Manager, Case Management, RN

ManagerManagerFull TimeRemoteTeam 501-1,000Since 2013H1B No SponsorCompany SiteLinkedIn

Location

California

Posted

15 days ago

Salary

$113.3K - $170.0K / year

Associate Degree5 yrs expEnglish

Job Description

• Responsible for the health care management and coordination of care for members with complex and chronic care needs • Assures compliance with SNP program requirements as outlined in the Model of Care • Monitors activities to support the timeliness of Health Risk Assessment completion • Monitors and reports program performance, including vendor performance monitoring • Oversee audits, regulatory compliance, and quality assurance activities • Provide coaching, performance reviews, and staff development to support team success

Job Requirements

  • Minimum 5 years of clinical case management experience
  • Minimum 1 year of experience working with SNP programs in a health plan
  • California RN license required
  • Willing to obtain an RN license in all of our states markets
  • At least 2 years of supervisory or team lead experience in a managed care or health plan setting
  • Strong knowledge of CMS SNP Model of Care and Medicare Managed Care Plans
  • Experience with utilization review criteria (e.g., MCG guidelines)
  • Comfortable navigating EHR systems and healthcare technology platforms

Benefits

  • Health insurance
  • 401(k) matching
  • Flexible work hours
  • Paid time off
  • Remote work options

Related Job Pages

More Manager Jobs

Aero Gas Turbines Technical Manager

Switzerland Global Enterprise

We support Swiss SMEs in their international business and help innovative foreign companies to establish in Switzerland.

Manager15 days ago
Full TimeRemoteTeam 51-200Since 1927H1B No Sponsor

Technical Manager coordinating refurbishment works for Aero Gas Turbines

Texas
$114.1K - $190.2K / year
Full TimeRemoteTeam 10,001+H1B No Sponsor

Aero Gas Turbines Technical Manager managing refurbishment processes and team coordination

Texas
$114.1K - $190.2K / year

Special Projects Manager

Vocal Media

Helping do good in the world through social media.

Manager15 days ago
Full TimeRemoteTeam 11-50Since 2021H1B No Sponsor

Special Projects Manager handling social media strategies at Vocal Media

United States
$77K - $85K / year

Diligence Manager – Production Flow

Selene Finance LP

A full-service residential mortgage loan servicer with proven loss mitigation strategies to preserve homeownership

Manager15 days ago
Full TimeRemoteTeam 501-1,000Since 2007H1B Sponsor

Diligence Manager - Production Flow at Selene Holdings managing mortgage diligence services

Illinois + 2 moreAll locations: Illinois, Texas, Wisconsin