Senior Complex Case Manager

ABOUT THIS TEMP POSITION

This is a temporary position and the length of assignment is estimated to go from September 2025 through December 2025. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.

There are 2 full-time (40 hours/week) opportunities available for this temporary assignment.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Medicare Care Management Manager (RN), this position: 

• Develops and manages an individualized comprehensive plan of care for Medicare Dual Eligible Special Needs Plan (D-SNP) members referred into the Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner
• Works with and educates members, families, providers, external agencies, and internal departments on the D-SNP Case Management Program
• Participates in Quality Improvement studies, to continually evaluate the program’s effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for members 
• Performs D-SNP Program oversight and support activities
• Acts as a liaison between the D-SNP Program and providers and community agencies to promote effective implementation of program objectives and requirements 

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

• Knowledge of:
• The principles and practices of clinical nursing
• The principles and practices of case management, including motivational interviewing and evidence-based guidelines 
• Care management and coordination 
• Complex chronic conditions, geriatric care, and psychosocial factors impacting health outcomes 
• The principles and practices of developing and implementing health improvement strategies to address social determinants of health 
• Evidence-based practice guidelines in the development of care plans 
• Electronic health record and/or care management platforms 
• Ability to:
  • Assess member risk, define problems, develop care plans, and collaborate across disciplines 
  • Demonstrate strong critical thinking and problem-solving skills
  • Interpret and apply policies and regulations 
  • Define issues, conduct research, interpret data, and identify and evaluate options 
  • Evaluate medical records and other health care data 
  • Organize work, manage complex priorities, and document with accuracy and timeliness 
  • Communicate effectively with a diverse population of members, including those with behavioral health issues 
• Education and Experience:
  • Current unrestricted license as a Registered Nurse 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 a minimum of one year of case management experience (a Bachelor’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying 
  • A minimum of one year of the required patient care experience must be in an acute or outpatient environment, working with adults and/or dual-eligible populations Education

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
• This is a temporary position and does not provide the benefits that are listed below (it is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options.  

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).