RN Case Manager
New
O
Optima Medical Management GroupHealthcare
Remote, 8:30 a.m.–5:00 p.m. PSTFull-TimeMiddle
Salary90,000 - 110,000 USD per year
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Job Details
- Languages
- Spanish (preferred)
- Experience
- Minimum 2 years of experience as a Registered Nurse.
- Required Skills
- MS OfficeEHR
Requirements
- Active California RN license in good standing (required regardless of physical location).
- Minimum 2 years of experience as a Registered Nurse.
- Strong understanding of Medi-Cal, care coordination, and social determinants of health.
- Excellent analytical, clinical judgment, interpersonal, and communication skills.
- Proficiency in MS Office (Excel, Word, Outlook).
- Experience with electronic health record (EHR) systems.
- Reliable high-speed internet and private, HIPAA-compliant home workspace.
- Ability to consistently work 8:30 a.m.–5:00 p.m. PST.
- Bachelor’s or Associate degree in Nursing (preferred).
- Bilingual in Spanish (preferred).
- Certified Case Manager (CCM) or equivalent (preferred).
- Experience in Managed Care, Community Health, or Behavioral Health (preferred).
Responsibilities
- Serve as the RN of record for a cohort of approximately 500 ECM members, maintaining full responsibility for documentation accuracy.
- Partner with Lead Care Managers, MAs, and Community Health Workers in an interdisciplinary pod.
- Review and provide clinical sign-off for individualized care plans, assessments, and clinical notes.
- Collaborate across the healthcare continuum with PCPs, specialists, hospitals, and community agencies to integrate care.
- Monitor member progress, adjust care plans, and facilitate safe care transitions and discharge planning.
- Analyze utilization patterns and quality performance reports to identify care gaps and reduce avoidable hospital/ED visits.
- Participate in team training on quality improvement, safety, and case management best practices.
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