California Licensed Case Manager Nurse

Job Summary

To support a growing healthcare team, the remote California Licensed Case Manager Nurse will conduct case management activities, develop and implement care plans, and collaborate with members and healthcare providers to ensure appropriate care delivery.

Key responsibilities

• Assess and evaluate members' care needs while educating them on services and the case management process
• Develop complex care plans in partnership with members and their primary care providers, ensuring compliance with regulatory requirements
• Monitor and evaluate progress, conduct interventions, and document activities in accordance with standards

Required qualifications

• Graduation from an accredited nursing school with an unrestricted California Registered Nurse license
• At least three years of clinical experience as an RN in a hospital or clinic
• Minimum of three years performing case management, utilization management, or discharge planning
• In-depth knowledge of managed care principles and government-sponsored programs as they apply to case management
• Strong clinical skills and the ability to interpret and apply complex clinical information