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Talented Medical Solutions

RN, Health Plan Care Manager-Roseville-CA-20083-Pay Negotiable

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What they do

A Nurse Manager manages nurses working in a clinical unit at a hospital or health care facility. Provides clinical experience as a registered nurse and supervises nurses that provide direct patient care. Creates and manages staff schedules and ensures that hospital policies and procedures are followed. Manages budget and recordkeeping for the unit.

$125,005 / year median in California

+6% projected growth

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Job Description

RN, Health Plan Care Manager-Roseville-CA-20083-Pay Negotiable Talented Medical Solutions - 5.0 Roseville, CA Job Details Contract $38 - $45 an hour 4 hours ago Qualifications Customer communication RN License Employee relationship building Full Job Description
RN, HEALTH PLAN CARE MANAGER
Job Summary:
Manages the development, implementation, and evaluation of care management services. Promotes continuity of care, cost effectiveness, care integration, case management, utilization review, and care planning.
Education & Experience:
Bachelor's Degree in Nursing (BSN) (Preferred) Nursing experience (Preferred)
Licenses & Certifications:
Registered Nurse (RN) licensure in state of practice (Required) Certified Case Manager (CCM) (Preferred)
Key Responsibilities:
Coordinates care management services for Health Plan members. Partners with physicians, claims, and data management teams to support member care. Coordinates preventative care, wellness, and nutritional counseling. Collaborates on quality improvement, resource utilization, and cost reduction initiatives. Reviews member conditions for medical necessity criteria. Manages discharge planning and utilization management communication. Maintains positive relationships with internal and external customers. Performs other job-related duties as assigned. #Workwolf