Care Manager, RN – Health Access, ECM

🕒 il y a 1 jour

🏄 California – Distant

🏄 California – Remote

💵 $91 249 - $120 910 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

👻 Score fantôme 2%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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IEHP

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 1995

🛡️ Assurance

💼 Conseil

📦 Logistique

💰 Grant en 2021-02

Insurance • Consulting • Logistics

IEHP est un plan de santé dédié à servir les individus et familles à faible revenu dans les comtés de Riverside et San Bernardino. Ils offrent divers programmes incluant Medi-Cal, DualChoice et Covered California, fournissant une couverture médicale pour les résidents qui n'auraient autrement pas accès aux services médicaux nécessaires. Avec un accent sur la santé holistique et le bien-être communautaire, IEHP collabore avec des médecins et établissements locaux pour garantir des soins complets à leurs membres, les soutenant avec des ressources en santé mentale, des cours de fitness et une éducation au bien-être.

Description

• 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

🎯 Exigences

• 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

🏖️ Avantages

• 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