Case Manager Nurse

7 days ago

French Camp, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time
Job DescriptionJob Description


The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.



Our Vision:

Continuously improve the health of our community.

Our Mission:

We provide healthcare value and advance wellness through community partnerships.



What You Will Be Doing:

Under general supervision, conducts case management activities on assigned members where analysis, synthesis and evaluation of data and information are required. In addition, this position is responsible for developing, implementing and evaluating individual care plans to ensure that care is rendered at the most appropriate level, for the requisite length of time, and in compliance with HPSJ, regulatory and contractual requirements. Work is varied and complex and requires a moderate amount of discretion and independent judgement.

  • Assesses and evaluates members care needs.
  • Educates member on HPSJ services and the case management process.
  • Develops complex care plans in partnership with member and member’s PCP.
  • Collaborates with member, his/her family, and external and internal resources to ensure understanding of and compliance with care plans.
  • Escalates high risk medical issues to Medical Director for review; approves or denies services as directed.
  • Monitors and evaluates progress at appropriate intervals; conducts appropriate interventions.
  • Supports and advises members on self-advocacy efforts.
  • Documents activities in appropriate HPSJ system(s) according to standards.
  • Tracks data as required; compiles data for, produces and submits routine reports.
  • Reviews care plans developed by LVN Case Managers and Entry Level Case Managers.

Remote. Must Reside in California

What You Bring:

Required

  • Produces work that is accurate and complete.
  • Produces the appropriate amount of work.
  • Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
  • Rebounds from setbacks and adversity when facing difficult situations.
  • Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
  • Strong clinical skills as defined in California scope of practice guidelines for RN’s.
  • In-depth knowledge of and proficient skills in administering protocols for utilization management, discharge planning and/or case management.
  • In-depth knowledge of health care delivery systems as they apply to case management.
  • Ability to read, interpret and apply clinical information, practice guidelines and other complex data and information.
  • Strong skills in assessment and analysis.
  • Strong problem solving skills.
  • Basic negotiation skills.
  • Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
  • Strong oral and written communication skills, with the ability to communicate professionally to diverse individuals inside and outside of HPSJ, effectively explain complex information, and document according to standards.
  • Ability to use tact and diplomacy to diffuse emotional situations.
  • Ability to work independently and as part of a team.
  • Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
  • Strong customer service skills.
  • Basic skills in Word and Excel.
  • Ability to enter data into and navigate through multiple databases.
  • Ability to speak and be understood in English.
  • May require proficiency in one of HPSJ’s threshold languages (as defined by HPSJ’s Cultural and Linguistic Program).
  • Ability to handle confidential information with appropriate discretion.

Required within one year of hire:

  • In-depth knowledge of government sponsored programs and regulations as they apply to case management.
  • In-depth knowledge of managed care principles, practices and regulatory requirements as they apply to case management

What You Have:

Required

  • Graduation from an accredited nursing school.
  • At least three years clinical experience as an RN in a hospital or clinic.
  • At least three years performing case management, utilization management or discharge planning.

Preferred

  • Experience as a clinician in a managed care setting.
  • Experience working with Medi-Cal and/or Medicare populations.
  • Certified Case Manager Designation.

Licensure, Certification, Registration

  • Unrestricted California Registered Nurse license.



What You Will Get:

HPSJ Perks:

  • Competitive salary
  • Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
  • Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
  • CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
  • Two flexible spending accounts (FSAs)
  • Employer-Paid Term Life and AD&D Insurance
  • Employer-Paid Disability Insurance
  • Employer-Paid Life Assistance Program
  • Health Advocacy
  • Supplemental medical, legal, identity theft protection
  • Access to exclusive discount mall
  • Education and training reimbursement in addition to employer-paid elective learning courses.
  • A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
  • A shorter commute ­– if you’re commuting from the Central Valley to the Bay Area.
  • Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.


We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.

HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics, or is associated with anyone who has or is perceived to have these characteristics.

Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.



  • Case Manager Nurse

    1 month ago

    French Camp, United States Health Plan San Joaquin Full time

    The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. We are hiring a Case Manager Nurse to join our team. Must reside in California - Remote.Our Vision: Continuously improve the health of our community. Our Mission: We provide healthcare value and advance wellness through...

  • Case Manager Nurse

    1 week ago

    French Camp, United States Health Plan San Joaquin Full time

    The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. We are hiring a Case Manager Nurse to join our team! Must reside in California - Remote position.Our Vision: Continuously improve the health of our community. Our Mission: We provide healthcare value and advance wellness...

  • Case Manager Nurse

    1 month ago

    French Camp, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time

    Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. We are hiring a Case Manager Nurse to join our team. Must reside in California - Remote.Our Vision:Continuously improve the health of our community. Our Mission:We provide healthcare value and...

  • Case Manager Nurse

    2 weeks ago

    French Camp, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time

    Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. We are hiring a Case Manager Nurse to join our team! Must reside in California - Remote position.Our Vision:Continuously improve the health of our community. Our Mission:We provide healthcare...

  • Case Manager Nurse

    4 days ago

    French Camp, United States Health Plan San Joaquin Full time

    The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. Our Vision: Continuously improve the health of our community. Our Mission: We provide healthcare value and advance wellness through community partnerships. What You Will Be Doing: Under general supervision, conducts case...

