RN Care Manager

As we continue to build something great, we are looking for Care Managers to lead a team of Care Coordinators (CC's) responsible for case management, health management, and transition of care activities to assist members with their healthcare needs. Our next team member will do the following: • Provide direction and guidance to the care coordination team to ensure implementation of activities that align with the model of care and that meet all regulatory requirements • Manage caseloads for the team appropriately with regard to complexity of medical or psychosocial needs (RN, LVN, LSW, other allied fields). • Maintain electronic case management documentation system in compliance with standard processes, standard documentation styles, and HIPAA. • Complete all training requirements and implement changes. • Promote multidisciplinary collaboration, provider outreach, and engagement of family and caregivers to enhance the continuity of care for members. • Audit case management assessments and care plan development for completeness and timeliness according to state requirements. • Monitor the completeness of the Transition of Care (TOC) assessment and the timeframes for contact per TOC protocols. • Actively participates in required internal and external audits either remote or onsite • Create business requirement documents, user training materials and other related documentation • Assist with care coordination for appropriate resources and services for members. You may be right for this job if you have the following: • An active California Registered Nurse License without restriction • A minimum of 3 years leading Care Coordinators • 3 or more years in management, case management, disease management, managed care in medical or behavioral health settings. • Knowledge of managed care principles and practices with emphasis in Care Management and/or Care Coordination. • Clinical knowledge and critical thinking skills with the ability to assess individualized whole-person care needs necessary to develop an effective care plan. • Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word, Excel, and specific case management programs. • Experience partnering with multiple members of a healthcare team both internally and externally. Our commitment to you: • A competitive salary of $85,000-$125,000/ year • Health, dental, and vision insurance • Paid time off • A 401k plan with a generous match • A chance to make a real difference in the Imperial Valley community Preference will be given to candidates who are local to Imperial, California, but remote candidates living in California will also be considered.