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Health Plan Nurse Coordinator
1 month ago
Health Plan Nurse Coordinator
Job Description:
The Health Plan Nurse Coordinator is a Registered Nurse assigned to one of several Health Services' operational units. These units include Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and Population Health programs. This position reports to the Program's Manager or their designee of the assigned unit.
Responsibilities:
- Perform utilization management activities, including telephonic or onsite clinical review;
- Conduct case or disease management, care coordination or transition, or population health activities;
- Collaborate with healthcare professionals to ensure high-quality patient care;
- Develop and implement care plans to meet the unique needs of patients;
- Communicate effectively with patients, families, and healthcare teams to ensure seamless care coordination.
Requirements:
- Active California RN license;
- Health plan experience;
- Clinical knowledge of adult or pediatric health conditions and disease processes;
- Ability to apply quality improvement theory, strategy, and practical methods to achieve rapid-cycle improvement;
- Strong multi-tasking, organizational, and time-management skills;
- Effective individual and collaborative work in a cross-functional team environment;
- Professional communication by phone, in writing, and in person;
- Excellent interpersonal communication skills;
- Compose clear, professional, and grammatically correct correspondence.
About Actalent:
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation, and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia, and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion:
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. We maintain an inclusive environment through persistent self-reflection, build a culture of care, engagement, and recognition with clear outcomes, and ensure growth opportunities for our people. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law. If you would like to request a reasonable accommodation, please email for other accommodation options.
