RN Job

Manager, Enhanced Care Management (RN or LCSW)

Full time
Pay Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.)
Job ID: 10946
Los Angeles, 90017

Reporting to the Director of Enhanced Care Management (ECM), the ECM Manager will be responsible for overseeing the day-to-day operations of both clinical and non-clinical ECM staff. The primary focus is on ensuring timely compliance and adherence to regulatory standards as outlined in the ECM Policy Guide, policies, and procedures. This position is responsible for enhancing care for the most vulnerable populations and actively participates in developing strategic approach to managing the ECM Team ensuring that it provide exceptional care management. This role extends to regulatory and accreditation compliance, as well as the oversight of ECM Providers and Plan Partners' delegated functions related to ECM. Collaboration with internal and external stakeholders, such as hospitals, providers, Local Initiatives, Plan Partners, and community-based organizations, is crucial to guaranteeing coordinated and cost-effective quality healthcare for L.A. Care Members.

Qualifications
  • Master's degree in Social Work OR Associates Degree in Nursing
  • In lieu of degree, equivalent education and/or experience may be considered.
  • Minimum of 6 years of recent care management experience in a managed care setting, such as a health insurance environment and/or experience as care manager in a community based organization with at least 4 years of leading a process, program or staff or supervisory/management experience. 
  • Experience in Medi-Cal/Medicaid, Medicare, or other government medical programs for underserved populations
  • Registered Nurse (RN);current and unrestricted California License OR Licensed Clinical Social Worker; current and unrestricted 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.

View Job

 

Additional Jobs at L.A. Care Health Plan

Manager, Care Management

Full Time
Pay Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.)
Job ID: 10723
Los Angeles, 90017

The Manager, Care Management is directly responsible for the oversight and...

View Job

Quality Management Nurse Specialist RN II

Full Time
Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)
Job ID: 10658
Los Angeles, 90017

The Quality Management Nurse Specialist RN II is responsible for overseeing the...

View Job

Customer Solution Center Appeals and Grievances Nurse Specialist RN II

Full time
Pay Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)
Job ID: 10893
Los Angeles, 90017

The Customer Solution Center Appeals and Grievances (A&G) Nurse Specialist...

View Job

Hiring Now

Experience the Digital Flip Mag

Flip through the pages of the latest Working Nurse magazine on your device.