Case Manager Nurse Salary in San Diego, CA

About UsIntegrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees' professional development. Large company perks...Small company feel!We are now seeking a Medical Review Manager to join our team. This is a contingent position.RequirementsMinimum three (3) years' experience practicing nursing as a licensed Registered NurseMinimum of three (3) years' experience of supervisory/managerial experience in the health insurance industryBachelor's degree in Nursing is required. Registered Nurse LicensureCertified Professional Coder (CPC) Certification or the ability to obtain this certification or similar coding certification within 12 months of appointment

Overview of the Role: The Alignment Jump Start Assessment (JSA) program is a physician-led and advanced practice clinician-driven program that is intended to care for and support Alignment Healthcare patients with complex and chronic care needs. As a JSA Advanced Practice Clinician (APC), you will work within an interdisciplinary team environment that includes physicians, nurse practitioners, physician assistants, case managers, and other health care team members to ensure proper delivery of clinical and home-based patient care. In this role, you will assess, develop, and coordinate options and services promoting quality care in order to achieve optimal health care outcomes while also ensuring cost-effective care complying with Alignment policy and all state and federal regulations. Our members are typically aged 65 and over and home and virtual visits will be between 45 and 60 minutes depending on whether it is an annual or initial visit.We offer a great total package that includes competitive base salary, annual bonus, stock options, CME, 401k and more! Responsibilities: Conduct in-home assessments (with some outpatient clinical work) on health plan members. In-Home Assessments will include obtaining comprehensive history, physical exam, medication review, and appropriate cognitive/depression/safety screenings. Comfort with End-of-life care discussions imperative. Laboratory specimen collection in the home setting when appropriate. Identify diagnoses to be used in active medical management and care management of patients with focus on chronic disease management. Communicate findings of the patient assessment to inform the PCP of potential gaps in care. Provide patient/family/caretaker education, with an emphasis on close monitoring and follow up of patient needs. Emphasis on knowledge of appropriate community resources for referral. Comply with all HIPAA regulations and maintain security of protected health information (PHI). Required Skills and Experience: Master's degree from an accredited NP Program or PA program Preferred one (1) year of prior clinical or home care experience Previous EMR experience preferred Active California state Nurse Practitioner or Physician Assistant license Active RN License and Furnishing number (Must, upon hire) NP only Active Nurse Practitioner Board Certification/Physician Assistant Certification NPI Number, DEA, Valid BLS Valid California driver license and current automobile insurance Experience in care of older adult (geriatric) patients preferred Excellent administrative, organizational, and communication skills required PAY RANGE: $105,500 - $157,000 annually.

Responsible for retention of existing business and the development of business within those assigned accounts. Client Service Executive associates act as a leader for the Client Service Team members to include Benefit Analysts and Client Managers.Essential Duties & ResponsibilitiesOversee ongoing client service activities.Meet with the client throughout the year to ensure a high level of service and that client expectations are being met.Responsible for meeting business retention goals.Participate in development of new business with existing clients by rounding out programs with additional and/or increased lines of coverage.Develop strong business relationships and client trust.Ensure client compliance with annual Form 5500 filing procedures as applicable.Advise Client Service Team, if needed, in resolving routine client concerns. Investigate any reoccurring and non-routine client and carrier concerns and bring to a successful resolution.Manage the renewal of existing plans.Coordinate coverage placement through instructions provided to Client Service Team.Provide direction to Client Service Team in the preparation of employee communication materials.Advise, inform and involve Client Sales Executive as required in marketing process.Prepare and present renewal outcomes to the client in a timely manner.Recommend improvements based on changing employee benefit legislation, suggest strategies to address client concerns, and provide resolutions if discrepancies, errors or inconsistencies are contained within the information.Conduct employee meetings to communicate benefit options as needed.Responsible for reviewing contracts, plan documents, Summary Plan Descriptions and other legal documents for accuracy and ensuring all material is sent to client in a timely manner.Act as a leader for Client Service Team members.Create an environment oriented to trust, open communication, and cohesive team effort.Facilitate problem solving and collaboration when faced with client difficulties.Focus the team on client requirements, familiarizing them with client specifications, work procedures and processes, quality standards, techniques and tools to support performance.Provide necessary business information to enhance the team's professional development.Ensure deliverables satisfy client requirements, cost and schedule.Work closely with Director of Employee Health & Benefits Division, Benefits Service Manager and Director of Operations to obtain necessary resources to support the team's requirements, discuss project impediments, and to escalate issues which cannot be resolved by the team.Prepare quarterly production and activity reports.Ensure good file maintenance with documentation of account issues and maintenance of the Agency Management System.Establish and consistently maintain effective and positive working relationships with Associates and clients.Education and/or ExperienceA minimum of seven to ten years' experience servicing large client group (50+ lives) health and benefit products.Bachelor degree strongly preferred.Professional history must show increasing levels responsibility directly related to the performance of the above duties.Strong familiarity with the Employee Health & Benefits marketplace to include unique business industry needs, educational and professional development associations, carriers, and other broker agencies.Current technical knowledge and understanding of Employee Benefit federal and state legislation.Ability to make independent decisions and use good judgment in addressing and servicing client needs.Strong communication skills with the ability to provide non-technical explanations to technical matters, and summarize and present information in a clear, concise and accurate written and verbal format.Maintain a valid unrestricted Life and Disability License in California and meet the continuing education requirements. If involved in the sale of Long Term Care, the individual must maintain the proper certification through continuing education.Maintain a valid California driver's license and dependable transportation.Must have knowledge of personal computing with the ability and willingness to learn and use all computer programs as required.Work Environment & Physical DemandsAbility to use computer keyboard and sit in a stationary position for extended periods as well as the use of office equipment such as fax and copy machines, and telephones. Work is performed in a typical interior/office work environment.Travel to client sites is required. Usually travel is within driving distance, but may occasionally consist of 2 - 5 night stay out of townExtended work hours (10 - 12 hrs/day) required on occasion to attend and participate in networking and industry functions that begin before the workday, and may extend into the evening.The applicable base salary range for this role is $81,300 to $173,300. The base pay offered will be determined on factors such as experience, skills, training, location, certifications, and education. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives. We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. Marsh & McLennan Agency offers competitive salaries and comprehensive benefits and programs including: health and welfare, tuition assistance, 401K, employee assistance program, domestic partnership benefits, career mobility, employee network groups, volunteer opportunities, and other programs. For more information about our company, please visit us at: http://marshmma.com/careers.#LI-DNI#MMAEHB

