Blue Shield of CA
Case Management - Nurse, Senior
Blue Shield of CA, Los Angeles, California, United States, 90079
Your Role
The Care Management team will support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role, you will ensure that services are provided based on standardized procedures, including coordination of care with specialists and community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities, demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care, including clinical nurses and treating physicians.
Your Knowledge and Experience
Current CA RN License. Bachelor of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or in process of completing certification when eligible based on CCM application requirements. Requires 5+ years of experience in nursing, health care, or a related field. 3+ years of managed care experience preferred; health insurance/managed care experience desired. Transitions of care experience preferred. Excellent communication skills.
Pay Range:
The pay range for this role is: $87,230.00 to $130,900.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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The Care Management team will support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role, you will ensure that services are provided based on standardized procedures, including coordination of care with specialists and community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities, demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members' care, including clinical nurses and treating physicians.
Your Knowledge and Experience
Current CA RN License. Bachelor of Science in Nursing or advanced degree preferred. Certified Case Manager (CCM) Certification or in process of completing certification when eligible based on CCM application requirements. Requires 5+ years of experience in nursing, health care, or a related field. 3+ years of managed care experience preferred; health insurance/managed care experience desired. Transitions of care experience preferred. Excellent communication skills.
Pay Range:
The pay range for this role is: $87,230.00 to $130,900.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
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