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Care Manager II - Chico

Company: Health Net of California
Location: Chico
Posted on: October 3, 2019

Job Description:

Description: Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.

  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
  • Provide patient and provider education
  • Facilitate member access to community based services
  • Monitor referrals made to community based organizations, medical care and other services to support the members' overall care management plan
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed Qualifications: Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Licenses/Certifications: Current state's RN license Apply Now Share this job
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  • More (Opens in New Window) Google+ (Opens in New Window) Tumblr (Opens in New Window) Check out this location See what's near our Chico location. View Map Back to Job Navigation (Map) Quote "I assisted with one of the Provider fairs in the community. Seeing how much we care for our community and our patients was very eye opening." - Julie Boulch, Director, Business Implementation Health Plan Initiatives "Centene is an exciting company to work for, the pace at which we're growing allows numerous advancement opportunities. Also, we foster an environment that supports and offers numerous leadership growth opportunities." - Esmeralda Baig, SVP Operations, Complex Care Products "I assisted with one of the Provider fairs in the community. Seeing how much we care for our community and our patients was very eye opening." - Julie Boulch, Director, Business Implementation Health Plan Initiatives "Centene is an exciting company to work for, the pace at which we're growing allows numerous advancement opportunities. Also, we foster an environment that supports and offers numerous leadership growth opportunities." - Esmeralda Baig, SVP Operations, Complex Care Products "I assisted with one of the Provider fairs in the community. Seeing how much we care for our community and our patients was very eye opening." - Julie Boulch, Director, Business Implementation Health Plan Initiatives Back to Job Navigation (Testimonials) Our Awards Centene is consistently recognized for how well we treat our members, our people, and the communities we serve. Honored to be Honored Back to Job Navigation (Our Awards) Our Hiring Process Learn more about our hiring process and discover other helpful information for applicants. Learn More "Flexibility is key. Centene is a company of change." Ashley Collier Started as a Referral Specialist, now a Project Manager IV See Ashley's career path Sign up for Job Alerts Join our Talent Network and get Centene news and job alerts delivered to your inbox. First Name Last Name Email Address Areas of InterestSelect a job category from the list of options. Search for a location and select one from the list of suggestions. Finally, click "Add" to create your job alert. Job Category Location
  • Clinical & Nursing, Chico, California, United StatesRemove Confirm Email Back to Job Navigation (Job Alerts) Match Your Skills Let us search jobs for you based on the skills and experience listed in your LinkedIn Profile. Start Matching

Keywords: Health Net of California, Chico , Care Manager II - Chico, Executive , Chico, California

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