desta empresa costumam ser preenchidas em 27 dias.

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IEHP

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 1995

🛡️ Seguros

💼 Consultoria

📦 Logística

💰 Grant em 2021-02

Insurance • Consulting • Logistics

IEHP é um plano de saúde dedicado a atender indivíduos e famílias de baixa renda nos condados de Riverside e San Bernardino. Eles oferecem uma variedade de programas, incluindo Medi-Cal, DualChoice e Covered California, fornecendo cobertura de saúde para residentes que, de outra forma, não teriam acesso aos serviços médicos necessários. Com foco na saúde holística e no bem-estar comunitário, a IEHP faz parcerias com médicos e instalações locais para garantir um cuidado abrangente para seus membros, apoiando-os com recursos em saúde mental, aulas de ginástica e educação para o bem-estar.

Descrição

• Manage a caseload of members with medical needs using independent clinical judgment and strategic planning • Recommend care coordination strategies using clinical tools and metrics, manage caseloads, and escalate high-risk cases appropriately • Engage members in person and by phone using evidence-based approaches such as Motivational Interviewing • Conduct comprehensive, holistic assessments within the RN scope of practice • Develop individualized care plans and communicate them with members, caregivers, and care team members • Lead interdisciplinary care team meetings and update care plans • Coordinate with internal and external health partners to support members’ comprehensive care needs • Participate in and lead care transition planning • Coordinate medical and behavioral health access issues with primary care offices, specialists, and ancillary services • Coordinate care for members with complex medical and social needs across physical, behavioral, and dental health systems • Provide training, clinical consultation, and support to Health Access team members • Represent the Enhanced Care Management team as lead member when necessary • Develop interventions that improve members’ ability to manage their health • Support non-clinically licensed care team members within the RN scope of practice • Build partnerships with providers, team members, and community stakeholders across in-person, telephonic, and digital platforms • Promote effective collaboration and resolve conflicts within the care management team • Participate in quality improvement initiatives, including addressing HEDIS gaps and other quality measures • Participate in staff, training, and committee meetings as needed • Ensure accurate documentation complies with regulatory and accreditation standards • Perform other duties required to support Health Plan operations and department business needs

🎯 Requisitos

• Three (3) or more years of care management experience in a health care delivery setting required • Experience working successfully within a team required • Experience developing and maintaining effective relationships with clients and coworkers required • 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 • 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 • 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 of evidence-based communication such as Motivational Interviewing or similar empathy-based communication strategies • Understanding of and sensitivity to multicultural community • Knowledge of self-management philosophies and practices, especially related to chronic medical conditions • Awareness of the impact of unmitigated bias and judgment on health, with commitment to addressing both • Bilingual (English/“Target Language”) preferred • Highly skilled interpersonal and relationship skills • Highly skilled interpersonal communication, including resolving conflict with coworkers • Skill in informally and formally sharing expertise • Ability to tolerate, manage, and effectively use a high level of ambiguity around new team models, new models of care, and new care management practices • Must live within a 25-mile radius of the assigned service area and have reliable transportation

🏖️ Benefícios

• 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 • Telecommute work location • Paid travel or transportation support is not explicitly stated; reliable transport is required

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