Senior Care Coordinator

1 week ago


Rancho Cordova, California, United States Blue Shield of California Full time
About This Role

We are seeking a highly skilled Senior Care Manager to join our Care Management team at Blue Shield of California. As a key member of our team, you will play a pivotal role in coordinating and managing patient care services in outpatient settings.

Key Responsibilities
  • Design and implement individualized care plans that ensure continuity of care and compliance with clinical guidelines.
  • Coordinate with medical groups, individual providers, and other healthcare professionals to ensure seamless transitions of care.
  • Determine appropriateness of referral for CM services, mental health, and social services.
  • Provide referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD).
Requirements
  • A current CA RN License is required.
  • Bachelor of Science in Nursing or advanced degree is preferred.
  • Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements.
  • Requires at least 5 years of prior experience in nursing, healthcare or related field.
  • A minimum of 3+ years managed care experience in inpatient, outpatient or managed care environment is preferred.
What We Offer

The pay range for this role is: $87,230.00 to $130,900.00 for California. Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.



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