California RN Case Management Manager

Job Summary

To support a growing team dedicated to improving member outcomes, the full-time Remote California RN Case Management Manager will oversee the health care management and coordination of care for members with complex and chronic needs while ensuring compliance with regulatory standards and driving operational excellence.

Key Responsibilities

• Lead, coach, and develop a high-performing case management team serving SNP members
• Ensure timely completion of Health Risk Assessments, Individualized Care Plans, and Interdisciplinary Care Team activities
• Monitor operational and quality performance metrics, implementing improvement strategies as needed

Required Qualifications

• Active, unrestricted California RN license
• Associate's or Bachelor's Degree in Nursing
• Minimum 5 years of clinical case management experience
• Minimum 1 year of experience supporting SNP programs within a health plan environment
• Strong understanding of CMS SNP Model of Care and Medicare Advantage regulations