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RN Care Navigator - Capitation (San Diego, CA) FULL-TIME, Days

San Diego, California
Job ID 3200 Date posted 10/18/2019 Schedule Temporary Shift Day Hours Full-Time Department Nursing; Managed Care Operations


Care Navigators function as proactive care coordinators for patients to ensure appropriate, efficient and timely health care service and promote health and preventive care. Care Navigators provide coaching to empower patients and families to be partners in care and take control of their own health care needs. The Care Navigator, under the guidelines of the managed care department (Capitation Services), works closely with the primary and specialty medical home providers and all other providers of services for the patient including community agencies, insurers, school systems, and others supporting the patient's healthcare needs. Care Navigation includes the whole child, encompassing dental, vision, behavioral health, medical and surgical care needs. The Care Navigator is the first line advocate for the patient and family and collaborates with the health care team to anticipate needs, coordinate effective care plans, and educate the patient and family in a manner that attends to the patient's medical, developmental, and social needs. This position works exclusively with patients who are part of an insurance company which is contractually capitated (i.e. prepaid for medical services) with RCHSD.


Bachelor's Degree

Area of study in a field related to the position

3 years of experience

California RN License

Competent in utilization of computers, various computer programs for data entry and retrieval; ability to run basic reports in various computer systems

Experience with complex and chronic care patients

Knowledge of or experience in obtaining services for patients (durable medical equipment, appointments, medications, and others)

Knowledge of community resources for healthcare (includes behavior health)

Knowledge of requirements and regulations surrounding healthcare management

Valid CA Driver's License


4 years of experience

Utilization review, case management, discharge planning experience

Bilingual English/Spanish


Schedule: Day, 8 hour

FTE: 1.0FTE/Full-time, Benefits Eligible

Location: Copley Building (San Diego, CA)

This is a Casual position with an anticipated end date of June 30, 2021, contract subject to renewal upon completion



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