Nurse Case Manager, High Risk

Work Boldly. Live Brilliantly.

At AltaMed, we don't just serve our communities, we are part of them. We have raised the expectations of what a community clinic can deliver because we think quality care is for everyone. And, we are determined to provide it no matter the challenges because this is more than a job. It's the calling of our lives and it compels us to keep moving forward.

Job Overview

he Case Manager, High Risk position is responsible for medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). Functions include providing health education, coaching, and disease management activities. The Case Manager (High Risk) would be responsible for managing competing priorities which could range from securing, coordinating, and authorizing skilled nursing services timely, review hospice or nursing progress notes routinely and provide direction as to ongoing need for continued services, completing initial assessment for newly enrolled hospitalized members, conducting home visits to evaluate for post hospitalization needs. Home visits may be completed independently or jointly with the Transition of Care (TOC) case management team. This position focuses on improving care coordination between the member, their physicians, and caregivers. The purpose of this special approach to case management is to help reduce health care costs by coordinating, authorizing, and monitoring skilled nursing services. The Case Manager (High Risk) serves as an advocate and assists member to reach optimal function and health in an appropriate environment that supports their needs.

Minimum Requirements:

1.Unrestricted California nurse license (i.e. RN or LVN).

2.Bachelor's degree in Human Services or related field is preferred.

3.Minimum of 2 years of experience in managed care required.

4.Minimum of 3 years of experience in a hospital, acute care, or direct care setting.

5.Case management, utilization review, concurrent review, discharge planning, or risk management experience.

6.Knowledge and experience with Medicare/Medicaid programs.

7.Essential Job Functions of Job Description

Benefits & Career Development

• Medical, Dental and Vision insurance

• 403(b) Retirement savings plans with employer matching contributions

• Flexible Spending Accounts

• Commuter Flexible Spending

• Career Advancement & Development opportunities

• Paid Time Off & Holidays

• Paid CME Days

• Malpractice insurance and tail coverage

• Tuition Reimbursement Program

• Corporate Employee Discounts

• Employee Referral Bonus Program

• Pet Care Insurance

Salary Range