The Client Manager provides advice and assistance requiring technical and industry knowledge and client service skills to meet client needs and resolve difficulties. Client Managers may occasionally perform in the capacity of a Client Executive Service for specifically assigned accounts to oversee the preparation of and providing renewal and new business presentations.Essential Duties & ResponsibilitiesAct as the initial point of contact for Clients, Carriers and others on the Client Service Team in the following areas:RFP review and preparation.Analysis of utilization reports, carrier reports and claims data and trends.COBRA, HIPAA and coordination of 5500 data.Work closely with and instruct carrier representatives to ensure smooth implementation of new plans.Ensure required plan information and materials are sent to the client in a timely manner.Guide and mentor Benefit Analysts throughout the process of gathering Client census and benefit plan information used to prepare materials for new business presentations, renewals and open enrollment meetings.Explain client needs and concerns focusing on how various plan designs and recommendations address those issues.Review renewals, new business presentations, and open enrollment materials to ensure they are accurate and complete in content, are compliant with company and regulatory guidelines, and reflect a professional appearance.Ensure that client files and documentation are maintained according to policy and procedures, and consistent with Marsh & McLennan professional standards.Develop analytical, customer service and communication skills needed to perform as a Client Manager II.Present to Client Service or Sales Executive the financial measures used to predict and analyze plan benefit costs, and the factors which influence those costs and premium rates.Under the guidance of the Client Executive Service, participate in prospect and renewal meetings to learn client needs, challenges and concerns.Learn best practices to present renewal outcomes to the client and provide recommendations based on the findings with the ultimate goal being to take on these responsibilities.Conduct employee open enrollment meetings to communicate benefit options.Respond to and resolve routine issues the client may encounter regarding receipt of benefit services and coverage questions.Keep Client Executive Service apprised of potential E&O concerns and client dissatisfaction. Strategize with Client Executive Service to develop possible resolutions and proactive solutions to avoid continued or future problems.Education and/or ExperienceMust possess a strong understanding of health and welfare plan benefits and carriers such that this expertise is recognized by colleagues and clients. This level of expertise is generally acquired through 5 years' experience providing group health and benefits sales or service while at a brokerage or carrier.Bachelor degree strongly preferred.Strong communication skills with the ability to provide non-technical explanations to technical matters, and summarize and present information in a clear, concise and accurate written and verbal format.Strong knowledge of employee health insurance carriers, their strengths and weaknesses, plan design features as well as the general factors which affect cost and plan design.Maintain a valid unrestricted Life and Disability License in California and meet the continuing education requirements.Maintain a valid driver's license and dependable transportation.Proficiency with Microsoft Word, Excel and PowerPoint to include work experience creating tables, charts, graphs, pivot tables and formulas.Work Environment & Physical DemandsAbility to use computer keyboard and sit in a stationary position for extended periods as well as use of office equipment such as fax and copy machines, and telephones. Work is performed in a typical interior/office work environment.Travel to client sites is required. Usually within driving distance, but occasionally consists of 2 - 5 night stay out of town.The applicable base salary range for this role is $60,000 to $128,000. The base pay offered will be determined on factors such as experience, skills, training, location, certifications, and education. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives. We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. Marsh & McLennan Agency offers competitive salaries and comprehensive benefits and programs including: health and welfare, tuition assistance, 401K, employee assistance program, domestic partnership benefits, career mobility, employee network groups, volunteer opportunities, and other programs. For more information about our company, please visit us at: http://marshmma.com/careers.#LI-DNI#MMAEHB

