Care Coordination Nurse (RN)

We have an opportunity to join the Alliance as a Care Coordination Nurse (RN) in the Community Care Coordination Department.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Complex Case Management Supervisor - Adult (RN), you will:

• Manage a plan of care for members referred into the Community Care Coordination Program, while promoting optimal, achievable outcomes in the most cost effective and appropriate manner
• Work with and educate members, providers, external agencies and internal departments on the Community Care Coordination Program
• Participate in Quality Improvement studies to support evaluation of program effectiveness and the promotion of quality driven, cost effective, achievable goals and outcomes for members

THE IDEAL CANDIDATE

• Bilingual (English/Spanish or English/Hmong)
• Bachelor's degree in Nursing
• Experience working in a managed care environment and/or government sponsored health plan (Medicare/Medicaid)

WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here .

• Knowledge of:
• Principles and practices of clinical nursing
• Principles and practices of case management
• Principles and practices of utilization management
• The Medi-Cal program and related policy and related Title 22 regulations
• Ability to:
  • Demonstrate strong critical thinking and problem solving skills
  • Competently navigate computer systems
  • Evaluate medical records and other health care data
  • Understand, interpret and apply policies, procedures, and regulations
  • Create correspondence and other program documents and compile reports
• Education and Experience:
  • Current unrestricted license as a Registered Nurse issued by the state of California
  • Associate's degree in Nursing and a minimum of five years of acute care experience in a medical/surgical or ICU floor setting, which included a minimum of six months of in-patient case management experience (a Bachelor's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

OTHER DETAILS

• While this position is connected to one of our Alliance offices, we are in hybrid telecommute work environment right now and we anticipate that the interview process will take place remotely.
• Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
• Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.

COVID-19 Vaccine Requirement: This position requires staff to be fully vaccinated and boosted upon their start date as a condition of employment. Proof of vaccination must be submitted at time of hire. Fully vaccinated and boosted is defined as receipt of the second dose in a 2-dose series (Pfizer & Moderna vaccines) OR receipt of a single-dose vaccine (Johnson & Johnson); AND receipt of the booster (if eligible); AND a 2-week period having passed since the administration of the last vaccine dose.
Additionally, all positions at the Alliance are required to meet these minimum qualifications.
OUR BENEFITS

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 11 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations
• And many more

ABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Merced, Monterey and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet .
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.