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Care Manager, RN

Date: Aug 9, 2019

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

 

 

 

POSITION PURPOSE

 

Under the general direction of the Care Management Manager, the Care Manager is responsible for working directly with the Plan, IPA medical groups, providers, hospitals, community agencies, Members/caregivers, and other entities supporting Member care to ensure coordinated, continuous care and serve as a resource person to these facilities. The RN Care Manager supports the care team, finalizes the care management assessment and Individualized Care Plan (ICP).

 

MAJOR RESPONSIBILITIES

 

  1. Responsible for serving as a resource for IEHP Members and Providers for care management and continuity of care.

     

  2. Responsible for assessing Members for appropriate care management needs including:
  • Conducting a clinical assessment and medication reconciliation.
  • Develop, implement, and evaluate Individualized Care Plans (ICP)
  • Act as a Member advocate
  • Serve as a liaison between Member, caregivers, and providers
  • Educate and support Members/caregivers with meeting ICP goals
  • Identify need for Interdisciplinary Care Team (ICT), organize the participants to be included and ensure facilitation and documentation of the ICT.

     

     3.   Review and revise contributions to assessment information and care planning from care team members (i.e. LVN

           Care Manager, Care Coordinator) as appropriate.

 

    4.   Assist with referrals for IEHP Members that are eligible for carve out programs such as CCS, multi-organ transplant,

          etc.

 

    5.   Assist members with immediate needs with regard to access, referrals and authorizations.

 

    6.  Assist member with resources such as LTSS, Independent Living and Diversity Services, Behavioral Health, and

         Community Resources.

 

    7.  Responsible for any other duties as required ensuring successful care management processes and Member

         outcomes using critical thinking and innovative techniques to engage and retain Members in the CM program.       

 

    8.  Any other duties as required or assigned to ensure Health Plan operations are successful.

 

    9.  Ensure the privacy and security of PHI (Protected Health Information) as outlined in IEHP's policies and procedures

        relating to HIPAA compliance.

 

 

MINIMUM QUALIFICATIONS

Education/License:

Possession of a valid, unrestricted RN license issued by the State of California   Possession of a valid State of California driver’s license.

 

 

Experience:

Minimum 2 years clinical experience in an acute care facility, skilled nursing facility, home health or clinic setting. Two  ( 2) or more years of care management experience in a health care delivery setting preferred.  Experience in a Managed Care (HMO, IPA) or in acute facility (i.e. hospital) care management preferred.

 

Pay Range: $69,284  -  $88,358.40

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 1,700 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles

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