RN Care Manager: Complex Care & Transitions

CareMore Health; California City (CA); On-site; USD 54,000 - 97,000; Full time

Job summary

CareMore Health in California is seeking an experienced RN Clinical Case Manager to manage a caseload of patients with complex or chronic conditions, applying RN-level clinical judgment to assess needs and coordinate individualized care plans.

You will lead multidisciplinary care coordination, including physicians, specialists, social workers, and community resources, to implement plans and resolve barriers to care.

Responsibilities

• Conduct comprehensive clinical assessments for patients with complex medical, behavioral, and social needs, developing individualized care plans within RN scope of practice.
• Lead care coordination across multidisciplinary teams — including physicians, specialists, social workers, and community resources — to implement care plans and resolve barriers to care.
• Manage care transitions including hospital discharge planning, post-acute placement, and follow-up monitoring to reduce readmissions and ensure continuity.
• Apply clinical judgment to adjust care plans in response to changing patient conditions, escalating to physicians or supervising clinicians when appropriate.
• Collaborate with payers on utilization management activities, authorization requirements, and documentation to support value-based contract performance.
• Maintain accurate, timely case documentation and contribute to quality monitoring and reporting activities.

Job description

CareMore Health in California is seeking an experienced RN Clinical Case Manager to manage a caseload of patients with complex or chronic conditions, applying RN-level clinical judgment to assess needs and coordinate individualized care plans.

You will lead multidisciplinary care coordination, including physicians, specialists, social workers, and community resources, to implement plans and resolve barriers to care.