Senior Complex Case Manager - D-SNP (RN)

Accepting applications through Wednesday, October 1, 2025 by 5:00 pm.

We have an opportunity to join the Alliance as a Senior Complex Case Manager - D-SNP (RN) in the Care Management Department. 

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Medicare Care Management Manager (RN), this position: 

• Develops and manages an individualized comprehensive plan of care for Medicare Dual Eligible Special Needs Plan (D-SNP) members referred into the Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner


• Works with and educates members, families, providers, external agencies, and internal departments on the D-SNP Case Management Program


• Participates in Quality Improvement studies, to continually evaluate the program’s effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for members 


• Performs D-SNP Program oversight and support activities


• Acts as a liaison between the D-SNP Program and providers and community agencies to promote effective implementation of program objectives and requirements 

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

• Knowledge of:




• The principles and practices of clinical nursing


• The principles and practices of case management, including motivational interviewing and evidence-based guidelines 


• Care management and coordination 


• Complex chronic conditions, geriatric care, and psychosocial factors impacting health outcomes 


• The principles and practices of developing and implementing health improvement strategies to address social determinants of health 


• Evidence-based practice guidelines in the development of care plans 


• Electronic health record and/or care management platforms 




• Ability to:
  
  
  
  • Assess member risk, define problems, develop care plans, and collaborate across disciplines 
  
  
  • Demonstrate strong critical thinking and problem-solving skills
  
  
  • Interpret and apply policies and regulations 
  
  
  • Define issues, conduct research, interpret data, and identify and evaluate options 
  
  
  • Evaluate medical records and other health care data 
  
  
  • Organize work, manage complex priorities, and document with accuracy and timeliness 
  
  
  • Communicate effectively with a diverse population of members, including those with behavioral health issues 
  
  
  
  


• 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 a patient care setting, including a minimum of one year of case management 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 
  
  
  • A minimum of one year of the required patient care experience must be in an acute or outpatient environment, working with adults and/or dual-eligible populations 
  
  
  
  

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.

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area

OUR BENEFITS 

Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

• Medical, Dental and Vision Plans


• Ample Paid Time Off 


• 12 Paid Holidays per year


• 401(a) Retirement Plan


• 457 Deferred Compensation Plan


• Robust Health and Wellness Program


• Onsite EV Charging Stations

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. 

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.