Lead RN Case Manager – Intensive Case Management, Hybrid/Remote

MedicalVirtual; Los Angeles (CA); Remote; USD 151,000 - 199,000; Full time

Job summary

MedicalVirtual in Los Angeles, CA seeks an ICM Nurse Lead to guide the Intensive Case Management program with clinical leadership and care coordination oversight for high-risk patients.

The role focuses on applying ICM standards, reducing avoidable ED visits, and coordinating across nursing, social work, and physicians to ensure safe transitions of care.

Qualifications

• Bachelor’s degree in Nursing is required.
• 5+ years professional nursing experience.
• 3+ years in complex case management, care management, utilization management, population health, or related experience.
• 3+ years experience caring for medically complex/high-risk populations.
• 3+ years experience with interdisciplinary care coordination.
• 3+ years experience with hospital discharge planning and/or transitions of care.
• 3+ years experience in Managed Care Organization, Medical Group operations, Health Plan administration and workflows.

Responsibilities

• Provide day-to-day clinical guidance and case consultation within the Intensive Case Management program.
• Oversee care coordination oversight and workflow support for complex patients.
• Escalate clinical issues and support transitions of care.
• Collaborate with Nursing, Social Work, Patient Navigators, physicians, and other partners.
• Promote adherence to ICM standards and documentation requirements.
• Drive process improvements and staff development to enhance program performance.

Skills

Nursing leadership

Case management

Care coordination

Interdisciplinary collaboration

Discharge planning

Education

Bachelor’s degree in Nursing

Job description

Los Angeles, California, Description The ICM Nurse Lead serves as a seniornurse case managerclinical leader within the Intensive Case Management program and is responsible for providing day-to-day clinical guidance, case consultation, care coordination oversight, workflow support, and clinical escalation management for complex and high-risk patients. The ICM Nurse Lead supports the delivery of a high-touch, longitudinal, interdisciplinary case management model designed to improve patient outcomes, reduce avoidable emergency department visits and hospitalizations, facilitate safe transitions of care, address social determinants of health, and improve coordination across the healthcare continuum. The Nurse Lead serves as a critical bridge between ICM leadership, Nurse Case Managers, Social Workers, Patient Navigators/Care Coordinators, physicians, specialists, inpatient teams, SNFs, home health, behavioral health, and other community partners. The position promotes consistent application of ICM standards, evidence-based clinical practices, acuity stratification, outreach expectations, documentation standards, interdisciplinary collaboration, and transition-of-care processes. The position plays a critical role in facilitating timely access to care, reducing barriers across the continuum, and supporting effective care transitions through close collaboration with interdisciplinary teams, including Nursing, Social Work, and Utilization Management. This role drives operational excellence through process improvement, data-informed decision-making, and staff development, contributing to improved patient engagement, quality outcomes, and overall program performance. Salary Range: $ 150,858 – $198, 986 annual Qualifications Required: Bachelor’s degree in Nursing 5+ Years Professional nursing experience 3+ Years C omplex case management, care management, utilization management, population health, or related experience 3+ Years Demonstrated experience caring for medically complex/high-risk populations 3+ Years Experience with interdisciplinary care coordination 3+ Years Experience with hospital discharge planning and/or transitions of care. 3+ Years Experience in Managed care Organization, Medical Group operations, Health Plan administration and workflows. 3+ Years Ability to manage multiple patient related tasks. Preferred: CCM – Certified Case Manager