RN Case Manager: Care Coordination & Community Support

Santa Clara Family Health Plan; San Jose (CA); On-site; USD 114,000 - 176,000; Full time

Job summary

The RN Case Manager at Santa Clara Family Health Plan provides ongoing case management for SCFHP members, coordinating medical and psychosocial services to achieve member goals and optimize outcomes.

Responsibilities include comprehensive assessments, individualized care planning, and collaboration with PCPs, specialists, and community partners to ensure effective care transitions and benefit coordination.

Qualifications

• Active California RN License without restriction.
• Minimum three years of experience in case management, discharge planning, or education.
• Knowledge of managed care principles and Utilization Management.
• Bi-lingual skills in Spanish, Vietnamese, Chinese or Tagalog.
• Ability to work within an interdisciplinary team.

Responsibilities

• Conduct comprehensive clinical and psychosocial assessments and follow-ups to measure progress toward goals.
• Maintain case files in compliance with SCFHP policies and regulatory requirements.
• Coordinate member care with PCPs, specialists, behavioral health, and LTSS providers.
• Facilitate development and implementation of member-specific care plans and goals.
• Communicate with interdisciplinary teams to ensure care plan development and coordination of benefits.

Skills

RN license

Case management

Communication skills

Bilingual (Spanish)

Team collaboration

Computer skills

Education

Registered Nurse (RN) license in California

Tools

Outlook

Word

Excel

Case management software

Job description

The RN Case Manager at Santa Clara Family Health Plan provides ongoing case management for SCFHP members, coordinating medical and psychosocial services to achieve member goals and optimize outcomes.

Responsibilities include comprehensive assessments, individualized care planning, and collaboration with PCPs, specialists, and community partners to ensure effective care transitions and benefit coordination.