CA
Employment Type:
Hybrid (50% remote, 50% on-site)
Job Location:
Bakersfield, CA
Salary Range:
$45.02 - $57.41 per hour
Position Summary:
The Clinical Program Oversight RN D-SNP is responsible for overseeing the care management and coordination for members with complex and chronic care needs under the Dual Special Needs Plan (D-SNP). This role ensures the delivery of high-quality clinical support services by monitoring health assessments, care plan development, and interdisciplinary team activities. The RN will also be involved in vendor performance audits and ensure compliance with program requirements. Regular collaboration with internal teams and vendors is required to enhance program performance and identify areas for improvement.
Company Overview:
Our organization is dedicated to improving the health of its members through integrated health care delivery. We prioritize a culture of collaboration, accountability, and continuous improvement to ensure quality care. We value diversity, respect, and support for our team members. Our mission is to provide exceptional service and promote the well-being of our members.
Performance Objectives:
- Assist in managing D-SNP performance and compliance with CMS/DHCS requirements.
- Support the creation, monitoring, and reporting of D-SNP program performance.
- Participate in audits and report opportunities for process improvements.
- Collaborate with internal teams and vendors to ensure effective care integration.
Key Competencies:
- Strong knowledge of Medicare/MediCal Managed Care Plans.
- Excellent communication and collaboration skills.
- Ability to analyze data and identify actionable insights.
- Ability to manage multiple priorities and meet deadlines.
- Proficiency in Microsoft Office Suite and care management software.
Requirements (Education, Experience, and Physical):
- Active, unencumbered California Registered Nursing license.
- Associate’s Degree in Nursing required (BSN/MSN preferred).
- Minimum of 3 years' experience in Care Management or Utilization Management.
- Certification in Care Management, Utilization Management, and/or Managed Care preferred.
- Valid California Driver’s License and auto liability insurance (up to 40% travel).
- Ability to travel independently and work in a fast-paced environment.
Commitment to Diversity: As an equal opportunity employer committed to meeting the needs of a multi-generational and multicultural workforce, Key Staffing recognizes that a diverse staff, reflective of our community, is an integral and welcome part of a successful and ethical business. We hire local talent at all levels regardless of race, color, religion, age, national origin, gender, gender identity, sexual orientation, or disability and actively foster inclusion in all forms both within our company and across interactions with clients, candidates, and partners.
If this position caught your eye, send us your resume! For best consideration, include the job title and source where you found this position in the subject line of your email to knegrete@hirekeystaff.com.