Senior Enhanced Care Management​/ECM Advisor, RN

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Senior Enhanced Care Management (ECM) Advisor, RN

We have an opportunity to join the Alliance as a Senior Enhanced Care Management (ECM) Advisor RN in the Enhanced Health Services (EHS) Department.

Reporting to the Enhanced Care Management Manager, this position will be the liaison between the Enhanced Care Management (ECM)/Community Supports (CS) Program and providers and community agencies to promote effective implementation of program objectives and requirements. This person will perform ECM/CS Program oversight and support activities and provide support to the Provider Services Department, along with other Alliance departments related to training ECM/CS providers and implementation of ECM/CS Program activities.

You will also develop and manage an individualized comprehensive plan of care for members referred into the assigned ECM Program with the goal of promoting optimal, achievable outcomes in the most cost-effective and appropriate manner, at such times that contracted ECM providers are unable to provide these services to members. And work with and educate members, families, providers, external agencies, and internal departments on the Case Management Program.

ABOUT THE TEAM

Enhanced Health Services (EHS) team provides extra services to members with complex needs. Each member in ECM has a Care Manager who collaborates with their care team, which can include doctors, mental health providers, specialists, pharmacists, case managers, social services providers, and others.

THE IDEAL CANDIDATE

• Has clinical expertise in healthcare practices and patient care
• Has an understanding of available resources and knows when to reach out for support
• Takes initiative and can be the lead in connecting with providers, ensuring smooth communication and collaboration
• Is a strong multitasker, with the ability to manage multiple tasks simultaneously with minimal supervision
• Is an effective problem solver with the ability to think critically and resolve issues
• Has experience in prioritizing tasks and remaining flexible in a dynamic work environment
• Is a collaborative team player who contributes to a positive work environment
• Has the ability to travel to community events as needed

WHAT YOU'LL NEED TO BE SUCCESSFUL

• Knowledge of:
  • The principles and practices of community-based service delivery to at-risk populations, including motivational interviewing, trauma-informed care, and other best practices
  • The principles and practices of case management, care management, and coordination
  • Evidence-based practice guidelines in the development of care plans
  • The principles and practices of customer service
• Ability to:
  • Analyze, interpret, and apply legal, regulatory, and contractual language, policies, procedures and guidelines, and legislative and regulatory directives
  • Evaluate medical records and other health care data
  • Manage multiple projects simultaneously, organize work, and achieve goals and timelines
  • Assist with the development and implementation of policies, procedures, projects, systems, and program
• 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 outpatient medical, care management, community health service delivery, behavioral health practice management, or related healthcare 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

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.

OUR BENEFITS

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred…