Job Information
Actalent Health Plan Nurse Coordinator in Santa Barbara, California
Job Title: Health Plan Nurse Coordinator
Job Description
The Health Plan Nurse Coordinator is a crucial role within our Health Services’ operational units. These units encompass various programs such as Utilization Management, Case Management, Enhanced Care Management, Disease Management, Pediatric-Whole Child Model, and Population Health programs. The position reports to the Program’s Manager or their designee of the assigned unit. Depending on the unit, the role may involve utilization management activities, which could include telephonic or onsite clinical review; case or disease management, care coordination or transition, or population health activities. The role may also involve sub-specialized programs within an operational unit, such as Mental/Behavioral Health services. These programs require the RN to perform UM or CM activities for a specific member population. Some positions may require bilingual skills in Spanish.
Hard Skills
Clinical knowledge of either adult or pediatric health conditions and disease processes
Ability to meet timelines/deadlines of daily work responsibilities
Understanding and application of quality improvement theory, strategy, and practical methods
Perform accurate HEDIS medical record abstraction
Soft Skills
Professional demeanor
Strong multi-tasking, organizational, and time-management skills
Ability to work effectively individually and collaboratively in a cross-functional team environment
Excellent interpersonal communication skills
Ability to compose clear, professional, and grammatically correct correspondence
Job Type
This is a contract position with a duration of 4 Month (Almost guaranteed Extension)
Work Site
On site
Work Environment
This role is based in an office setting, working closely with the services team which includes Case Management, Pharmacy, UM, and Peds team. The direct CM team comprises two other CM's and two admins. We pride ourselves on our highly collaborative, supportive, and helpful team environment. Our company is mission-driven and takes good care of its employees, offering benefits such as catered lunches weekly.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.