TurlockRecruiter Since 2001
the smart solution for Turlock jobs

Care Manager II (CA)

Company: Centene Corporation
Location: Rescue
Posted on: October 23, 2019

Job 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
    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

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Centene Corporation, Turlock , Care Manager II (CA), Executive , Rescue, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Executive Jobs

Business Relationship Manager - Sacramento
Description: Job Description br Important Note: During the application process, ensure your contact information email and phone number is up to date and upload your current resume prior to submitting your application (more...)
Company: Wells Fargo Bank
Location: Davis
Posted on: 11/13/2019

Community Apartment Manager
Company: United Development Group Inc.
Location: Sacramento
Posted on: 11/13/2019

Supervisor, Utilization Management
Description: Position Purpose: Supervise the daily operations of the utilization management UM department br br li Supervise the daily operations of the UM staff br li Ensure appropriate usage of resources (more...)
Company: Centene Corporation
Location: Davis
Posted on: 11/13/2019

Operations Manager - Residential Installation/Service
Description: Currently looking for an experienced Operations Manager to manage the install and service teams. Interested candidates should have a degree with at least 5
Company: KB Search Team, LLC
Location: Rancho Cordova
Posted on: 11/13/2019

Director, Revenue Recognition
Description: Job Description PowerSchool is looking for a candidate to manage revenue assurance who will be responsible for global revenue recognition and ensure the Company stays up-to-date on GAAP pronouncements. (more...)
Company: PowerSchool Group LLC
Location: Sacramento
Posted on: 11/13/2019

Project Manager
Description: The ideal candidate will be responsible for planning, coordinating, and implementing projects within the decided-upon budget, timeline,
Company: EMCOR Group, Inc.
Location: Sacramento
Posted on: 11/13/2019

Business Development Manager
Description: COMPANY OVERVIEW br br At Motorola Solutions, we create technologies our customers refer to as their lifeline. Our technology platforms in communications, software, video and services help our customers (more...)
Company: Motorola
Location: Sacramento
Posted on: 11/13/2019

Tax Manager
Description: Tax Manager Tax Manager - Skills Required - Good communication skills, CPA, Tax Accounting, Management Skills, Estate Gift Tax, S-Corp, C-Corp, PartnershipsTitle: Tax ManagerLocation: Woodland Hills, (more...)
Company: CyberCoders
Location: Fair Oaks
Posted on: 11/13/2019

Director, Medical Management RN
Description: Highly desired: RN with in-depth knowledge and experience in either Prior Authorization or Appeals x2F Grievance and Appeals Relocation assistance available Position Purpose: Direct medical management (more...)
Company: Centene Corporation
Location: Clarksburg
Posted on: 11/13/2019

Supervisor, Utilization Management
Description: Position Purpose: Supervise the daily operations of the utilization management UM department br br li Supervise the daily operations of the UM staff br li Ensure appropriate usage of resources (more...)
Company: Centene Corporation
Location: Courtland
Posted on: 11/13/2019

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Turlock RSS job feeds