Care Management Specialist

6 days ago


Burlingame, California, United States Sutter Health Full time

Care Management Role Overview

Sutter Health is seeking a skilled Care Management Specialist to join our team. As a key member of our care coordination team, you will play a vital role in ensuring the timely progression and transition of patients to the appropriate level of care.

Key Responsibilities:

  • Collaborate with physicians, utilization managers, medical social workers, and bedside RNs to coordinate patient care.
  • Develop and implement effective care plans to prevent unnecessary admissions or readmissions.
  • Communicate with patients, families, and healthcare providers to ensure seamless care transitions.
  • Work with interdisciplinary teams to achieve optimal health, access to care, and resource utilization.

Requirements:

  • Graduate of an accredited school of nursing.
  • Broad knowledge of healthcare delivery and case management within a managed care environment.
  • Comprehensive knowledge of utilization review, levels of care, and observation status.
  • Awareness of healthcare reimbursement systems, including HMO, PPO, PPS, CMS, and value-based reimbursement models.

Working at Sutter Health

Sutter Health is an equal opportunity employer and offers a competitive compensation package, including base pay, benefits, and opportunities for professional growth and development.


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