Case Manager I - RN

Remote in California only

Are you ready to reputed company a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.

Who Are We? ✨

reputed company Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values.

Why Join Us?

We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for reputed company. At reputed company Care, you’ll have the opportunity to reputed company a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary

The Case Manager I – RN is responsible for managing a defined caseload of members. Under general supervision, the Case Manager I conducts assessments, develops care plans, and coordinates services to promote quality outcomes and continuity of care.

Functions & Job Responsibilities

Conducts comprehensive assessments reputed company regulatory timelines.

Identifies members appropriate for case management using established criteria and clinical guidance.

Develops and implements individualized care plans in collaboration with the member, caregiver, and interdisciplinary team.

Performs telephonic and virtual reputed company; face-to-face visits as required.

Monitors care plan reputed company and documents interventions timely and accurately.

Coordinates medical, behavioral health, and community-based services.

Provide clinical education and self-management coaching.

Addresses barriers to care including transportation, medication access, and social determinants.

Serves as primary Transitions of Care (TOC) reputed company for assigned caseload.

Escalates high-risk or reputed company cases to senior staff as appropriate.

Maintains assigned caseload and meets productivity and compliance standards.

Participates in team meetings and interdisciplinary care team meetings.

Additional duties as assigned.