Managed Care Case Manager RN ~ Central Valley Health Plan
2 months ago
*Employment Type:* Full time *Shift:* Day Shift *Description:* *SUMMARY*
Reporting to the Director CVHP Operations, CVHP Operations, this position coordinates care and service for defined patient populations across the acute care continuum for CVHP members. This includes discharge planning, utilization management, care coordination, and support for resource utilization. This position works collaboratively with an interdisciplinary team to improve patient care through the effective utilization of the facility's resources. The incumbent makes significant contributions toward achievement of desired clinical, financial, and resource utilization outcomes.
*REQUIREMENTS*
1. High school diploma or equivalent is required. A degree from an accredited baccalaureate nursing program is preferred.
2. Current licensure as a Registered Nurse in the state of California is required.
3. Current American Heart Association (AHA) Healthcare Provider CPR card is required.
4. CCM national certification is preferred.
5. Experience with two (2) areas of clinical specialty is preferred.
6. Excellent communication skills, critical thinking, creative problem-solving skills, and competent organizational and planning skills are required.
7. Ability to be self-directed and tolerate frequent interruptions while managing a demanding workload is required.
8. Knowledge regarding hospital protocol and procedures, clinical standards and outcomes, funding options, familiarity with community resources and outside professional agencies, familiarity with federal and state regulations governing hospital and home care, as well as understanding of the financial structure of health plan and delivery system is preferred.
Pay Range ($48.86 - $70.85)
*Our Commitment to Diversity and Inclusion*
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
-
Fresno, United States Saint Agnes Medical Center Careers Full timeManaged Care Case Manager RN ~ Central Valley Health Plan at Saint Agnes Medical Center Careers summary: The Managed Care Case Manager RN at Central Valley Health Plan is responsible for coordinating care and services for defined patient populations, focusing on effective discharge planning, utilization management, and care coordination. This role...
-
Fresno, United States Saint Agnes Medical Center Careers Full timeManaged Care Case Manager RN ~ Central Valley Health Plan at Saint Agnes Medical Center Careers summary: The Managed Care Case Manager RN at Central Valley Health Plan is responsible for coordinating care and services for defined patient populations, focusing on effective discharge planning, utilization management, and care coordination. This role...
-
Care Manager Coordinator
2 weeks ago
Fresno, California, United States Central California Asthma Collaborative Full timeJoin the Central California Asthma Collaborative team as a Care Manager Coordinator and play a vital role in reducing asthma disparities in the San Joaquin Valley. This rewarding position involves working with health plans, healthcare providers, and other CCAC entities to implement Enhanced Care Management services.Job DescriptionRole Summary: As a Lead Care...
-
Fresno, United States Saint Agnes Medical Center Careers Full time*Employment Type:* Full time *Shift:* Day Shift *Description:* *SUMMARY* Reporting to the Director CVHP Operations, CVHP Operations, this position coordinates care and service for defined patient populations across the acute care continuum for CVHP members. This includes discharge planning, utilization management, care coordination, and support for...
-
Fresno, United States Saint Agnes Medical Center Careers Full time*Employment Type:* Full time *Shift:* Day Shift *Description:* *SUMMARY* Reporting to the Director CVHP Operations, CVHP Operations, this position coordinates care and service for defined patient populations across the acute care continuum for CVHP members. This includes discharge planning, utilization management, care coordination, and support for resource...
-
Fresno, United States Saint Agnes Medical Center Careers Full time*Employment Type:* Full time *Shift:* Day Shift *Description:* *SUMMARY* Reporting to the Director CVHP Operations, CVHP Operations, this position coordinates care and service for defined patient populations across the acute care continuum for CVHP members. This includes discharge planning, utilization management, care coordination, and support for resource...
-
Case Manager
2 months ago
Houston, TX, United States Texas Children's Hospital Full timeCase Manager (RN) for Care Coordination - Health PlanWe are searching for a Case Manager (RN - Road Warrior) for Care Coordination - Health Plan - someone who will utilize a collaborative approach, asses, plan, implement, monitor and evaluate the options and services required to meet an individual's health needs. This nurse will provide comprehensive ongoing...
-
Central Valley Community Advocate
1 week ago
Fresno, California, United States Education Leadership Foundation Full timeCentral Valley Community Advocate Job DescriptionAs a Central Valley Community Advocate, you will be responsible for providing immigration legal services to low-income families in the Central Valley. The estimated salary for this position is $60,000 - $70,000 per year.This is a full-time permanent position that requires excellent time management and...
