We are seeking an experienced and reliable Registered Nurse Case Manager to join our clinical care team in the city of Riverside for an exciting opportunity!
$75,000 - $95,000 per year!!!
Under the general supervision of the Director of Nursing (DON), this position is responsible for working effectively with, and as part of the Community Based-Care program to provide high quality, effective care management to Health Homes Program (HHP) members. This position works collaboratively as part of the Community- Based Care Management Entity (CB-CME) team, members and families, and other professionals, in addition to working collaboratively with the designated PCP care team.
KEY TASKS & RESPONSIBILITIES
- Responsible for primarily working with a caseload of HHP Members with complex medical needs (tier 1).
- Responsible for utilizing brief interventions as necessary to improve the Member's ability to manage their own health.
- Provide formal and informal training and support for HHP members on medical conditions, including treatments and evidence-base for treatment.
- Responsible for assisting Members with care coordination needs, including, but not limited to, the following:
- Ensure completion of the Complex Health Assessment (CHA) for all eligible HHP Members within specified time Conduct comprehensive, holistic assessment according to the scope of the RN license
- Assimilate CHA information into a Shared Care Plan (SCP)/Health Action Plan (HAP).
- Communicate SCP/ HAP with Member, approved family or caregiver and other Members of the care team
- Lead CB-CME team meetings to share information, update and inform care plan
- Coordinate with internal and external health partners to support Members comprehensive care needs
- Participate and lead care transition plan
EDUCATION AND EXPERIENCE
- Current unrestricted California RN License required.
- Valid driver’s license and automobile insurance required.
- Current American Heart Association (AHA) BLS certification required
- Three (3) or more years of care management experience in a health care delivery
- Experience in a Health Care Organization or experience in Managed Care setting preferred.
- Minimum 1-year clinical experience in an acute care facility, skilled nursing facility, home health or clinic setting preferred.
- Must be able to travel locally as necessary to complete the responsibilities of the position.
KNOWLEDGE, SKILLS AND ABILITIES
- Progressive knowledge and experience in quality management, HIPAA, OSHA, and Title XXII.
- Strong analytical and critical thinking skills; ability to pay close attention to detail.
- Strong computer skills, with high proficiency in Microsoft Office. Experience using an EHR (NextGen) is highly preferred.