Organization: Gold Coast Health Plan
Location: Camarillo, CA
Date Job Posted: August 29, 2022
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RN, Clinical Care Manager I (PEDS)
Full Time Regular
Camarillo, CA, US
Requisition ID: 1328
The Gold Coast Health Plan (GCHP) Clinical Care Manager I, supports the GCHP mission to improve the health of the members through provision of the best possible quality care and services. As defined by the Case Management Society of America (CMSA): Care management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.
The Clinical Care Manager I, works closely with other team members and is a role model and resource to colleagues. This position acts as a bridge by facilitating communication between the member, member’s family and the providers. The Clinical Care Manager I also provides member advocacy and education to maintain or improve clinical outcomes.
Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Essential Functions Statement(s)
POSITION QUALIFICATIONS Competency Statement(s)
SKILLS & ABILITIES
Education: Bachelor's Degree (four-year college or technical school) is preferred, Field of Study: in a health-related field and managed care experience is desired
Registered Nurse (RN) valid and current license. CCM certification preferred
Experience: 2 plus years of experience in the health care field. Required.
Care management, discharge planning, or equivalent combination of education and experience.
Managed care experience in a health plan, preferred.
Certain positions may require bilingual skills in English and Spanish.
Computer Skills: Strong background and knowledge of computer systems.
Personal computer skills included in the MS Office products.
Certifications & Licenses:
Active, valid and unrestricted license, Registered Nurse CCM or other CM certification preferred.
Other Requirements: SKILLS, KNOWLEDGE & ABILITIES:
An attitude to excel, a special empathy for working with multiple populations, an investigative personality and a willingness to mentor colleagues.
A working knowledge of Medi-Cal and related policy and regulations.
Ability to evaluate clinical and other health data and to communicate effectively both orally and in writing.
Ability to synthesize thoughts and plans succinctly in writing. Ability to balance multiple tasks.
Strong organizational skills. Critical thinking skills.
Flexibility in role delineation and workload assignments. Team player.
Office work environment.