Email Alert for
ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.
Actalent
Santa Barbara, CA, United States
Job Title: Health Plan Nurse Coordinator Job Description The Health Plan Nurse Coordinator is a crucial role within our Health Services operational units. These units encompass various programs such as Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and Population Health programs.
Job Source: ActalentCenCal Health
Santa Barbara, CA, United States
Job Details Job Location : Main Office - Santa Barbara, CA Position Type : Full Time Salary Range : Undisclosed Job Category : Medical Management Description Salary Range: $82,165 - $119,140 Job Summary The Health Plan Nurse Coordinator Enhanced Care Management- (HPNC ECM) is a Registered Nurse who is assigned to Enhanced C
Job Source: CenCal HealthCenCal Health
Santa Barbara, CA, United States
Job Details Job Location : Main Office - Santa Barbara, CA Position Type : Full Time Salary Range : Undisclosed Job Category : Medical Management Description California Salary Range: $82,165 - $119,140 annually Job Summary The Health Plan Nurse Coordinator Community Supports - (HPNC CS) is a Registered Nurse who is assigned
Job Source: CenCal HealthActalent
Santa Barbara
Job Title: Health Plan Nurse Coordinator Job Description The Health Plan Nurse Coordinator is a crucial role within our Health Services’ operational units. These units encompass various programs such as Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and Population Health programs.
Job Source: ActalentActalent
Santa Barbara
Job Title: Health Plan Nurse Coordinator Job Description The Health Plan Nurse Coordinator is a crucial role within our Health Services’ operational units. These units encompass various programs such as Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and Population Health programs.
Job Source: ActalentActalent
Santa Barbara
Non-profit healthcare network is looking for a registered nurse case manager to join their team on a contract basis! Opportunity to gain experience with Medi-Cal and work REMOTELY in a fast-paced environment. REQUIREMENTS: + CA RN license + Flexible to work a 3-month contract + Whole person case management experience + Preferred - bilingual in Span
Job Source: ActalentCottage Health
Santa Barbara, CA, United States
Job Description To render professional nursing care pursuant to the goals, objectives, and policies of Cottage Health System, following the standards of practice. To manage quality care through the nursing process of assessment, planning, implementation, and evaluation. Previous experience with medial technology/equipment as needed based on assig
Job Source: Cottage HealthUnited States Air Force
Santa Barbara, CA, United States
CARE FOR THE STRESSES WE CAN’T SEE Today’s Airmen face undeniable stresses and unique challenges in the line of duty. Our Mental Health Nurses play a crucial role in helping diagnose and aid in their continued all-over health. Providing safe and effective treatment alongside the mental health care team, they help promote and foster positive environ
Job Source: United States Air ForceSanta Barbara, CA, United States
Non-profit healthcare network is looking for a registered nurse case manager to join their team on a contract basis! Opportunity to gain experience with Medi-Cal and work REMOTELY in a fast-paced environment.
REQUIREMENTS:
CA RN license
Flexible to work a 3-month contract
Whole person case management experience
Preferred - bilingual in Spanish/English
WHAT'S IN IT FOR YOU:
Remote opportunity
Gain experience with a leading healthcare organization
Description:
The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to one of several Health Services’ operational units. These units include, but are not limited to, the Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and Population Health programs. This position reports to the Program’s Manager or their designee of the assigned unit. Depending on unit assignment, the HPNC may perform utilization management activities, which may include telephonic or onsite clinical review; case or disease management, care coordination or transition, or population health activities; or a combination of all. The HPNC may be assigned to sub-specialized programs within an operational unit, such as Mental/Behavioral Health services. These sub-specialized programs require the RN to perform UM or CM activities for a specific member population. Bilingual in Spanish may be required for positions that primarily requires interaction with members
Responsibilities:
Comply with HIPAA, Privacy, and Confidentiality laws and regulations
Adhere to Health Plan, Medical Management and Health Services policies and procedures
Be abreast on clinical knowledge related to disease processes
Effectively communicate, verbally and in writing, with providers, members, vendors, and other health care providers and in a timely, respectful and professional manner
Function as a collaborative member of Medical Management/Health Services’ multi-disciplinary medical management team
Identify and report quality of care concerns to management and as directed, to appropriate department for follow up
Support and collaborate with the management, medical management and health services team members in the implementation and management of Utilization Management, Case Management, Disease Management, Population Health, Care Coordination, and Care Transition activities
As required, actively participate in the implementation, assessment, and evaluation of quality improvement activities as it relates to job duties
Adhere to mandated reporting requirements appropriate to professional licensing requirements
Comply with regulatory standards of governing agency
Be positive, flexible, and open toward operational changes
Attend and actively participate in department meetings
Support and work collaboratively with the Medical Management and Health Services management team in the implementation and management of UM/CM/DM/PH activities
Actively participate in the development, implementation and the evaluation of department initiatives with the intent to assess any measurable improvements to member’s quality of care
Keep abreast of health care benefits and limitations, regulatory requirements, disease processes and treatment modalities, community standards of patient care, and professional nursing standards of practice
Skills:
Case Management, Medi-Cal, Medicare, RN, health plan
Experience Level:
Intermediate LevelAbout Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [email protected] (%[email protected]) for other accommodation options.
Email Alert for Health Plan Nurse Coordinator jobs in Santa Barbara, CA, United States
ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.