  • Nurse Practitioner

    1 month ago

    French Camp, United States Barton Associates Full time

    Another locum tenens opportunity has arrived in California! Our client is looking for a nurse practitioner specializing in family practice to begin coverage in late June. Hours include 8a - 5p shifts from Mondays - Fridays. The selected locum will be handling colds, coughs, flu symptoms, aches, pains, and other family medicine cases. There is a chance for an...

  • Manager, Behavioral Health Treatment

    1 month ago

    French Camp, United States Health Plan San Joaquin Full time

    The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. Remote position - must reside in California. What You Will Be Doing: The Behavioral Health Treatment Manager works closely with the Behavioral Health and Social Services, Contracting, Provider Services, Compliance, Audits...

  • Assistant Nurse Manager-Mother/Baby

    1 month ago

    French Camp, United States Kaiser Full time

    Job Summary: Manages activities of the unit(s), monitors quality, service and utilization standards. Supervises the day to day shift activities.Essential Responsibilities: Manages the units day to day clinical operations including practice standards, staffing, payroll, budgets, fiscal management, and quality improvement.  Ensures the highest quality of...

  • Behavioral Health Treatment Manager

    3 weeks ago

    French Camp, United States Health Plan of San Joaquin Full time

    Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. We are hiring a Behavioral Health Treatment Manager to join our team!Remote position - must reside in California. What You Will Be Doing:The Behavioral Health Treatment Manager works closely...

  • Manager, Behavioral Health Treatment

    1 month ago

    French Camp, United States Health Plan of San Joaquin Full time

    Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. Remote position - must reside in California. What You Will Be Doing:The Behavioral Health Treatment Manager works closely with the Behavioral Health and Social Services, Contracting, Provider...

  • Manager, Compliance

    1 month ago

    French Camp, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time

    Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. We are hiring a Clinical Compliance Audit & Oversight Manager to join our team! Must reside in California - Remote position.What You Will Be Doing:Under general supervision responsible for...

  • Locums Anesthesiologist

    3 weeks ago

    French Camp, Mississippi, United States Jobot Full time

    Job DescriptionJob DescriptionDo your own cases in CA as a locumsThis Jobot Consulting Job is hosted by: Chris BlakeAre you a fit? Easy Apply now by clicking the "Apply Now" buttonand sending us your resume.Salary: $341 - $350 per hourA bit about us:Dedicated team in French Camp, CA, as a Locums Anesthesiologist. We are a leading healthcare facility...

  • Locums Anesthesiologist

    2 weeks ago

    French Camp, United States Jobot Full time

    Do your own cases in CA as a locumsThis Jobot Job is hosted by: Chris BlakeAre you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume.Salary: $325 - $375 per hourA bit about us:Dedicated team in French Camp, CA, as a Locums Anesthesiologist. We are a leading healthcare facility committed to providing high-quality patient care to...

  • Locums Anesthesiologist

    1 week ago

    French Camp, United States Jobot Full time

    Do your own cases in CA as a locums This Jobot Job is hosted by: Chris Blake Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $325 - $375 per hour A bit about us: Dedicated team in French Camp, CA, as a Locums Anesthesiologist. We are a leading healthcare facility committed to providing high-quality patient...

  • Locums Anesthesiologist

    1 month ago

    French Camp, United States Jobot Full time

    Do your own cases in CA as a locumsThis Jobot Consulting Job is hosted by: Chris BlakeAre you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.Salary: $341 - $350 per hourA bit about us:Dedicated team in French Camp, CA, as a Locums Anesthesiologist. We are a leading healthcare facility committed to providing high-quality...

  • Nurse Practitioner I-inpatient

    4 weeks ago

    French Camp, United States San Joaquin County Full time

    **Approximate Salary** - $72.08 - $87.61/hour **Opening Date** - 4/17/2024 08:00:00 AM **Closing Date** - Continuous **Employment Type** - Per Diem (Health Care Services Only)**Analyst** - Karyn Watson **Introduction**: - Correctional Health Services provides health care to adult inmates at the San Joaquin County jail facility, located at 7000 Michael...

  • Referral Nurse

    3 weeks ago

    French Camp, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time

    **What You Will Be Doing**: - Reviews and verifies authorizations and supporting documentation for accuracy and completeness, including but not limited to eligibility, codes and clinical notes. - Obtains required documentation and information from a variety of internal and external sources. - Determines if request meets established medical guidelines, and...

  • Shift Supervisor

    1 week ago

    French Camp, United States Turning Point Community Programs Full time

    Job DescriptionJob DescriptionGENERAL PURPOSEUnder the administrative supervision of the Program Director or designee, this position is responsible for oversight of shift operations, scheduling, and assisting the Program Director.DISTINGUISHING CHARACTERISTICSThis is an at-will leadership position within a program. Additionally, this position is responsible...

  • Shift Supervisor

    1 week ago

    French Camp, United States Turning Point Community Programs Full time

    Job DescriptionJob DescriptionGENERAL PURPOSEUnder the administrative supervision of the Program Director or designee, this position is responsible for oversight of shift operations, scheduling, and assisting the Program Director.DISTINGUISHING CHARACTERISTICSThis is an at-will leadership position within a program. Additionally, this position is responsible...

  • Shift Supervisor

    1 week ago

    French Camp, United States Turning Point Community Programs Full time

    Job DescriptionJob DescriptionGENERAL PURPOSEUnder the administrative supervision of the Program Director or designee, this position is responsible for oversight of shift operations, scheduling, and assisting the Program Director.DISTINGUISHING CHARACTERISTICSThis is an at-will leadership position within a program. Additionally, this position is responsible...