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Managed Care Case Manager RN ~ Central Valley Health Plan
1 month 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.
