Care Manager, RN – Health Access, ECM

🔥 12 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $91.2k - $120.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 2%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• 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

🎯 Requirements

• 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

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