Senior Complex Case Manager- Pediatric (RN)

We have an opportunity to join the Alliance as a Senior Complex Case Manager - Pediatric (RN) on the Care Management team! 

ABOUT THE TEAM

Who is Care Management? We look to support, connect, and empower members through community-based organizations and providers, in furtherance of improving health outcomes. The Care Management Team's mission is to coordinate care and empower members to achieve their health and wellness goals through collaboration and by facilitating member relationships with community providers. In Care Management, we serve the Alliance by creating a bridge between the Alliance, our communities, and individual members. We bring the voice of the member into the room when collaborating with our fellow departments at the Alliance and we assist the members in connecting the dots to successfully navigate options and resources for their care.

The Care Management Department has two units with Senior Complex Case Managers. 

• Adult Care Management: Our work in this unit centers on adult complex case management. We consider the member holistically and prioritize their needs, while also looking to health outcomes.
• Pediatric Care Management: This unit is also about complex case management, but for our younger members. We work with the counties in line with California Children's Services Whole Child Model. 

IDEAL CANDIDATE:

The ideal candidates for this role will be a team player, flexible, eager to learn, and a critical thinker. This role involves working in the grey and working independently, but also being willing to, and knowing when to, collaborate with other team members to provide the best possible care for our pediatric members and families. It is important to add someone to this team who is excited and ready to be part of a team who works closely together and frequently. 

WHAT YOU'LL BE RESPONSIBLE FOR

• Developing and managing an individualized comprehensive plan of care for members referred into the assigned Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner
• Working with and educates members, families, providers, external agencies and internal departments on the Case Management Program and provides assistance as needed
• Participating 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
• Performing other duties as assigned

 

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
  • The principles and practices of clinical nursing
  • Care management and coordination
  • Evidence-based practice guidelines in the development of care plans
• Ability to:
  • 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 and manage complex priorities
• 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 five years of experience in a patient care setting, including at least one year of case management experience a combination of education and relevant work 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 the population of assignment (i.e. pediatrics or adults)

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.

 

The full compensation