Temporary Integrated Transitional Care Nurse, RN

Inland Empire Health Plan

Rancho Cucamonga, CA

JOB DETAILS
SKILLS
Analysis Skills, Case Management, Certified Coding Specialist (CCS), Child and Youth Services, Communication Skills, Concurrency, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Driver's License, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Quality, Hospital, Insurance, Interpersonal Skills, Leadership, Licensed Clinical Social Worker (LCSW), National Committee for Quality Assurance (NCQA), Nursing, Nursing Credentials, Organizational Skills, Pharmacy, Record Keeping, Registered Nurse (RN), Risk, Team Player, Time Management, Transitional Care, Utilization Management, Vehicle Driving
LOCATION
Rancho Cucamonga, CA
POSTED
8 days ago

This is a short-term assignment.

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!

Under the direction of the Integrated Transition Care Department Leadership, the incumbent will work with Hospitals and Independent Physician Association (IPA) with their assigned Team Center, that may include an LCSW, CHW, Pharmacist, Pharmacy Technician, Coordinator, Care Transition, and Transportation to initiate coordinated and continuous cost-effective quality healthcare to ensure the continuity of the Member's care needs are met timely throughout the continuum of care and readmission prevention for our high-risk Members. This will be accomplished through concurrent review processes using nationally recognized criteria. The Integrated Transitional Care Nurse, RN will participate in providing transitional care services to the Members with each transition from one care setting to the next.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Education & Requirements

  • Two (2) or more years of Utilization Management/Case Management in a health care delivery setting in Acute or Skilled nursing, with an emphasis on Concurrent Review and Utilization Management

  • High school diploma or GED required

  • Bachelor's degree in Nursing from an accredited institution preferred

  • Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN required

Key Qualifications

  • Must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
  • Knowledge of evidence based clinical criteria and California Children Services (CCS)
  • Must have analytical skills
  • Excellent communication, interpersonal and organizational skills
  • Self-starter and a team player

Start your journey towards a thriving future with IEHP and apply TODAY!

About the Company

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Inland Empire Health Plan