Remote RN Case Manager – Care Plans & Advocacy

Anacalifornia; California; Remote; USD 95,000 - 125,000; Full time

Benefits offered by this job

Health Insurance

Wellness Program

Dental & Vision

PTO and Holidays

Retirement Plan

FSAs

Life Insurance

Disability Insurance

Tuition Reimbursement

Remote Work

Job summary

Health Plan of San Joaquin is seeking a Case Manager Nurse for a remote position. Candidate must reside in California and have a valid California RN license with 3+ years of RN and case management experience.

You will conduct case management, develop care plans, and coordinate care with PCPs and families. The role requires strong clinical judgment, data documentation, and collaboration with internal/external resources to ensure quality care and adherence to regulations.

Qualifications

• Graduation from an accredited nursing school.
• At least three years clinical experience as an RN.
• At least three years performing case management, utilization management or discharge planning.
• Unrestricted California Registered Nurse license.

Responsibilities

• Assesses and evaluates members care needs.
• Educates member on HPSJ services and the case management process.
• Develops complex care plans in partnership with member and member's PCP.
• Collaborates with member, family, and resources to ensure understanding and compliance with care plans.
• Escalates high risk medical issues to Medical Director for review; approves or denies services as directed.
• Monitors and evaluates progress at appropriate intervals; conducts appropriate interventions.
• Documents activities in appropriate HPSJ system(s) according to standards.
• Tracks data as required; compiles data for, produces and submits routine reports.
• Reviews care plans developed by LVN Case Managers and Entry Level Case Managers.

Skills

RN Case Management

Communication Skills

English Proficiency

Time Management

Data Entry

Education

Nursing degree (RN)

Tools

Word

Excel

EHR Systems

Job description

Health Plan of San Joaquin is seeking a Case Manager Nurse for a remote position. Candidate must reside in California and have a valid California RN license with 3+ years of RN and case management experience.

You will conduct case management, develop care plans, and coordinate care with PCPs and families. The role requires strong clinical judgment, data documentation, and collaboration with internal/external resources to ensure quality care and adherence to regulations.