California Licensed Complex Care RN

Job Summary

Managing the member journey for high-acuity Medicare Advantage patients, the full-time California Licensed Complex Care RN will coordinate care across disciplines, oversee transitions of care, and ensure timely clinical monitoring in a fully remote environment.

Key responsibilities

• Own the member journey and care coordination for medically complex, high-risk patients through consistent engagement and proactive monitoring
• Manage transitions of care and hospital discharge coordination, ensuring timely follow-up and medication reconciliation to reduce readmissions
• Complete medication reconciliations and clinical monitoring, escalating concerns and facilitating communication across the care team

Required qualifications

• Minimum 3 years of clinical RN experience in complex care, care management, or related clinical settings
• Experience managing high-risk patient populations, including chronic disease management and care transition coordination
• Prior experience in a Medicare Advantage or managed care environment with knowledge of HEDIS and care gap management
• Active, unrestricted Registered Nurse (RN) license in applicable state(s)
• Associate Degree in Nursing (ADN) with a Bachelor of Science in Nursing (BSN) strongly preferred