To initiate and coordinate a multidisciplinary team approach to case management. Engages the member/member’s representative in a care plan that assists a member in meeting his/her health and wellness goals. Collaborates, assesses, plans, facilitates, evaluates, and advocates to meet the comprehensive medical, behavioral, and psychosocial needs of the member, while promoting quality and cost-effective outcomes.
Associate’s degree in Nursing required; Bachelor’s degree in Nursing (or higher) preferred. 2 years of experience preferred, to include at least one (1) year of case management experience and one (1) year in an acute care setting; or equivalent combination of education and experience. General knowledge of managed care and/or experience with Medicaid population preferred.
Current and unrestricted California Registered Nurse License. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business. Bilingual skills in Spanish, Russian, or Tagalog preferred.
Special Skills, Licenses and Certifications
Performance Based Competencies
Strong organizational, communication, critical thinking skills and attention to detail required. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Effective telephone and computer data entry skills required. Experience in managed care business practices and ability to access data information using various computer systems. Excellent English written and verbal communication skills required.
Work Environment And Physical Demands
Able to utilize multiple computer platforms simultaneously. Daily use of telephone and computer for most of the day. Standard cubicle workstation. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs.
All HealthPlan employees are expected to:
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.