Case Management Nurse Senior

BLUE SHIELD OF CALIFORNIA • Milwaukee, WI • 1d ago

JOB REQUIREMENTS: Your Role The Care Management team will serve to
support the mission of the department, which is to provide support to
patients in maintaining health and wellness in the outpatient setting.
The Case Management - Nurse, Senior will report to the Manager of Care
Management. In this role you will play a pivotal role in assessing
member needs, providing clinical education, as well as care coordination
with providers, medical groups, and community resources. You will be
responsible for managing and coordinating patient care, ensuring that
our members receive the highest quality of care and services. Care
Managers perform care management (CM) activities demonstrating clinical
judgement and independent analysis, collaborating with members and those
involved with members\' care including clinical nurses and treating
physicians. Your Knowledge and Experience Requires a current and valid
CA RN License or valid RN license(s) from other state(s). Preferred
licensure from a compact state. If assigned to another state, must
maintain an active, unrestricted RN license in assigned state(s) or the
ability to obtain required RN license (in addition to primary state
license) within 90 days of hire Bachelor of Science in Nursing or
advanced degree preferred Certified Case Manager (CCM) Certification or
is in process of completing certification when eligible based on CCM
application requirements Requires 5 years experience in nursing,
healthcare, or related field A minimum of 3 years managed care
experience in inpatient, outpatient, or managed care environment
preferred Health insurance/managed care experience preferred Transitions
of care experience preferred Strong knowledge of healthcare delivery
systems, managed care principles, and care coordination Excellent
communication skills External hires must pass a background check/drug
screen. Qualified applicants with arrest records and/or conviction
records will be considered for employment in a manner consistent with
Federal, State and local laws, including but not limited to the San
Francisco Fair Chance Ordinance. All qualified applicants will receive
consideration for employment without regards to race, color, religion,
sex, national origin, sexual orientation, gender identity, protected
veteran status or disability status and any other classification
protected by Federal, State and local laws. *** APPLICATION
INSTRUCTIONS: Apply Online: ipc.us/t/5107607A26D14D27

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