Remote RN Case Manager – CA Health Plan

California Nursing Students Association Incorporated; Modesto (CA); Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical coverage

Wellness program

Dental & vision

PTO & holidays

CalPERS retirement

FSAs

Life & AD&D insurance

Disability insurance

Assistance program (EAP)

Health Advocacy

Voluntary benefits

Discount mall

Tuition reimbursement

Remote work eligibility

Mission-driven organization

Job summary

Health Plan of San Joaquin in California is hiring a Case Manager Nurse to join our team. This is a remote position; you must reside in California and coordinate care for enrolled members under general supervision, developing and evaluating care plans to ensure appropriate services.

The role requires strong clinical skills, utilization management, discharge planning, and the ability to work independently while collaborating with PCPs, families, and internal teams.

Qualifications

• RN with California license required.
• 3+ years clinical RN experience.
• 3+ years case management or discharge planning.
• Managed care experience (Medi-Cal/Medicare) preferred.
• Certified Case Manager designation preferred.

Responsibilities

• Assess care needs and educate members.
• Develop complex care plans with member and PCP.
• Collaborate with member, family, and resources to ensure plan adherence.
• Escalate high-risk issues to Medical Director; approve/deny services as directed.

Skills

RN Case Management

Utilization Management

Discharge Planning

Care Coordination

Assessment & Education

Data Entry

English Proficiency

Education

Graduation from accredited nursing school

California RN license

Job description

Health Plan of San Joaquin in California is hiring a Case Manager Nurse to join our team. This is a remote position; you must reside in California and coordinate care for enrolled members under general supervision, developing and evaluating care plans to ensure appropriate services.

The role requires strong clinical skills, utilization management, discharge planning, and the ability to work independently while collaborating with PCPs, families, and internal teams.