Job Summary:

The RN Case Manager oversees comprehensive care coordination for diverse patient cases, utilizing effective communication strategies and cultural sensitivity to engage members and providers. With a focus on chronic conditions, mental health, and homelessness, they assess, develop, and implement care plans while ensuring regulatory compliance and compassionate patient support.

Supervisory Responsibilities:

• Supervise the care management staff, including assisting in the development, training, network development, and assignment of work/projects.

• Supervises and evaluates appropriateness of care coordination and directs the case management staff to modify plans as needed.

Duties/Responsibilities:

• Utilize medical interventions to enhance members' self-management of health.

• Engage with ECM Lead Care Managers via phone or in-person for assessment and care plan development.

• Provide training for ECM Team Members on medical conditions and treatments.

• Coordinate with internal and external partners to support members' comprehensive care.

• Coordinate clinical care for ECM Program clients and establish care plan goals.

• Organize and monitor services needed by recipients.

• Perform bio-psycho-social assessments and develop care plans.

• Oversee care plan implementation and monitor treatment adherence.

• Provide coaching for behavior change and health improvement.

• Document interactions and interventions accurately.

• Collaborate with executives and assist in staff training for safety and quality assurance.

• Design and execute training programs for Lead Care Managers.

• Prepare formal responses and reports for regulatory agencies.

• Establish effective processes and ensure compliance with regulations.

• Assist in maintaining operational efficiency and quality care for patients.

• Performs other duties as assigned.

Education and Experience:

• Registered Nurse with a valid CA license from an accredited nursing school.

• Associate degree in Nursing from an accredited institution required.

• Bachelor's degree in nursing from an accredited institution preferred. Experience in a Health Care Organization or experience in Managed Care setting preferred.

• 1-2 years of case management experience with low-income populations, focusing on complex chronic conditions, mental illness, and homelessness.

• 2 years of experience with homeless, low-income, and mentally ill populations, including substance abuse.

• Experience in Medicare and Medi-Cal environments preferred.

Required Skills/Abilities:

• Proficient in evidenced-based communication techniques like Motivational Interviewing.

• Understanding and sensitivity to multicultural communities.

• Knowledgeable in self-management practices for chronic conditions.

• Skilled in phone-based engagement with members and providers.

• Proficiency in data interpretation and learning new software systems.

• Strong attention to detail, analytical thinking, and interpersonal skills.

• Ability to work autonomously and as part of a team.

• Exceptional organizational and time management abilities.

• Compassionate and empathetic approach to patient care.

• Ability to analyze situations and act ethically and in compliance with regulations.

• Flexibility to adapt to changing environments

Physical Requirements:

• Willingness to travel to different locations.

• Prolonged periods sitting at a desk and working on a computer.
• Must be able to lift up to 10 pounds at times.

Pay range

$90,000-$100,000 USD

Benefits

Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:

Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.

Short & Long-Term Disability Benefits: Protection when you need it most.

Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.

Flexible Spending Accounts: Manage your finances with flexibility.

Employee Assistance Program (EAP): Support when life throws challenges your way.

401(K): Building your financial future with us. Effective after 1 year of employment.

Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.

Paid Holidays: Quality time to enjoy celebrations.

Employee Referral Program: Share the opportunities and reap the rewards.

Company Discount Program: Enjoy savings on everyday expenses and memberships.