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Care Manager (Transitional Care Services) - Job Opportunity at CalOptima

Orange, United States
Full-time
Mid-level
Posted: March 2, 2025
Remote
USD 72,096 - 115,353 per year

Benefits

Comprehensive CalPERS retirement plan with employer contribution
Premium healthcare coverage including medical, dental, and vision
Flexible work scheduling with telework options
Robust wellness program with diverse activities
401(a) with 4% employer contribution
457(b) retirement plans with pre/post-tax options
Competitive paid time off package
Work-life balance initiatives

Key Responsibilities

Lead care transition management for high-risk patients post-discharge
Develop and implement personalized care plans using SMART methodology
Coordinate multi-stakeholder healthcare teams across facilities
Conduct comprehensive health needs assessments
Manage interdisciplinary care team communications
Facilitate access to behavioral health and support services
Direct quality improvement initiatives for transitional care
Execute care documentation and outcomes tracking

Requirements

Education

Bachelor's degree in social work, psychology, gerontology, public health or related field

Experience

2 years of clinical experience and/or managed care experience

Required Skills

Care coordination Health assessment Clinical documentation Project management Communication skills Problem-solving abilities Computer proficiency Team leadership

Certifications

Valid driver's license
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Sauge AI Market Intelligence

Industry Trends

Healthcare systems are increasingly focusing on transitional care management to reduce readmission rates and improve patient outcomes Growing emphasis on integrated care models combining physical and behavioral health services Rising demand for care managers with experience in both clinical and social determinants of health Increased adoption of telehealth and remote care management technologies

Salary Evaluation

The offered salary range is competitive for the Orange County market, aligning with industry standards for mid-level care management positions. The wide range ($72,096 - $115,353) allows for experience-based differentiation and career growth.

Role Significance

Typically operates within a care management team of 8-12 professionals, collaborating with multiple departmental teams
Mid-level position with significant autonomous decision-making authority and direct impact on patient outcomes and healthcare costs

Key Projects

Hospital discharge care coordination programs Emergency department utilization reduction initiatives Long-term care transition management Quality metric improvement projects Care plan development and implementation

Success Factors

Strong clinical assessment and care planning capabilities Excellent interpersonal skills for managing diverse stakeholder relationships Ability to navigate complex healthcare systems and regulations Cultural competency and experience with diverse populations Proficiency in care management technology and documentation systems

Market Demand

High demand position due to healthcare industry focus on reducing readmission rates and improving care transitions. The role combines clinical expertise with care coordination, making it increasingly valuable in modern healthcare delivery systems.

Important Skills

Critical Skills

Care transition management expertise critical for reducing readmissions and improving outcomes Cultural competency essential for serving diverse Orange County population Documentation and regulatory compliance knowledge vital for public agency operations

Beneficial Skills

Bilingual capabilities highly valued for serving diverse populations Experience with behavioral health integration increasingly important Knowledge of community resources and social services networks

Unique Aspects

Combination of clinical care management with public service mission
Strong focus on cultural competency and diverse population service
Comprehensive telework options unusual for healthcare sector
Robust public sector benefits package including CalPERS

Career Growth

Typical progression to senior role within 2-3 years, management positions possible within 4-5 years with demonstrated leadership capabilities

Potential Next Roles

Senior Care Manager Care Management Program Supervisor Clinical Operations Manager Population Health Manager Quality Improvement Director

Company Overview

CalOptima

CalOptima is Orange County's largest health insurer, serving approximately 25% of the county's population as a public agency

Leading position in managed Medi-Cal services with strong community presence and established provider networks
Dominant player in Orange County healthcare market with significant influence on local healthcare delivery systems
Public agency environment with strong emphasis on mission-driven service and work-life balance, offering stability and comprehensive benefits
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