Senior Complex Case Manager (RN) - D-SNP (Temporary)

Central California Alliance for Health • Mariposa County, California, CA

4d • $56 - $63 • Hybrid

About The Position

The Senior Complex Case Manager (RN) develops and manages individualized, comprehensive plans of care for Medicare Dual Eligible Special Needs Plan (D-SNP) members referred to the Case Management Program. The goal is to promote optimal, achievable outcomes in the most cost-effective and appropriate manner. The position works with and educates members, families, providers, external agencies, and internal departments about the D-SNP Case Management Program; participates in Quality Improvement studies; performs D-SNP Program oversight and support; and serves as a liaison between the program, providers, and community agencies.

This is a full-time, 40-hour-per-week temporary assignment. The estimated assignment period is November 2, 2026, through December 31, 2026, subject to business needs and possible changes. The worker would be assigned to the Alliance but employed by a temporary employment agency. The organization operates in a hybrid work environment. Interviews are expected to take place remotely via Microsoft Teams. Some staff may work fully remotely, but attendance at quarterly company-wide events or department meetings is expected. In-office or in-community presence may be required depending on business needs.

The role requires a current, unrestricted California Registered Nurse license; an associate’s degree in Nursing and at least seven years of patient-care experience, including at least one year in case management (a bachelor’s degree may substitute for two years of required experience); or an equivalent combination of education and experience. At least one year of the required patient-care experience must be in an acute or outpatient environment working with adults and/or dual-eligible populations.

Pay ranges are $60.00–$63.00 per hour in Zone 1 and $56.00–$60.00 per hour in Zone 2, depending on work location and other factors. The listed Alliance employee benefits are not available to temporary employees on assignment; temporary employees are connected to a staffing agency with separate benefit options.

Requirements

• Current unrestricted Registered Nurse license issued by the State of California.
• Associate’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. An equivalent combination of education and experience may qualify.
• At least one year of the required patient-care experience must be in an acute or outpatient environment working with adults and/or dual-eligible populations.
• Knowledge of clinical nursing principles and practices.
• Knowledge of case-management principles and practices, including motivational interviewing and evidence-based guidelines.
• Knowledge of care management and coordination.
• Knowledge of complex chronic conditions, geriatric care, and psychosocial factors affecting health outcomes.
• Knowledge of developing and implementing health-improvement strategies addressing social determinants of health.
• Knowledge of evidence-based practice guidelines for developing care plans.
• Knowledge of electronic health records and/or care-management platforms.
• Ability to demonstrate strong critical-thinking and problem-solving skills.
• Ability to interpret and apply policies and regulations.
• Ability to define issues, conduct research, interpret data, and identify and evaluate options.
• Ability to organize work, manage complex priorities, and document accurately and promptly.
• Ability to communicate effectively with diverse members, including people with behavioral health issues.

Responsibilities

• Develop and manage individualized, comprehensive plans of care for D-SNP members referred to the Case Management Program, promoting optimal and achievable outcomes in a cost-effective and appropriate manner.
• Work with and educate members, families, providers, external agencies, and internal departments about the D-SNP Case Management Program.
• Participate in Quality Improvement studies to evaluate program effectiveness and its ability to promote quality-driven, cost-effective, achievable member goals and outcomes.
• Perform D-SNP Program oversight and support activities.
• Act as a liaison between the D-SNP Program, providers, and community agencies to promote effective implementation of program objectives and requirements.
• Assess member risk, define problems, develop care plans, and collaborate across disciplines.
• Interpret and apply policies and regulations; research and evaluate issues, data, and options.
• Evaluate medical records and other health care data.
• Organize work, manage complex priorities, and document accurately and promptly.
• Communicate effectively with a diverse population of members, including those with behavioral health issues.

Benefits

• The posting lists Medical, Dental and Vision Plans, ample paid time off, 12 paid holidays per year, a 401(a) Retirement Plan, a 457 Deferred Compensation Plan, a health and wellness program, and onsite EV charging stations as benefits for regular Alliance employees. It explicitly states these benefits are unavailable to temporary employees on assignment; temporary employees may have separate benefit options through the staffing agency.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree