Registered Nurse - Complex Case Manager - Sacramento


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Registered Nurse Specialist (RN)
Complex Case Manager
Sacramento, California
 
The city of Sacramento is the capital of California, with a population of over 500,000. The broader Sacramento metro area is home to over 2.4 million residents. Sacramento is a major center for healthcare, with world-renowned UC Davis School of Medicine close by, making it an ideal location for talented healthcare professionals. Whether you prefer to work in a hospital, clinic, home care or senior housing setting - Sacramento job opportunities in healthcare are abundant.
 
Our client is searching for an energetic Registered Nurse who is passionate about working with patients and their family members. You will be providing targeted interventions to avoid hospitalizations & emergency room visits as well as participate in team meetings to further assess & create care plans to optimize patients health statuses.
 
Registered Nurse Specialist - Complex Case Manager Responsibilities:
  • Conducts clinical assessments with members and providers utilizing motivational interviewing; gathers, analyzes, synthesizes and prioritizes member needs and opportunities based upon the clinical assessment and research and collaborates with the interdisciplinary care team to develop a comprehensive plan of care
  • Receives referral for member identified with high cost, complex medical conditions and telephonically outreaches to the member, family and providers to engage in complex case management program
  • Collaborates and communicates with the health care team; e.g. member, family, designated representative, health care provider on a plan of care that produces positive clinical results and promotes high–quality, cost effective outcomes
  • Identifies relevant BCBSMN and community resources and facilitates program and network referrals.
  • Monitors, evaluates, and updates plan of care over time
  • Ensures member data is documented according to BCBSMN application protocol and regulatory standards
  • Collaborates with interdisciplinary care team to develop a comprehensive plan of care to identify key strategic interventions to address member’s needs and health care cost drivers.
 
Registered Nurse Specialist - Complex Case Manager Requirements:
  • Registered Nurse with a current license and with no restrictions
  • 5 years relevant clinical care experience
  • CCM Certificate, or ability to obtain within 1 year of starting in the position
  • Excellent telephonic skills, communication skills, conceptual thinking skills, and organizational skills
  • Excellent research, analytical, and creative problem-solving skills
  • Prefer 2+ years of managed care experience; e.g. case management/health coach, utilization management and/or auditing experience