Care Manager, RN – Health Access, ECM

This is a fully remote position, open to applicants in California.

📋 Description

• Collaborate effectively with the Health Access Enhanced Care Management Care Coordination team, members and their families, other professionals, and designated healthcare organization medical teams.

• Deliver high-quality, effective care management services to IEHP members.

• Implement a person-centered approach that considers members’ medical, behavioral, and social needs.

• Perform outreach and engagement activities with members.

• Engage members through skilled therapeutic interactions to foster health-related behaviors.

• Provide behavioral health interventions within the defined scope of practice.

• Coordinate care and connect members to necessary resources.

• Collaborate with professionals and community organizations to ensure the delivery of quality care.

• Facilitate smooth transitions of care, ensuring the right care at the right time.

• Offer clinical expertise, leadership, and oversight within the Enhanced Care Management program.

• Advocate for behavioral health principles focused on relationship-based care and education within IEHP and the broader community.

• Conduct face-to-face meetings with high-risk/high-utilizer populations in the field, with member consent.

• Support and motivate members to encourage positive health behaviors.

• Work in partnership with care team members and external partners.

• Integrate IEHP Quality Program objectives, including HEDIS, CAHPS, and NCQA Accreditation.

⛳️ Requirements

• A minimum of three (3) years of experience in care management within a healthcare delivery environment is required.

• Proven track record of successfully working within a team.

• Experience in developing and maintaining effective relationships with clients and colleagues.

• Experience in a Managed Care setting is preferred.

• At least one (1) year of clinical experience in an acute care facility, skilled nursing facility, home health, or clinic setting is preferred.

• Experience with populations of focus: Adults, unaccompanied youth & children, and families facing homelessness.

• Experience with adults, youth, and children at risk for avoidable hospital or emergency department care.

• Experience with adults, youth, and children with serious mental health and/or substance use disorder needs.

• Experience supporting adults living in the community who are at risk for long-term care institutionalization.

• Experience with adult nursing facility residents transitioning to the community.

• Experience with children and youth enrolled in CCS or CCS Whole Child Model who have additional needs beyond their CCS conditions.

• Experience with children and youth involved in child welfare (foster care).

• Experience with adults and youth transitioning from incarceration.

• Experience with pregnant and postpartum individuals, focusing on birth equity.

• An Associate’s degree in Nursing from an accredited institution is required.

• A valid, active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN is required.

• A Bachelor’s degree in Nursing from an accredited institution is preferred.

• Certification as a Case Manager (CCM) is preferred.

• A valid California Driver’s license and current automobile insurance are required.

• Must meet and maintain driving record standards to operate company vehicles according to IEHP insurance guidelines, which allow no more than three (3) points.

• Strong knowledge and comprehensive understanding of evidence-based communication techniques, such as Motivational Interviewing or similar empathy-driven strategies.

• Awareness of and sensitivity to multi-cultural communities.

• Familiarity with self-management philosophies and practices, particularly concerning chronic medical conditions.

• Understanding the effects of unmitigated bias and judgment on health outcomes; commitment to addressing these issues.

• Bilingual ability (English/“Target Language”) is preferred.

• Exceptional interpersonal skills with a strong ability to build relationships.

• Proficient in interpersonal communication, including conflict resolution with colleagues.

• Competent in sharing expertise both informally and formally.

• Capable of managing and effectively utilizing a high degree of ambiguity surrounding new team models, innovative care approaches, and new care management practices.

🏝️ Benefits

• Competitive salary.

• On-site state-of-the-art fitness center.

• Medical insurance with dental and vision coverage.

• Options for life insurance, short-term, and long-term disability.

• Opportunities for career advancement and professional development.

• Wellness programs that support a healthy work-life balance.

• Flexible Spending Account for health care and childcare expenses.

• CalPERS retirement plan.

• 457(b) plan with matching contributions.

• Paid life insurance for employees.

• Pet care insurance.