RN Case Manager: Home & Community Care Coordinator

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

Job summary

Santa Clara Family Health Plan (SCFHP) is seeking an RN Case Manager in California to provide ongoing case management and member advocacy. You will coordinate among the care team to ensure goals and services are delivered in a compliant, cost-effective manner, developing individualized care plans across healthcare and social services.

The role requires an active California RN license, a minimum of three years in case management or related areas, and strong communication with diverse teams to

Qualifications

• Active California RN License without restriction.
• Minimum three years of experience in case management, discharge planning, or education or certifications, or equivalent experience.
• Bi-lingual: Spanish, Vietnamese, Chinese, or Tagalog (D).
• Knowledge of managed care principles and utilization management.

Responsibilities

• Conduct, review and document comprehensive clinical and psychosocial assessments and follow-up interventions.
• Maintain case files in compliance with policies and regulatory requirements.
• Coordinate care plans with PCP, specialists, Behavioral Health and LTSS providers.
• Facilitate transitions of care and communication among care team and members.

Skills

CA RN License

Case Management

Utilization Management

Tools

Outlook

Excel

Word

Job description

Santa Clara Family Health Plan (SCFHP) is seeking an RN Case Manager in California to provide ongoing case management and member advocacy. You will coordinate among the care team to ensure goals and services are delivered in a compliant, cost-effective manner, developing individualized care plans across healthcare and social services.

The role requires an active California RN license, a minimum of three years in case management or related areas, and strong communication with diverse teams to