Telephonic Case Manager

Solvo Global Careers; Philippines; Hybrid; PHP 4,397,000 - 6,281,000; Full time

Job summary

Solvo Global Careers is seeking a dedicated Telephonic Case Manager with an active California RN license to join our Clinical Operations team. This full-time role focuses on coordinating patient care, conducting assessments, and developing care plans through telephonic outreach.

You will collaborate with physicians, specialists, and health plans to improve outcomes while ensuring HIPAA compliance. The position offers remote/hybrid work from a US-based environment with strong nursing,

Qualifications

• Active and unrestricted RN license issued by California BRN.
• Minimum of 1 year of clinical nursing experience in case management or related setting.
• Experience conducting telephonic patient assessments and care coordination.
• Proficiency with EMR and Microsoft Office.
• Excellent verbal and written communication; ability to work remotely.

Responsibilities

• Conduct comprehensive telephonic assessments of medical, psychosocial, and healthcare needs.
• Develop and monitor individualized care plans based on clinical evaluations.
• Coordinate services among physicians, hospitals, and community resources.
• Educate patients on diagnoses, treatment plans, and medication adherence.
• Identify barriers to care and boost patient engagement and compliance.
• Monitor progress and adjust interventions as needed.
• Maintain compliant documentation in EMR and case management systems.
• Collaborate with multidisciplinary teams to ensure quality care.
• Ensure HIPAA and regulatory compliance and cost-effective care.

Skills

RN license (CA)

Clinical nursing experience

Telephonic assessments

EMR proficiency

Microsoft Office

Communication skills

Remote work capability

Job description

Position Title: Telephonic Case Manager (Active California RN License Required)

Location: Remote / Hybrid (U.S.-Based)

Department: Clinical Operations / Case Management

Employment Type: Full-Time

Position Summary

We are seeking a dedicated and compassionate Telephonic Case Manager with an active California Registered Nurse (RN) license issued by the California Board of Registered Nursing (California BRN). The Telephonic Case Manager will be responsible for coordinating patient care, conducting comprehensive assessments, developing care plans, and providing ongoing case management support through telephonic outreach.

The ideal candidate will possess strong clinical knowledge, excellent communication skills, and the ability to collaborate effectively with patients, healthcare providers, and interdisciplinary teams to improve health outcomes while ensuring compliance with applicable healthcare regulations and organizational standards.

Key Responsibilities

• Conduct comprehensive telephonic assessments to evaluate patients' medical, psychosocial, and healthcare needs.
• Develop, implement, and monitor individualized care plans based on clinical evaluations and established guidelines.
• Coordinate healthcare services among physicians, specialists, hospitals, rehabilitation facilities, and community resources.
• Provide patient education regarding diagnoses, treatment plans, medication adherence, preventive care, and available benefits.
• Identify barriers to care and implement strategies to improve patient engagement and treatment compliance.
• Monitor patient progress and adjust case management interventions as needed.
• Perform utilization review and resource coordination when applicable.
• Maintain accurate, timely, and compliant documentation in electronic medical records and case management systems.
• Collaborate with multidisciplinary teams to ensure quality care and achievement of clinical goals.
• Support cost-effective healthcare delivery while maintaining high standards of patient care.
• Ensure compliance with HIPAA, state and federal regulations, and company policies.

Required Qualifications

• Active and unrestricted Registered Nurse (RN) license issued by the California Board of Registered Nursing (California BRN).
• Minimum of 1 years of clinical nursing experience in case management, utilization management, disease management, workers' compensation, managed care, home health, or a related healthcare setting.
• Experience conducting telephonic patient assessments and care coordination.
• Strong knowledge of healthcare regulations, clinical guidelines, and care management principles.
• Proficiency with electronic medical records (EMR) and Microsoft Office applications.
• Excellent verbal and written communication skills.
• Ability to work independently in a remote environment while managing multiple priorities.

Preferred Qualifications

• Experience with Medicare, Medicaid, Managed Care, or Workers' Compensation populations.
• Previous experience in telehealth or remote case management environments.