Case Manager Care Coordinator

2 weeks ago

Eureka, California, United States Partnership HealthPlan of California Full time
Job Summary

We are seeking a skilled Nurse Case Manager I to join our team at Partnership HealthPlan of California. As a key member of our healthcare team, you will play a vital role in coordinating care for our members and ensuring they receive the best possible outcomes.

As a Nurse Case Manager, you will work independently to manage a caseload of members with varying levels of complexity. Your primary responsibility will be to initiate and coordinate individualized care plans that address both clinical and non-clinical components. This will involve collaborating with multidisciplinary teams, including health services integrated rounds meetings, to resolve member needs and ensure a smooth implementation and continuum of care.

Key Responsibilities:
  • Manage a caseload of members with complex health needs, providing case management services independently and performing field-based case management with supervision as needed.
  • Develop and maintain accurate and timely documentation, records, and case files in our PHC Case Management System.
  • Coordinate referrals and authorizations for services required to improve the member's health status.
  • Collaborate with other internal departments to identify members suitable for case management.
  • Participate in essential skills training, unit and departmental assigned learning, and other departmental activities as assigned.

Requirements:

To be successful in this role, you must have an Associate's degree in Nursing and 2 years of experience, including at least 1 year of case management experience and 1 year in an acute care setting. A current and unrestricted California Registered Nurse License is also required.

A valid California driver's license and proof of current automobile insurance compliant with PHC policy are necessary to operate a vehicle and travel for company business.

Bilingual skills in Spanish, Russian, or Tagalog are preferred.

Performance-Based Competencies:

This role requires strong organizational, communication, critical thinking skills, and attention to detail. You must be able to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines.

You should possess excellent English written and verbal communication skills and be proficient in managed care business practices and ability to access data information using various computer systems.

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