SNP Case Manager (TEMPORARY)

Alignment Healthcare • Orange, CA

1d

About The Position

Position Summary: The SNP Case Manager is responsible for health care management and coordination, within the scope of licensure, for members with complex and chronic care needs. The SNP Case Manager delivers care to members utilizing the nursing process and effectively interacts with members, care givers, and other interdisciplinary team participants. The Case Manager will assist with closing gaps in care and resolving barriers that prevent members from attaining improved health. The SNP Case Manager will connect with members telephonically.

Requirements

• 1-3 years clinical experience, 2 or more years of case management experience; or any combination of education and experience, which would provide an equivalent background.
• Must have and maintain an active, valid, and unrestricted RN or LVN license in the state for which you are applying
• Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs
• Extensive knowledge of the management of chronic conditions
• Excellent verbal and written communications skills
• Team player who builds effective working relationships
• Ability to work independently
• Experience using standardized clinical guidelines required
• Strong organizational skills
• Ability to operate PC-based software programs including proficiency in Word, Excel and PowerPoint
• The employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Nice To Haves

• Health Plan experience preferred

Responsibilities

• Coordinate care by serving as a resource for the member, their family and their physician.
• Ensure access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate.
• Complete comprehensive assessments within their scope of practice that includes assessing the member's current health status, resource utilization, past and present treatment plan and services.
• Collaborates with the member, the PCP and other members of the care team to implement a plan of care.
• Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners and specialists on the development of care management treatment plans.
• Provide education and self-management support based on the member’s unique learning style.
• Assists in problem solving with providers, claims or service issues.
• Works closely with delegated or contracted providers, groups or entities to assure effective and efficient care coordination.
• Maintains confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed