Senior Care Manager
4 weeks ago
Blue Shield of California is seeking a highly skilled Senior Care Manager to join our team. As a key member of our Care Management team, you will play a critical role in supporting the mission of our department, which is to provide exceptional care and support to patients in the outpatient setting.
Key Responsibilities:
- Develop and implement individualized care plans to promote quality of care and cost-effective health services.
- Collaborate with healthcare professionals, including clinical nurses and treating physicians, to ensure seamless transitions of care.
- Conduct thorough health risk assessments and develop targeted interventions to enhance patient outcomes.
- Provide referrals to Quality Management, Disease Management, and Appeals and Grievance departments as needed.
- Manage member treatment plans to ensure timely and effective care.
- Assess and re-evaluate patient health and progress on an ongoing basis, making adjustments to care plans as necessary.
Requirements:
- Current CA RN License.
- Bachelor's 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.
- Minimum of 1 year experience in inpatient, outpatient, or managed care environment.
- Health insurance/managed care experience desired.
- Transitions of care experience desired.
What We Offer:
Blue Shield of California offers a competitive salary range of $87,230.00 to $130,900.00 for this role in California. Our salaries are based on a variety of factors, including the candidate's experience, location, and current employee salaries for similar roles.
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