RN Job

Enhanced Care Management Clinical Specialist II

Full time
Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)
Job ID: 10881
Los Angeles, 90017

The Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management and oversight activities associated with L.A. Care's ECM network.  The position reports to the Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management. The position is responsible for providing oversight, feedback, and technical assistance to ECM Providers to support effective delivery of ECM services and ensure compliance with local, State, and Federal regulations, statues and guidelines. The position is responsible for conducting regular meetings with providers, reviewing Assessments & Care Plans, providing guidance on clinical best practices, and assisting with escalation of cases that require additional assistance from L.A. Care. The position works directly with Care Management and Provider Network Management staff to inform Provider capacity-building and training activities related to the ECM Program operations.

Qualifications
  • Associate's Degree in Nursing
  • Master's Degree in Social Work for Licensed Clinical Social Workers
  • Minimum 3 years of  recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments.  
  • Previous care management experience to include auditing/oversight/performance management experience. 
  • Working knowledge of Medi-Cal and Medicare regulations.
  • Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse (RN); current and unrestrited California License.
About the Hospital

As the nation's largest publicly-operated health plan, we have a great responsibility to the communities we serve, and our employees play an essential role in ensuring we meet those needs.

Why Join Us?
Opportunity. Amazing co-workers. A supportive management team. Great compensation and benefits. Camaraderie and a true sense of mission. If you want a career that truly contributes to the good of all, join us as we work towards a healthier L.A.

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