This is a Full-Time position with a Monday-Friday schedule during normal business hours. No weekends or holidays required.

Position is remote but requires to be on-site at our 4s Ranch location once a month. Must be local to San Diego.

Join the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding career with one of the most respected healthcare organizations nationwide.

Why join Scripps Health?

AWARD-WINNING WORKPLACE:

• Fortune Best Workplaces in Health Care 2023
• 2023 PEOPLE Companies that Care
• Fortune 100 Best Companies to Work for 2023
• Recognized by Newsweek as one of America's Greatest Workplaces for Diversity in 2024
• Nearly a quarter of our employees have been with Scripps Health for over 10 years.

We invite you to join our Complex Care Manager team who is a small team that works collaboratively with our Scripps Health Plan team, providing documentation and care to deliver excellent patient care.

The Complex Care Manager screens patients in their assigned caseload to identify those that are medically vulnerable, who may have needs that may be addressed at another location; or within contracted programs/vendors specific to their needs/health plan.

• Coordinates with the health care team and the patient/family to address issues that may impact their care, and to develop a transition plan of care based on the patients' needs.

Preferred Education/Experience/Specialized Skills/Certification:

• Bachelor of Science in Nursing (BSN) highly desired.
• Case management certification highly preferred.
• Demonstrate knowledge of utilization management including experience managing prior-authorization and concurrent review.
• Knowledge of Medicare and Commercial health plans.
• 3+ years of diverse clinical experience; preferred in caring for the acutely ill patients with multiple disease conditions.
• Current BLS for Health Care Provider from American Heart Association.

Required Education/Experience/Specialized Skills:

• 2+ years clinical experience.
• 1-2 years of CM experience required.
• Excellent verbal and written communication (including documentation) skills demonstrated by completing the required forms and the ability to work effectively with individuals and or teams across disciplines.
• Ability to independently utilize critical thinking skills, nursing judgement and decision-making skills. Ability to prioritize, plan, and handle multiple tasks/demands simultaneously as evidence by capacity of open cased, active care plan rate and the ability to handle multiple tasks.
• Ability to read, analyze and interpret information in medical records, and health plan documents.
• Demonstrates knowledge in Microsoft Office applications including Outlook, Word, and Excel.
  

Required Certification/Registration:

• Current California RN License.