ABOUT THIS TEMP POSITIONThis is a temporary position expected to go through the summer. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.THE IDEAL CANDIDATEThe ideal candidate for the Senior Complex Case Manager (Temporary) role is someone who has managed care plan and teleworking experience. Having Pediatrics case management, any case management or insurance experience is a plus. Having the ability to manage high amounts of caseloads with ease will help you succeed in this role. Understanding NCQA standards and a strong internal drive to support our communities will make you an excellent candidate for this role.ABOUT THE TEAMThe Pediatric Complex Case Management team is a collaborative, multi-disciplinary team, that supports one another while case managing and advocating for children with complex medical and developmental issues. It is a busy team that always makes time to come together, constantly communicates, and delegates to remain efficient and productive. They are looking for another great team player, who also likes to have some fun in between the hard work.WHAT YOU'LL BE RESPONSIBLE FORUnder direction, you will develop and manage an individualized comprehensive plan of care for members referred into the assigned Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner. You will also:Work with and educate members, families, providers, external agencies and internal departments on the Case Management Program ad provide assistance as neededParticipate in Quality Improvement studies, to continually evaluate the program's effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for membersWHAT YOU'LL NEED TO BE SUCCESSFULKnowledge of:The principles and practices of clinical nursingThe principles and practices of case managementCare management and coordinationEvidence-based practice guidelines in the development of care plansThe use of Windows-based PC systems and Microsoft Word, Outlook, PowerPoint and ExcelAbility to:Demonstrate strong critical thinking and problem-solving skillsInterpret and apply policies and regulationsDefine issues, conduct research, interpret data, and identify and evaluate optionsEvaluate medical records and other health care dataOrganize work and manage complex prioritiesCreate and edit documents, letters and reportsCommunicate effectively with a diverse population of members, including those with behavioral health issuesExercise good judgement and tact when relating to health care providers and beneficiaries Work independently and work collaboratively as a member of a teamEducation and Experience:Current unrestricted license as a Registered Nurse issued by the State of CaliforniaAssociate's degree in Nursing and a minimum of seven years of experience in a patient care setting, including at least one year of case management experience (a Bachelor's degree may substitute for two years of the required experience); or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifyingA minimum of one year of the required patient care experience must be in an acute or outpatient environment, working with adults To read the full position description, and list of requirements click here .OTHER DETAILSWhile this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview processThis is a temporary position, and does not provide the benefits that are listed below (it is standard language from our regular job posts and cannot be altered or removed)
