Remote RN Case Manager – Care Coordinator

Anacalifornia; Modesto (CA); Remote; USD 90,000 - 115,000; Full time

Benefits offered by this job

Robust medical coverage (HMO/PPO)

Dental and vision plan

Generous paid time off

CalPERS retirement pension program

Volunteer flexible benefits

Remote work contingent on guidelines

Job summary

Health Plan of San Joaquin is hiring a Case Manager Nurse for a remote role requiring CA residency. You will assess member needs, develop and monitor care plans, and collaborate with members, families, and PCPs to ensure appropriate care levels. Strong clinical and case management skills are essential.

The role emphasizes utilization management, discharge planning, and accurate documentation in HPSJ systems, with emphasis on independent judgment under supervision. California RN license required.

Qualifications

• Graduation from an accredited nursing school.
• At least three years' clinical RN experience in hospital/clinic.
• At least three years in case management, utilization management, or discharge planning.
• Unrestricted California RN license.

Responsibilities

• Assess and evaluate members' care needs.
• Educate members on HPSJ services and case management process.
• Develop complex care plans with member and PCP.
• Collaborate with member, family, and resources to ensure plan compliance.
• Escalate high-risk medical issues to Medical Director for review.
• Monitor and evaluate progress; apply interventions.
• Document activities in HPSJ systems; produce routine reports.
• Review care plans developed by LVN Case Managers and Entry Level Case Managers.

Skills

Clinical skills

Case management

Utilization management

Discharge planning

Communication skills

Time management

Teamwork

Data interpretation

English proficiency

MS Word/Excel

Education

RN license

Bachelor of Science in Nursing

Tools

Word

Excel

Job description

Health Plan of San Joaquin is hiring a Case Manager Nurse for a remote role requiring CA residency. You will assess member needs, develop and monitor care plans, and collaborate with members, families, and PCPs to ensure appropriate care levels. Strong clinical and case management skills are essential.

The role emphasizes utilization management, discharge planning, and accurate documentation in HPSJ systems, with emphasis on independent judgment under supervision. California RN license required.