Care Management Nurse, New Century Health Plan

Description

Step into a vital role at New Century Health Plan and coordinate the care

for our Medicare Advantage members. As a Care Management Nurse, you will focus

on improving health outcomes and streamlining the care journey for members with

complex healthcare needs.

In this position, you will work closely with members, their families, and

healthcare providers. Your responsibilities will include:

Develop, implement, and monitor individualized care plans based on Health Risk Assessment.

Facilitate transitions of care, including hospital discharge planning and follow-up.

Close care gaps for members enrolled in the Complex Care Management program.

Support the Appeals & Grievances team in resolving members concerns.

Collaborate with medical director in investigating potential quality issues.

Salary Range: $129,018- $166,852/annuallyQualifications

Were seeking a highly qualified candidate with:

BSN or MSN degree, required

Current unrestricted California RN license, required

Three or more years of clinical nursing experience, preferably in care management, care coordination, or a related field

Experience with Medicare Advantage plans and knowledge of CMS regulations is highly desired

Strong assessment and critical thinking skills, with the ability to work independently and as part of a team

Proficiency in electronic health records (EHR) and care management software, along with exceptional organizational and time management skills

Dependability, integrity, initiative, and a strong ethical standard, with attention to detail and the ability to learn quickly

Exceptional interpersonal, written, and verbal communication skills

Proficiency in Microsoft Office applications (Word, Excel, PowerPoint)

A proactive approach to take initiative while appropriately soliciting input and advice

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.