Manager, Case Management – RN License Required

This is a fully remote position, open to applicants in California.

📋 Description

• Supervise the daily operations of a comprehensive care management team catering to Medicare Advantage SNP members.

• Ensure adherence to CMS Model of Care standards.

• Promote quality, efficiency, and outcomes centered around member needs.

• Guide, mentor, and cultivate a high-achieving case management team.

• Guarantee the prompt completion of Health Risk Assessments, Individualized Care Plans, and Interdisciplinary Care Team initiatives.

• Evaluate operational and quality performance indicators.

• Work collaboratively across departments with Utilization Management, HEDIS/STARS, Quality Improvement, Provider, and Clinical Operations teams.

⛳️ Requirements

• Possession of an active, unrestricted RN license in California.

• An Associate’s or Bachelor’s Degree in Nursing.

• A minimum of 5 years of experience in clinical case management.

• At least 1 year of experience working with SNP programs in a health plan setting.

• Willingness to pursue RN licensure in additional company markets, if necessary.

• Strong knowledge of the CMS SNP Model of Care.

• Familiarity with Medicare Advantage regulations.

• Expertise in care coordination and population health strategies.

🏝️ Benefits

• Flexible remote work options.

• Opportunity to lead and advance within a rapidly growing organization.

• Meaningful engagement in improving outcomes for high-risk Medicare populations.

• A collaborative, mission-focused culture emphasizing quality care and innovation.

• Capability to influence and enhance case management programs on a larger scale.

• Competitive salary and comprehensive benefits package.