DescriptionStep into a vital role at New Century Health Plan and coordinate the carefor our Medicare Advantage members. As a Care Management Nurse, you will focuson improving health outcomes and streamlining the care journey for members withcomplex healthcare needs.
In this position, you will work closely with members, their families, andhealthcare providers. Your responsibilities will include : Develop, implement, and monitor individualized care plans based on Health Risk Assessment.
Facilitate transitions of care, including hospital discharge planning and follow-up.Close care gaps for members enrolled in the Complex Care Management program.
Support the Appeals & Grievances team in resolving members' concerns.Collaborate with medical director in investigating potential quality issues.
Salary Range : $129,018- $166,852 / annuallyQualificationsWe're seeking a highly qualified candidate with : BSN or MSN degree, requiredCurrent unrestricted California RN license, requiredThree or more years of clinical nursing experience, preferably in care management, care coordination, or a related fieldExperience with Medicare Advantage plans and knowledge of CMS regulations is highly desiredStrong assessment and critical thinking skills, with the ability to work independently and as part of a teamProficiency in electronic health records (EHR) and care management software, along with exceptional organizational and time management skillsDependability, integrity, initiative, and a strong ethical standard, with attention to detail and the ability to learn quicklyExceptional interpersonal, written, and verbal communication skillsProficiency in Microsoft Office applications (Word, Excel, PowerPoint)A proactive approach to take initiative while appropriately soliciting input and adviceUCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.
Care Management Nurse, New Century Health Plan
As a Care Management Nurse, you will focuson improving health outcomes and streamlining the care journey for members withcomplex healthcare needs. DescriptionStep into a vital role at New Century Health Plan and coordinate the carefor our Medicare Advantage members. Your responsibilities will includ...
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