Complex Care Clinical Liaison

General Description

Develops and supports transitions of care services for members across HPSM’s post-acute, sub-acute and inpatient facilities. Supports optimal member outcomes and facilitates care coordination by building relationships and being a champion for change with providers and community partners.

Position overview

Essential Functions:

Requirements

These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply.

Education and experience

• Associate or Bachelor’s degree in nursing.
• Four (4) years clinical nursing experience.
• Two (2) years of experience in managed care and concurrent review practices.

License:

• Valid California license as a Registered Nurse

Knowledge of:

• Case management principles and practices.
• Managed Care processes, including use of evidenced-based clinical guidelines.
• Medi-Cal and Medicare regulations
• Working knowledge of all relevant federal, state, local and regulatory requirements.
• San Mateo County community resources.

Ability to:

• Conduct root cause analysis to identify system or process issues.
• Think creatively and identify outside-the-box solutions.
• Demonstrate a friendly and professional demeanor in sometimes stressful situations.
• Professionally represent HPSM in internal and external meetings.
• Work independently using sound professional judgement to meet deadlines and prioritize competing needs.
• Establish and maintain cooperative working relationships with coworkers and external stakeholders.
• Interact well with a variety of people and work effectively as part of a cross-functional team.
• Organize and prioritize tasks and deliver results within set deadlines.
• Influence without authority.

Other Requirement:

• Must have own vehicle and valid driver’s license with proof of insurance in conformity with state law minimums.

Skills:

• Demonstrated skills in public speaking, group facilitation.
• Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, and PowerPoint.
• Detail orientation and focus on accuracy.
• Utilization of sound clinical judgement.
• Excellent time management skills.
• Effective communication skills, both verbally and in writing.
• Qualitative and quantitative problem solving and basic analysis.
• Interpersonal and conflict resolution skills.

Salary and benefits

The starting salary range is $44.35 - $56.96 per hour, depending on the candidate’s work experience.

Excellent benefits package includes:

• HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums)
• Fully paid life, AD&D and LTD insurance
• Retirement plan (HPSM contributes equivalent of 10% of annual compensation)
• 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year
• Tuition reimbursement plan
• Employee wellness program

It is HPSM's policy to provide equal employment opportunities for all applicants and employees.  HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law.  HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.