Nurse, Individualized Care Nurse Care Manager

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

📋 Description

• Coordinate medical treatments, provide patient education, and establish support systems to ensure continuity of care.

• Develop, implement, monitor, and evaluate clinical care and care-management services.

• Ensure adherence to federal, state, and regulatory requirements, including proper documentation and record-keeping.

• Accurately and promptly document patient encounters and activities in the designated system.

• Participate in interdisciplinary case conferences and team huddles.

• Identify patients for case management and assess, modify, coordinate, and intervene in their care.

• Analyze clinical pathway trends and share insights with service and management teams.

• Support quality-improvement initiatives by identifying trends, barriers, and opportunities.

• Obtain member consent for Care Management enrollment and outreach efforts.

• Manage patient care through telephone interactions, reviewing medical, functional, and psychosocial needs.

• Conduct medication reconciliation and assess adherence.

• Reinforce education on disease self-management and symptom management.

• Communicate oncology provider instructions and supply educational materials to patients.

• Coordinate referrals to community services, as well as appointments, tests, treatments, and procedures.

• Facilitate follow-up visits for acute or chronic medical needs.

• Document concerns and follow up, escalating issues appropriately to clinical teams or oncology providers.

• Provide coaching and health promotion to foster self-management and adherence.

• Manage a caseload of 100–150 members.

• Order patient supplies, such as blood pressure monitors and remote monitoring equipment.

• Track and report member progress, escalating complex cases as necessary.

• Conduct outreach to members involved in Transitional Care Management.

• Assist with discharge planning, medication reconciliation, and post-acute follow-up appointments.

• Assess patient needs and determine the appropriate action, including scheduling appointments, provider triage, or emergency-room referrals.

• Connect onsite clinical teams with community resources during care transitions.

• Meet regularly with management to discuss call monitoring, quality reviews, productivity, and quality objectives.

• Attend relevant meetings, seminars, and conferences as needed.

⛳️ Requirements

• Must be a Registered Nurse with a current, unrestricted California license.

• 5 years of experience in a hospital or clinical setting, particularly with patients having complex chronic disease states, is preferred.

• Experience in Care Management is strongly preferred.

• Previous experience with oncology patients is highly preferred.

• Proficient in Microsoft Office products.

• Basic computer skills, including familiarity with electronic health records (EHR) and Excel spreadsheets.

• Exceptional verbal and written communication abilities.

• Capacity to work collaboratively and maintain a team-oriented focus.

• Strong organizational skills.

• Excellent presentation, communication, multitasking, and time management skills.

• Ability to identify problems and propose effective solutions.

• Capability to work independently with minimal supervision.

• Commitment to enhancing health equity and supporting vulnerable populations.

• Must adhere to HIPAA guidelines.

• Must have a dedicated, quiet, and private remote work environment free from distractions.

• High-speed broadband internet connection that meets specified speed, ping, and hardwired requirements.

• Availability to work Monday to Friday, from 8:30 AM to 5:00 PM PST.

• Mandatory attendance for new-hire training from 8:00 AM to 5:00 PM CST.

• Bilingual skills are considered a plus.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off plan.

• Health savings account (HSA).

• 401k savings plan.

• Access to wages before payday through myFlexPay.

• Flexible spending accounts (FSAs).

• Short- and long-term disability coverage.

• Work-Life resources.

• Paid parental leave.

• Healthy lifestyle programs.

• Employer-provided computer, technology, and equipment.

• Full-time remote work opportunity.

• Mandatory training conducted during paid employment hours.