Ambulatory Care Manager - Care Management - Position #194

AMBULATORY CARE MANAGER - CARE MANAGEMENT - Position #2017-194

Date Posted:
Classification:
Administrative
Type
Full Time
Location
OPEN UNTIL FILLED Monday - Friday 8:00a.m. - 5:00p.m.

Job Description

The Ambulatory Care Manager works with outpatient members, providers and caregivers to provide intensive, comprehensive care management and increase efficient utilization of services; identifies chronic or catastrophic cases through the care management process and initiates intensive care management according to program guidelines. Provides education, counseling and on demand information to patients who have a specific chronic condition. The RN will provide education and coordinate care needs with the patient’s primary provider from information gathered via interview and face to face contact. Services are performed telephonically from the Care Management Department. Serves as a liaison between providers, patients and care management teams. All interactions are documented and sent to appropriate individuals. Provides reports as requested.

Qualifications

Graduation from an accredited School of Nursing. Bachelor’s Degree in nursing or healthcare related field or current equivalent related work experience. Two years clinical or case management experience in an acute care or ambulatory care setting required. Two or more years of experience in a IPA/Medical Group or health plan in a managed care environment preferred. Working knowledge of guidelines and regulations relevant to case management and utilization management, including Medicare, DMHC, NCQA, and Milliman Care Guidelines. Current State of California Unrestricted RN licensure. CCM preferred. Bilingual skills desirable

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