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Case Management - Nurse, Senior- Pregnancy and Postpartum

Ecge Fa Us2 Oraclecloud Com CX 1003 · Long Beach, CA, United States · Hybrid · Active · Oracle Recruiting Cloud / Fusion HCM

Job facts

FieldValue
CompanyEcge Fa Us2 Oraclecloud Com CX 1003
TitleCase Management - Nurse, Senior- Pregnancy and Postpartum
Normalized title-
Department / teamHealthcare Services and Operations
LocationLong Beach, CA, United States
Work modelHybrid / Hybrid
Employment typeFull Time
Salary-
Statusactive
ATS providerOracle Recruiting Cloud / Fusion HCM
Posted / first seen2026-04-07 / 2026-05-31
Changed / last seen2026-05-31 / 2026-06-06

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ATS provider jobsActive postings observed through Oracle Recruiting Cloud / Fusion HCM.Open
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City jobsActive postings in Long Beach.Open
Department jobsActive postings in Healthcare Services and Operations.Open
Work model jobsActive Hybrid postings.Open
Lifecycle eventsOpen, update, close, and reopen events for this posting.Open
Original postingCanonical source or apply URL captured from the ATS.Open

Linked records

CompanyEcge Fa Us2 Oraclecloud Com CX 1003
Source2426c13c-5fb6-4954-b4fc-d0476cec17ee
ATS providerOracle Recruiting Cloud / Fusion HCM

Description

Description Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Responsibilities Your Work In this role, you will: Research and design treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type. Initiation of timely individualized care plans (ICP) based on health risk assessment (HRA) completion, participation in and documentation of interdisciplinary meetings (ICT), assisting in transitions of care across all ages. Determines appropriateness of referral for CM services, mental health, and social services. Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases. Manages member treatment in order to meet recommended length of stay. Ensures DC planning at levels of care appropriate for the members needs and acuity. Assessment: Assesses members health behaviors, cultural influences and clients belief/value system. Evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers. Research opportunities for improvement in assessment methodology and actively promotes continuous improvement. Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers and BSC. Determines realistic goals and objectives and provides appropriate alternatives. Actively solicits client’s involvement. Planning: Designs appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Adjusts plans or creates contingency plans as necessary. Assesses and re-evaluates health and progress due to the dynamic nature of the plan of care required on an ongoing basis. Initiates and implements appropriate modifications in plan of care to adapt to changes occurring over time and through various settings. Develops appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Recognizes need for contingency plans throughout the healthcare process. Develops and implements the plan of care based on accurate assessment of the member and current of proposed treatment. Qualifications Your Knowledge and Experience Current CA RN License required Bachelor of Science in Nursing or advanced degree preferred. Requires 5 years’ experience in nursing, health care or related field. 3 years managed care experience preferred. Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements. At least 2 years within Health Plan / Managed Care Plan, specific to Medi-Cal line of business preferred At least 2 years of experience in maternity, labor and delivery, or post-partum preferred Transitions of care experience desired Excellent communications skills Hybrid Virtual Work This role allows employees to work virtually full-time, however employees will be expected to come into the office based on business need.

Full job record

Job ID75d371ee271180f8b410d0e2de6519dd5f16e2ae
Org ID202edd25-dd99-459f-9155-82b80529e892
Source ID2426c13c-5fb6-4954-b4fc-d0476cec17ee
Board ID2426c13c-5fb6-4954-b4fc-d0476cec17ee
Provideroracle_hcm
Provider Job Key20260648
TitleCase Management - Nurse, Senior- Pregnancy and Postpartum
Normalized Title
Statusactive
Activeyes
Location TextLong Beach, CA, United States
DepartmentHealthcare Services and Operations
Team
Employment Typefull_time
Workplace Typehybrid
Remote Policyhybrid
CountryUnited States
RegionCA
CityLong Beach
Salary RawDescription Your Role The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Responsibilities Your Work In this role, you will: Research and design treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type. Initiation of timely individualized care plans (ICP) based on health risk assessment (HRA) completion, participation in and documentation of interdisciplinary meetings (ICT), assisting in transitions of care across all ages. Determines appropriateness of referral for CM services, mental health, and social services. Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD). Conducts member care review with medical groups or individual providers for continuity of care, out of area/out of network and investigational/experimental cases. Manages member treatment in order to meet recommended length of stay. Ensures DC planning at levels of care appropriate for the members needs and acuity. Assessment: Assesses members health behaviors, cultural influences and clients belief/value system. Evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers. Research opportunities for improvement in assessment methodology and actively promotes continuous improvement. Anticipates potential barriers while establishing realistic goals to ensure success for the member, providers and BSC. Determines realistic goals and objectives and provides appropriate alternatives. Actively solicits client’s involvement. Planning: Designs appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Adjusts plans or creates contingency plans as necessary. Assesses and re-evaluates health and progress due to the dynamic nature of the plan of care required on an ongoing basis. Initiates and implements appropriate modifications in plan of care to adapt to changes occurring over time and through various settings. Develops appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access, and cost-effective outcomes. Recognizes need for contingency plans throughout the healthcare process. Develops and implements the plan of care based on accurate assessment of the member and current of proposed treatment. Qualifications Your Knowledge and Experience Current CA RN License required Bachelor of Science in Nursing or advanced degree preferred. Requires 5 years’ experience in nursing, health care or related field. 3 years managed care experience preferred. Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements. At least 2 years within Health Plan / Managed Care Plan, specific to Medi-Cal line of business preferred At least 2 years of experience in maternity, labor and delivery, or post-partum preferred Transitions of care experience desired Excellent communications skills Hybrid Virtual Work This role allows employees to work virtually full-time, however employees will be expected to come into the office based on business need.
Salary Min
Salary Max
Salary Currency
Salary Period
Source URLhttps://ecge.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1003/job/20260648
Apply URLhttps://ecge.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1003/job/20260648
First Seen At2026-05-31 17:55:51Z
Last Seen At2026-06-06 19:41:05Z
Last Checked At2026-06-06 19:41:05Z
Last Changed At2026-05-31 17:55:51Z
Inactive At
Source Posted At2026-04-07 01:05:53Z
Source Updated At
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    ],
    "ShortDescriptionStr": "The Care Management team will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Senior Care Manager will report to the Manager of Care Management. In this role you will ensure that services are provided based on standardized procedures including coordination of care with specialists, community resources. Care Managers perform a blended function of utilization management (UM) and care management (CM) activities demonstrating clinical judgement and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians.",
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    "PrimaryLocationCountry": "US",
    "ExternalQualificationsStr": null,
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    "InternationalTravelRequired": null
  },
  "detail_meta": {
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}
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