-
Central Valley Oral Health Specialist
1 week ago
Fresno, California, United States Clinica Sierra Vista Full timeAbout UsClinica Sierra Vista serves patients at 31 health centers in Fresno and Kern counties, offering a range of services including Pediatric Care, Adult Care, Dental Care, Behavioral Health, Case Management, Prenatal & Women's Health, Substance Abuse Treatment, HIV/AIDS testing and treatment, Health Education, Outreach, and WIC services.Work...
-
Central Valley Liaison
2 weeks ago
Fresno, California, United States Education Leadership Foundation Full timeAbout the JobAre you passionate about advocating for the rights of immigrant families? Do you have a strong understanding of immigration law and policy? If so, we encourage you to apply for the Central Valley Liaison position at the Education Leadership Foundation. As a liaison, you will play a critical role in connecting immigrant families with vital...
-
Centralized Case Management Specialist
1 month ago
Weymouth, MA, United States South Shore Health Full timeJob Description Summary Under the general supervision of the Care Progression Manager acts as a Centralized Case Management Specialist to SSH&EC clients. Works in coordination with various care partners across the System, i.e. RN Care Coordinators, Social Work, Mobile Integrated Health, Emergency department, Urgent and Ambulatory Care centers, to coordinate...
-
Case Manager, RN
4 weeks ago
Aiea, HI, United States Hawaii Pacific Health Full timeWith 118 beds and more than 400 physicians on its medical staff, Pali Momi Medical Center offers a full range of services for the communities of Central and West O'ahu. The hospital has delivered many medical firsts for the community, including Central and West O'ahu’s only interventional cardiac catheterization unit to detect and treat heart disease, a...
-
Centralized Case Management Specialist
2 months ago
Weymouth, MA, United States South Shore Health Full timeJob Description Summary Under the general supervision of the Care Progression Manager acts as a Centralized Case Management Specialist to SSH&EC clients. Works in coordination with various care partners across the System, i.e. RN Care Coordinators, Social Work, Mobile Integrated Health, Emergency department, Urgent and Ambulatory Care centers, to coordinate...
-
Centralized Case Management Specialist
2 months ago
Weymouth, MA, United States South Shore Health Full timeJob Description SummaryUnder the general supervision of the Care Progression Manager acts as a Centralized Case Management Specialist to SSH&EC clients. Works in coordination with various care partners across the System, i.e. RN Care Coordinators, Social Work, Mobile Integrated Health, Emergency department, Urgent and Ambulatory Care centers, to coordinate...
-
Bilingual Lead Case Manager
3 days ago
Fresno, United States RH Community Builders Full timeRH Community Builders is a community organization focused on provding housing and homeless services in the Central Valley of California. With a focus on service, dignity, and equity, RHCB provides community based services to the most vulnerable individuals in our community. Position Summary The ECM Lead Case Manager is responsible for providing direct...
-
Centralized Programs Care Coordinator- LVN/RN
3 weeks ago
Fresno, United States Sante Health Full timeA new opportunity awaits a Centralized Programs Care Coordinator- LVN/RN at one of our busy medical sites, Community Medical Providers (CMP) with Sante Health System in Fresno, CA. This position is responsible for collaboration with site staff, physicians, and management to perform and achieve objectives of the Chronic Care Management program for all...
-
Central Health | Registered Nurse
1 month ago
Austin, TX, United States Central Health Full timeRegistered Nurse (RN) ResidencyOverviewThe RN Resident is expected to complete the 6-month Nurse Residency Program (NRP). The RN Resident is a proactive member of an interprofessional team of licensed and unlicensed caregivers who ensure that patients receive individualized, high-quality, safe patient care. The Nurse Resident collaboratively assists as an...
-
Bilingual Housing Tenancy Case Manager
1 day ago
Fresno, United States RH Community Builders Full timeRH Community Builders is a community organization focused on provding housing and homeless services in the Central Valley of California. With a focus on service, dignity, and equity, RHCB provides community based services to the most vulnerable individuals in our community. Position Summary The Housing Tenancy Case Manager provides direct services to...
-
Registered Nurse RN Case Manager
4 weeks ago
Orlando, FL, United States AdventHealth Home Care Central Florida Full timeJob Description: All the benefits and perks you need for you and your family: Up to $10,000 Sign on Bonus Benefits from Day One Paid Days Off from Day One Career Development Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to...
-
Outpatient Case Manager
4 weeks ago
San Diego, CA, United States Southern California Physicians Managed Care... Full timeDepartment: Medical Management Level: Non-supervisory Reports To: Manager, Utilization Management Private Health Information (PHI): Position requires "read and write" access to member authorizations, "read only" access to claims and eligibility Job Classification: Non-Exempt Job Type: Full time - Four-Day 10 hour days, Monday - Thursday Pay Rate: ...