We have an opportunity to join the Alliance as a Senior Complex Case Manager - Pediatric (RN) working in the Pediatric Complex Case Management Unit.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Complex Case Management Supervisor, you will develop and manage an individualized comprehensive plan of care for members referred into the assigned Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner. You will also:
- Work with and educate members, families, providers, external agencies and internal departments on the Case Management Program and provide assistance as needed
- Participate in Quality Improvement studies, to continually evaluate the program's effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for members
ABOUT THE TEAM
Coordinates care and empowers members to achieve their health and wellness goals through collaboration and by facilitating member relationships with community providers.
WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here.
- Knowledge of:
- The principles and practices of clinical nursing
- The principles and practices of case management
- Care management and coordination
- Evidence-based practice guidelines in the development of care plans
- The use of Windows-based PC systems and Microsoft Word, Outlook, PowerPoint, and Excel
- Ability to:
- Demonstrate strong critical thinking and problem-solving skills
- Interpret and apply policies and regulations
- Define issues, conduct research, interpret data, and identify and evaluate options
- Evaluate medical records and other health care data
- Organize work and manage complex priorities
- Create and edit documents, letters and reports
- Education and Experience:
- Current and unrestricted license as a Registered Nurse issued by the state of California
- Associate's degree in Nursing and a minimum of five years of experience in a patient care setting, including at least one year of case management experience; or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifying
- A minimum of one year of the required patient care experience must be in acute or outpatient environment, working with the population of assignment (i.e. pediatrics or adult)
- While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
- Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
- Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.
Additionally, all positions at the Alliance are required to meet these minimum qualifications.
- Medical, Dental and Vision Plans
- Ample Paid Time Off
- 12 Paid Holidays per year
- 401(a) Retirement Plan
- 457 Deferred Compensation Plan
- Robust Health and Wellness Program
- Onsite EV Charging Stations
- And many more
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Merced, Monterey and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.
The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status.
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.