Providence St. Joseph Health

Job Information

St. Joseph Health / Covenant Health Care Manager RN - Access to Care in Brea, California

We are looking for a Care Manager RN with HSS Access to Care Department at St. Joseph Heritage Healthcare.

Location : Brea, California

Schedule : On Call/ Per Diem

Shift: 8 Hour Day Shift

Job Summary:

Care Management is a collaborative practice model including the patients, nurses, social workers, physicians, other practitioners, caregivers and the community. The care management process encompasses excellent communication, both verbal and written, and facilitates care along a continuum through effective resource coordination.The goal of the Care Manager is to advocate for and assist the patient in the achievement of optimal health, access to care, and appropriately utilizing resources. The Care Manager utilizes the following processes to meet the patient's individual healthcare needs: assessment, planning, implementation, coordination, monitoring and evaluation of the plan of care.


  • Basic computer skills including Windows, Microsoft Word, internet navigation and an e-mail system.

  • Knowledge of managed care principles, utilization management, case management and healthcare provided throughout the continuum.

  • Knowledge of physical and psychological characteristics of disease processes, recognizes potential clinical problems, and recommends intervention in a preventative, pro-active way.

  • Excellent interpersonal, verbal and written communication skills.

  • Ability to problem-solve.

  • Ability to access and evaluate community resources to meet patient’s needs.

  • Ability to handle multiple tasks at a time and remain organized.

  • Ability to work autonomously but demonstrates the ability to work collaboratively on a team.

  • Ability to work in an ambiguous environment; work effectively under pressure due to changes in priorities.

  • Excellent computer and IT system knowledge

  • Possesses the knowledge and skills necessary to communicate with third party payers.

  • Establishes and maintains a good rapport with physicians and interacts well with all internal and external customers in a professional and courteous manner.

  • Proficiency in Milliman Care Guidelines (preferred)

Minimum Position Qualifications:


  • Graduate of an accredited school of nursing

Experience :

  • 3 years of clinical experience in an HMO, medical group, affiliated model, hospital or medical office/clinic setting.


  • Active and Unrestricted California Registered Nurse license.

Preferred Position Qualifications:

Education :

  • Bachelor's Degree in Nursing or Master's Degree in related field


  • 3 years of experience in utilization management or case management

Licenses and Certifications:

  • Certification in Case Management (CCM, ACM)

  • Specialty Certification in Oncology, Rehab, Pediatrics, Transplant or Wound Care

St. Joseph Health - Mission Heritage Medical Group is one of California's most respected medical groups. With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, Mission Heritage Medical Group has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.St. Joseph Health - Mission Heritage Medical Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Mission Heritage Medical Group complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Company: Heritage Healthcare

Category: Case Management

Req ID: R321875