Care Manager, RN – Health Access, ECM

🔥 27 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $91.2k - $120.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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IEHP

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1995

🛡️ Insurance

💼 Consulting

📦 Logistics

💰 Grant on 2021-02

Insurance • Consulting • Logistics

IEHP is a health plan dedicated to serving low-income individuals and families in Riverside and San Bernardino counties. They offer a variety of programs including Medi-Cal, DualChoice, and Covered California, providing healthcare coverage for residents who may not otherwise have access to necessary medical services. With a focus on holistic health and community wellness, IEHP partners with local doctors and facilities to ensure comprehensive care for their members, supporting them with resources in mental health, fitness classes, and wellness education.

📋 Description

• Exercise independent clinical judgment and strategic planning in managing a caseload of members with medical needs according to department processes and procedures. • Recommend care coordination strategies for members, including but not limited to: Utilize clinical tools and metrics (i.e., brief medical interventions) as necessary to inform interventions, manage caseloads, and escalate high-risk cases appropriately. • Engage with members, both in-person and on the phone, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the member and his or her medical/behavioral team, as well as improving the member’s ability to manage and control their whole health. • Conduct comprehensive, holistic assessment according to the scope of the RN license. • Assimilate assessment information into an individualized care plan (ICP), communicate ICP with members, approved family or caregiver, and other members of the care team. • Lead inter/transdisciplinary care team meetings to share information, update and inform care plan. • Coordinate with internal and external health partners to support Members comprehensive care needs. • Participate and lead care transition plan responsibilities. • Assist with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services. • Coordinate care for members with complex medical and social needs, including across the physical, behavioral, and dental health delivery systems. • Provide formal and informal training and support for Health Access Team Members on medical conditions, including treatments and evidence-based for treatment. • Provide clinical consultation and support for Health Access ECM Team Members on physical health conditions, including evidence-based care. • Represent the Enhanced Care Management team as the lead member when necessary.

🎯 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. • 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. • Must have a valid California Driver’s license and valid automobile insurance.

🏖️ Benefits

• 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