Nurse Case Manager Senior Position in Outpatient Care

6 days ago


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

We are seeking a highly skilled and experienced Nurse Case Manager to join our team at Blue Shield of California. In this senior role, you will play a pivotal part in coordinating and managing patient care services in outpatient settings.

As a key member of our Care Management team, your primary responsibility will be to design and implement individualized care plans that ensure continuity of care and compliance with clinical guidelines.

Key Responsibilities
  • Coordinate and manage patient care services in outpatient settings, ensuring seamless transitions across different care levels.
  • Develop and implement individualized care plans that prioritize patient needs, health outcomes, and cost-effectiveness.
  • Collaborate with healthcare providers, specialists, and community resources to ensure comprehensive care delivery.
  • Assess patient health behaviors, cultural influences, and values to inform care planning and interventions.
  • Analyze data and research opportunities for improvement in assessment methodologies to enhance patient outcomes.
Requirements

To succeed in this role, you will need:

  • A current CA RN License and a Bachelor of Science in Nursing or advanced degree.
  • At least 5 years of prior experience in nursing, healthcare, or a related field, with a minimum of 3+ years managed care experience in inpatient, outpatient, or managed care environments.
  • Certified Case Manager (CCM) Certification or eligibility based on CCM application requirements.
  • Excellent communication skills and the ability to work effectively in a fast-paced environment.
Compensation

The salary range for this position is $87,230 to $130,900 per year, reflecting the company's commitment to fair compensation and recognition of expertise.


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