Senior Care Manager

8 hours ago


Rancho Cordova, California, United States Blue Shield of California Full time

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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