PHM Transplant Case Manager RN I, Bakersfield, CA

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Population Health Management Transplant Case Manager RN I

KHS Family Health Care, Bakersfield, California, United States of America Req #2622

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).

KHS reasonably expects to pay starting compensation for the position of Population Health Management Transplant Case Manager RN I in the range of $45.02 - 57.41 hourly.

"On-Site Position"
***5,000 Sign-On Bonus***

About us

Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

About the role

The PHM Transplant Case Manager RN I is responsible for coordinating and managing the clinical care of transplant patients, focusing on supporting the transplant process. This entry-level role includes assisting with evaluations, care plan management, and communication with providers, members, and caregivers. The RN will help manage pre- and post-transplant care, address barriers to care, and ensure the completion of necessary processes. This role provides foundational support in transplant services under the guidance of more senior team members.

Essential Functions

• Serve as the point of contact for members and providers regarding transplant services.
• Assist in coordinating care among providers, transplant centers, and other entities to ensure appropriate care, including transportation and lodging as needed.
• Identify members for specific case management and/or disease management activities or interventions by utilizing established screening criteria/guidelines.
• Support the development of individualized care plans, ensuring they meet clinical guidelines.
• Review medical necessity for outpatient services and collaborate with senior team members to ensure high-quality care.
• Participate in Interdisciplinary Care Team (ICT) meetings and case management discussions to improve patient care.
• Collaborate with the KHS Member Service Department, Quality Improvement, and the Provider Relations Department regarding quality of care and other grievance issues to facilitate timely problem resolutions.
• Maintain accurate, timely documentation of all case management activities in accordance with professional standards and department procedures.
• Educate patients on self-management of health conditions and follow up to ensure care plans are followed throughout the transplant journey.
• Assist with the collection and monitoring of transplant data as required by the Department of Health Care Services (DHCS).
• Maintain knowledge of covered benefits for all programs.
• Performs other duties as assigned.

Qualifications:

• Licensure: Active, unrestricted California Registered Nurse (RN) license.
• Education: Associate’s degree in nursing required; bachelor’s degree in nursing preferred.
• Experience:
  • Minimum of two years' experience in clinical nursing, preferably in an acute care setting or related field.
  • Experience in case management or transplant care is a plus.
• Skills & Competencies:
  • Serve as a liaison to community providers and KHS Members.
  • Basic understanding of transplant processes and case management practices.
  • Strong interpersonal communication skills to work effectively with team members, providers, and patients.
  • Ability to manage caseload under supervision and collaborate within a team.
  • Attention to detail with the ability to perform tasks accurately within required timeframes.
  • Preferred: Managed care or case management experience.
  • Bilingual is a plus but not required.
  • Travel Up to 10%, position may involve some travel for patient care coordination.

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

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