Care Manager

2 weeks ago

Riverside, California, United States Heritage Health Network Full time
About Heritage Health Network

Heritage Health Network (HHN) is a prominent healthcare organization dedicated to enhancing the health and well-being of vulnerable populations in Riverside and San Bernardino counties.

Role Overview

We are seeking a seasoned Registered Nurse (RN) to lead our Enhanced Care Management (ECM) Care Team as the ECM Care Team Leader. This pivotal role involves overseeing a multidisciplinary team of professionals, ensuring comprehensive, integrated care delivery.

Responsibilities
  • Outreach and Engagement: Establish meaningful connections with eligible ECM members, educating them about the program and facilitating their enrollment.
  • Leadership and Coordination: Foster a holistic approach to patient care by leading the ECM Care Team.
  • Community and In-Home Engagement: Meet with members in the community or at their homes to deliver personalized care services.
  • Caseload Management: Effectively manage a caseload of 60-75 members, prioritizing timely interventions and seamless care transitions.
  • Comprehensive Care Planning: Conduct thorough risk assessments and collaboratively develop Patient-Centered Care Plans with members.
  • Case Coordination and Support: Serve as the primary point of contact for members, navigating access to care, services, and resources.
  • Healthcare Provider Collaboration: Develop partnerships with healthcare providers and community-based organizations to facilitate care integration and referrals.
  • Transitional Care Coordination: Coordinate discharge plans with hospital staff and other stakeholders to ensure smooth transitions.
  • Reporting and Documentation: Contribute to completing monthly reports for health plans and maintaining internal resources directories.
Requirements
  • Licensure: Active Registered Nurse (RN) license in California is mandatory.
  • Experience: At least 3 years of nursing experience, with a minimum of 1 year in a leadership or management position.
  • Specialized Knowledge: Experience in care coordination and managing complex patient populations, preferably within an ECM or similar program.
  • Skills: Strong clinical skills necessary for assessing, planning, implementing, and evaluating patient care effectively.
  • Interpersonal Skills: Excellent communication and interpersonal skills essential for effective teamwork.
  • Regulatory Knowledge: Familiarity with healthcare regulations, Medicare/Medi-Cal guidelines, and care management best practices.
Benefits
  • Competitive Salary: $120,000 - $150,000 annually.
  • Sick Time and Paid Time Off: Comprehensive benefits package.
  • Paid Holidays: Enjoy designated holidays off.
  • Work Flexibility: Opportunity to work from home several days a week.
  • Career Development: Opportunities for career advancement and professional growth.

Heritage Health Network offers a supportive environment and opportunities for professional development, aiming to enhance both patient and employee experiences.

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