Remote Temporary Senior Complex Case Manager (RN) Pediatrics – California

Job Overview

  • Clinical License RN
  • State(s) CA

Full job description

 

ABOUT THIS TEMP POSITION

This is a temporary position and the length of the assignment is estimated to go through the summer. The length of the assignment is always dependent on business needs and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.

 

THE IDEAL CANDIDATE

The ideal candidate for the Senior Complex Case Manager (Temporary) role is someone who has managed care plan and teleworking experience. Having adult case management, any case management or insurance experience is a plus. Having the ability to manage high amounts of caseloads with ease will help you succeed in this role. Understanding NCQA standards and a strong internal drive to support our communities will make you an excellent candidate for this role.

WHAT YOU’LL BE RESPONSIBLE FOR

Under direction, 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 ad 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

 

WHAT YOU’LL NEED TO BE SUCCESSFUL

  • 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
    • Communicate effectively with a diverse population of members, including those with behavioral health issues
    • Exercise good judgement and tact when relating to health care providers and beneficiaries
    • Work independently and work collaboratively as a member of a team
  • Education and Experience:
    • Current unrestricted license as a Registered Nurse issued by the State of California
    • Associate’s degree in Nursing and a minimum of seven years of experience in a patient care setting, including at least one year of case management experience (a Bachelor’s degree may substitute for two years of the required 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 an acute or outpatient environment, working with adults

To read the full position description, and list of requirements click here.

 

OTHER DETAILS

  • 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
  • This is a temporary position, and does not provide the benefits that are listed below (it is standard language from our regular job posts and cannot be altered or removed)

 

 

OUR BENEFITS

  • 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

 

ABOUT US

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.

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. We are an E-Verify participating employer

Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We currently serve more than 418,000 members. To learn more about us, take a look at our Fact Sheet.

 

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.

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