California Licensed Case Manager RN

Job Summary

Seeking a part-time California Licensed Case Manager RN, this role will provide telephonic case management to ensure high-quality, cost-effective healthcare for health insurance plan participants while working remotely.

Key responsibilities

• Conduct thorough assessments of patients' physical, psychosocial, and financial needs
• Develop and monitor treatment plans in collaboration with patients, caregivers, and healthcare providers
• Advocate for patients by facilitating quality care delivery and reducing overall costs

Required qualifications

• Graduation from an accredited Registered Nursing (RN) program
• Current California RN license; multi-state license preferred
• Minimum of five years of medical/surgical or acute care experience, including two years in case management
• Prior experience in emergency room, critical care, or relevant clinical settings
• Knowledge of medical claims and ICD-10, CPT, HCPCS coding