The Health Plan Nurse Coordinator (HPNC) is a Registered Nurse who is assigned to the Utilization Management, Case Management, and Pediatric-Whole Child Model Unit. This position reports to the Program’s Supervisor or their designee of the assigned unit. The HPNC CM/UM PEDS will perform utilization management activities, which may include telephonic or onsite clinical review; case or disease management, care coordination or transition, or population health activities; or a combination of all. The HPNC may be assigned to sub-specialized programs within an operational unit, such as Mental/Behavioral Health services. These sub-specialized programs require the RN to perform UM or CM activities for a specific member population. Bilingual in Spanish may be required for positions that primarily requires interaction with members.
Pay: $47.00 - $48.00 per hour
Application Question(s):
- Do you have utilization management, case management or managed care experience?
- Are you able to work M-F 8a-5p (Pacific time)
License/Certification:
- RN license in the State of California (Required)
Work Location: Hybrid remote in Santa Barbara, CA 93110
