Senior Care Manager
3 weeks ago
About the Role
The Senior Care Manager will play a key role in supporting the mission of Blue Shield of California, providing high-quality care to patients in the outpatient setting. This position requires a collaborative and analytical individual who can work effectively with healthcare professionals to coordinate care and optimize outcomes.
Key Responsibilities
- Design and implement individualized care plans to promote quality of care and cost-effective health services.
- Conduct health risk assessments and participate in interdisciplinary meetings to inform care decisions.
- Referral and coordination of care with specialists, community resources, and other healthcare providers.
- Develop and implement contingency plans to ensure seamless transitions of care.
- Collaborate with members, clinical nurses, and treating physicians to ensure continuity of care.
Requirements
- Current CA RN License
- Bachelor of Science in Nursing or advanced degree preferred
- Certified Case Manager (CCM) Certification or in process of completing certification
- At least 5 years of prior experience in nursing, healthcare, or related field
- Managed care experience in inpatient, outpatient, or managed care environment preferred
- Excellent communication skills
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