Care Management - Nurse, Senior (CA Children's Services)

Your Role 

The Children’s Services Program (CSP) team provides identification, referrals, and care management for all Medi-Cal members under years old and collaborates within Promise Clinical Team. The Case Management Nurse, Senior will report to the CSP Manager. In this role you will be Perform clinical review, assessment, evaluation of medical services for the organization using the established and approved Blue Shield Medical Policies and California Children’s Services (CCS), Early Intervention-Early Start (EIES), Developmental Disability Services (DDS), Children with Special Healthcare Needs (CSHCN), Early Periodic Screening Diagnostic Treatment (EPSDT) services Eligibility guideline which align with nationally recognized standards. Responsible for managing member needs for specific CCS/EIES/DDS/CSHCN/EPSDT and other clinical programs and care coordination. Responsible in assisting and working daily inventory, providing high-quality clinical reviews, perform...