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Nurse Manager, Case Management (RN - Sacramento)

Primary Location: W. Sacramento, CA
Additional Locations: CA-W. Sacramento
Aetna Better Health of California is currently seeking a Manager of Care Management to join our California Medicaid team in Sacramento. The Manager of Care Management develops, implements, supports and promotes clinical strategies, policies and programs that drive the delivery of quality healthcare to our members. The Manager, Care Management is also responsible for the day-to-day oversight and management of clinical team processes including the organization and development of high performing teams. This is an in-office position in Sacramento. There is a travel requirement of 10-25% in the Sacramento area.

Fundamental Components:
Reinforces clinical philosophy, programs, policies and procedures. Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes. Accountable for meeting the financial, operational and quality objectives of the unit.

Accountable for the day-to-day management of the Case Management team for appropriate implementation and adherence with established practices, policies and procedures. Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.

Develop, initiate, monitor and communicate performance expectations. May act as a single point of contact for designated groups and participates in meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills. Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.

Consistently demonstrates the ability to serve as a model change agent and lead change efforts. Accountable for maintaining compliance with policies and procedures and implements them at the employee level. Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.

Background Experience:
  • 5+ years of Case Management Experience; Required
  • Supervisory Leadership Experience; Required
  • Registered Nurse License and BSN; Required
  • Ability to use Technology to Analyze Healthcare Data; Required
  • Master's degree; Preferred
  • CCM Certification; Preferred
  • Managed Care experience; Preferred
  • Medi-Cal Experience; Preferred
  • Experience using the Dynamo System; Preferred
  • Bilingual Language Fluency; Preferred

Additional Job Information:
This position will be responsible for following policies and procedures and developing/mentoring the case management team to ensure standards are being met/followed and the team is developed and supported.This is a Medicaid health plan in California that serves 2 counties. This position is based in Sacramento and will collaborate closely with the San Diego Manager of Case Management.

Functional Skills:
Administration / Operation - Management: < 25 employees, Clinical / Medical - Direct patient care (hospital, private practice), Clinical / Medical - Disease management

Nursing - Registered Nurse (RN)

Potential Telework Position:

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.


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