AMBULATORY CARE MANAGER - CARE MANAGEMENT - Position #2017-288
- Date Posted:
- Full Time
- Open Until Filled Monday - Friday 8:00a.m. - 5:00p.m.
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.
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.