Careers that Change Lives Bring your talents to an industry leader in medical technology and healthcare solutions - we're a market leader and growing every day. You can be proud to sell medical technologies that are rooted in our long history of mission-driven innovation. Our expanding portfolio delivers measurable clinical and economic value - and opens doors. You will be empowered to shape your own career. We support your growth with the training, mentorship, and guidance you need to own your future success. Together, we can transform healthcare.Join us for a career in sales that changes lives.The Ear, Nose, and Throat Operating Unit is a global leader and trusted partner for innovative ENT solutions that improve patient access, outcomes, and customer satisfaction. We partner with the ENT community to understand the needs of customers and patients, delivering solutions that improve lives as we embody a culture of accountability and trust. Over the past 20 years, we have become the global market leader in three key segments - image-guided surgery, intraoperative nerve monitoring, and powered surgical instruments. We continue to launch valuable ENT solutions in these areas as well as tissue health and balloon sinus dilation.Click here to learn more about products.The Market Development Representative is responsible for case support and selling activities. This role reports to the local district manager but has a dotted line to 1-3 area sales managers where accounts have multiple team members. The majority of time is spent maintaining established customer relationships and expanding utilization of current and adjacent products in the ENT portfolio.Responsibilities may include the following and other duties may be assigned. Responsible for developing, building, and strengthening long-term relationships with stakeholders including surgeons, nurses, administrators and key opinion leaders. Responsible for pursuing leads, assessing needs and providing product support and services to maximize the benefits derived from Medtronic's ENT products and/or services. Provides technical support during cases and informs the clinician of patient treatment options. Promotes education of the company's products and/or services. Conducts and/or evaluates market research including customers and competitors' activities. Develops and/or implements market development plans/strategies and changes as needed. Assesses customer needs and feedback regarding new products and/or modifications to existing products and communicates to internal stakeholders including R&D, Operations and Marketing. Establishes effective relationships and collaborates with other departments (Marketing, Finance, HR, Sales Training, etc.) to address key business issues and opportunities. The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position. We seek out and hire a diverse workforce at every level: We need fresh ideas and inclusive insights to continue to be an innovative industry leader -that's why we make it a point to seek out, attract and develop employees who are patient-centric, passionate, and who represent the same wide variety of life experiences as our patients.To learn more about Inclusion & Diversity at Medtronic Click Here Must Have: Minimum Requirements To be considered for this role, please ensure these minimum requirements are evident on your resume. A Bachelor's degree Nice to Have 2 Years of sales or clinical experience Operating Room Experience Relationships within the ENT space Preference will be given to local qualified candidates and candidates with Medtronic experience. About Medtronic Together, we can change healthcare worldwide. At Medtronic, we push the limits of what technology, therapies and services can do to help alleviate pain, restore health and extend life. We challenge ourselves and each other to make tomorrow better than yesterday. It is what makes this an exciting and rewarding place to be.We want to accelerate and advance our ability to create meaningful innovations - but we will only succeed with the right people on our team. Let's work together to address universal healthcare needs and improve patients' lives. Help us shape the future. Physical Job Requirements Required to function using healthcare universal precautions to minimize exposure to infectious disease and radiation. Ability to serve as the primary resource for scheduled and unscheduled clinical events, periodically required to work weekends, evenings and nights and may be required to engage in overnight travel within own district or neighboring districts. Ability to work efficiently and autonomously with little direction when outside of clinical events. Ability to attend national meetings, district meetings and other training as requested. Ability to wear a 7-9 lbs protective lead apron for extended periods of time in the operating room. Ability to lift up to 40 pounds. Ability to sitting, standing, and/or walking for 8+ hours per day. Ability to bend/stoop, squat and balance frequently. • Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus in relation to travel and operating a personal computer.Must have a valid driver's license and active vehicle insurance policy. In addition, your driving record will be reviewed and will be considered as part of your application. Must be able to drive approximately 50% of the time within assigned territory and may require overnight travel.The physical demands described within the Day in the Life section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create. We offer a wide range of benefits, resources, and competitive compensation plans designed to support you at every career and life stage. Learn more about our benefits here .In addition to Base Salary, this position is eligible for a Sales Incentive Plan (SIP), which provides the opportunity to earn significant incentive compensation for achieving or exceeding your goals. Learn more about total rewards here .The base salary range is applicable across the United States, excluding Puerto Rico and specific locations in California. The offered rate complies with federal and local regulations and may vary based on factors such as experience, certification/education, market conditions, and location. Compensation and benefits information pertains solely to candidates hired within the United States (local market compensation and benefits will apply for others).