Remote Medical Case Manager – Transform Care Coordination

CalOptima Health; Town of Florida (NY); On-site; USD 91,000 - 145,000; Full time

Benefits offered by this job

Full Telework

Competitive compensation

Benefits package

CalPERS pension

Job summary

CalOptima Health is seeking a Medical Case Manager to coordinate intensive case management for members, assess needs, plan care, and collaborate with providers and LTSS partners. This role emphasizes advocacy, quality improvement, and effective documentation while supporting a flexible telework setup within California.

The position requires an ADN with 3+ years of clinical or managed care experience, CA RN licensure, and strong collaboration skills to coordinate with clinicians, community

Qualifications

• RN license to practice in CA or eligible
• Associate degree in nursing with 3+ years clinical/managed care experience
• Experience with care coordination and case planning
• Strong communication and collaboration with providers and families

Responsibilities

• Provide intensive case management including assessment, planning, coordination, monitoring and evaluation
• Facilitate communication among health care team and members
• Develop and implement SMART care plans
• Coordinate care with LTSS and community resources
• Advocate for funding and timely services
• Participate in Interdisciplinary Team meetings
• Document interventions per protocol

Skills

RN license

Case management

Communication

Bilingual (English + another language)

Education

Associate degree in nursing (ADN)

BSN (preferred)

Tools

Microsoft Office

Care coordination systems

Job description

CalOptima Health is seeking a Medical Case Manager to coordinate intensive case management for members, assess needs, plan care, and collaborate with providers and LTSS partners. This role emphasizes advocacy, quality improvement, and effective documentation while supporting a flexible telework setup within California.

The position requires an ADN with 3+ years of clinical or managed care experience, CA RN licensure, and strong collaboration skills to coordinate with clinicians, community