Senior Complex Case Manager - D-SNP (RN) (Temporary) at Central California Alliance for Health

, California, United States -

Full Time

Start Date

Immediate

Expiry Date

24 Feb, 26

Salary

62.6

Posted On

26 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Nursing, Case Management, Motivational Interviewing, Care Management, Chronic Conditions, Geriatric Care, Psychosocial Factors, Health Improvement Strategies, Evidence-Based Practice, Electronic Health Records, Critical Thinking, Problem-Solving, Policy Interpretation, Data Evaluation, Communication

Industry

Hospitals and Health Care

Description

ABOUT THIS TEMP POSITION This is a temporary position and the length of assignment is estimated to go from December 2025 to July 2026. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with. There is 1 full-time (40 hours/week) opportunity available for this temporary assignment. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Medicare Care Management Manager (RN), this position: Develops and manages an individualized comprehensive plan of care for Medicare Dual Eligible Special Needs Plan (D-SNP) members referred into the Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner Works with and educates members, families, providers, external agencies, and internal departments on the D-SNP Case Management Program Participates in Quality Improvement studies, to continually evaluate the program’s effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for members Performs D-SNP Program oversight and support activities Acts as a liaison between the D-SNP Program and providers and community agencies to promote effective implementation of program objectives and requirements WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description, and list of requirements click here. Knowledge of: The principles and practices of clinical nursing The principles and practices of case management, including motivational interviewing and evidence-based guidelines Care management and coordination Complex chronic conditions, geriatric care, and psychosocial factors impacting health outcomes The principles and practices of developing and implementing health improvement strategies to address social determinants of health Evidence-based practice guidelines in the development of care plans Electronic health record and/or care management platforms Ability to: Assess member risk, define problems, develop care plans, and collaborate across disciplines Demonstrate strong critical thinking and problem-solving skills Interpret and apply policies and regulations Define issues, conduct research, interpret data, and identify and evaluate options Evaluate medical records and other health care data Organize work, manage complex priorities, and document with accuracy and timeliness Communicate effectively with a diverse population of members, including those with behavioral health issues Education and Experience: Current unrestricted license as a Registered Nurse issued by the State of California Associate’s degree in Nursing and a minimum of seven years of experience in a patient care setting, including a minimum of one year of case management experience (a Bachelor’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying A minimum of one year of the required patient care experience must be in an acute or outpatient environment, working with adults and/or dual-eligible populations Education OTHER INFORMATION We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. This is a temporary position and does not provide the benefits that are listed below (it is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options. The full compensation range for this position is listed by location below. The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location). Zone 1 (Monterey, San Benito and Santa Cruz) $48.15—$62.60 USD Zone 2 (Mariposa and Merced) $43.82—$56.96 USD OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. Medical, Dental and Vision Plans Ample Paid Time Off 12 Paid Holidays per year 401(a) Retirement Plan 457 Deferred Compensation Plan Robust Health and Wellness Program Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

Responsibilities

Develop and manage individualized comprehensive care plans for Medicare D-SNP members, promoting optimal outcomes. Act as a liaison between the D-SNP Program and various stakeholders to ensure effective implementation of program objectives.