Care Coordination Manager - Remote Eligible

Community Health Plan of Imperial Valley; Sacramento (CA); Remote; USD 85,000 - 125,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Paid time off

401k with generous match

Job summary

Community Health Plan of Imperial Valley (CHPIV) is Imperial County's Medi-Cal managed care plan. We are seeking a skilled leader to guide the care coordination team, manage caseloads, and ensure regulatory compliance across all case management activities.

The ideal candidate will hold a California RN license, have 3+ years leading care coordinators, and strong knowledge of managed care. Remote options are available for CA residents, with a competitive salary and excellent benefits.

Qualifications

• Active California RN license without restrictions.
• Minimum 3 years leading care coordinators.
• 3+ years in management, case management, or care coordination in medical/behavioral health.
• Knowledge of managed care principles and practices.
• Clinical knowledge to assess whole-person care needs and develop care plans.
• Proficient in Outlook, Word, Excel and case management software.
• Experience collaborating with internal and external healthcare teams.

Responsibilities

• Provide direction and guidance to the care coordination team to ensure model-of-care implementation and regulatory compliance.
• Manage caseloads for the team considering medical or psychosocial complexity.
• Maintain electronic case management documentation compliant with HIPAA and standard processes.
• Complete trainings and implement required changes.
• Promote multidisciplinary collaboration and provider engagement to improve continuity of care for members.
• Audit case management assessments and care plan development for timeliness and completeness.
• Monitor TOC assessments and contact timelines per TOC protocols.
• Participate in internal and external audits (remote or onsite).
• Create business requirement docs, user training materials and related documentation.
• Assist with care coordination for appropriate resources and services for members.

Skills

Leadership

Care coordination

Critical thinking

Team collaboration

Communication

Education

California RN License

Tools

Outlook

Word

Excel

Case management software

Job description

Community Health Plan of Imperial Valley (CHPIV) is Imperial County's Medi-Cal managed care plan. We are seeking a skilled leader to guide the care coordination team, manage caseloads, and ensure regulatory compliance across all case management activities.

The ideal candidate will hold a California RN license, have 3+ years leading care coordinators, and strong knowledge of managed care. Remote options are available for CA residents, with a competitive salary and excellent benefits.