RN Case Manager (Remote)

AMN Healthcare; Riverside (CA); Remote; Full time

Job summary

A leading healthcare organization is seeking a Remote RN Case Manager to conduct comprehensive assessments and develop service plans for participants in the Medicaid HCBS Waiver Program. This role involves ensuring compliance with regulatory standards, engaging with clients and providers, and maintaining documentation. The ideal candidate will have an active RN license and experience in case management. Join a dynamic team dedicated to improving participant care and service delivery.

Benefits

Medical, dental, and vision benefits

Earned time off and paid holidays

Paid continuing education

401(K) retirement plan

Short-term disability

Life insurance

Paid jury duty

Qualifications

• Minimum two years of experience in case management or community-based care.

Responsibilities

• Conduct Initial, Annual, and Re-Assessments for Medicaid HCBS Waiver Program.
• Develop and update Individualized Service Plans (ISPs).
• Ensure compliance with Medicaid HCBS Waiver Program standards.

Skills

Client Assessment

Care Planning

Compliance

Documentation

Communication

Education

Active California Registered Nurse (RN) license

Tools

Apricot

Job description

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Job Description & Requirements

RN Case Manager (Remote)

Start Date: 6/30/2025 | Pay Rate: $35.00 - $50.00

Position Summary

The RN Case Manager is responsible for conducting comprehensive Initial Assessments, Annual Assessments, Re-Assessments, and Monthly Summary Visits (MSVs) for participants in the Medicaid Home and Community-Based Services (HCBS) Waiver Program. This role ensures regulatory compliance, develops Individualized Service Plans (ISPs), and monitors participant care and service delivery.

Position Duties

• Client Assessment and Care Planning
• Conduct Initial, Annual, and Re-Assessments to determine the level of care and eligibility for waiver services.
• Develop and update Individualized Service Plans (ISPs) to align with participant needs and HCBS waiver requirements.
• Ensure that participants receive the required two waiver services per month, as mandated by CMS and DHCS.
• Monitoring and Documentation
• Perform Monthly Summary Visits (MSV) virtually or in-person, ensuring “eyes on the client.”
• Submit all assessment and visit documentation within 24–48 hours using agency software.
• Capture and upload facility conditions and relevant client-related images.
• Compliance & Quality Assurance
• Maintain compliance with Medicaid HCBS Waiver Program standards.
• Submit accurate and timely Unusual Incident Reports (UIRs) per DHCS guidelines.
• Participate in audits and corrective action plans as required.
• Participant and Provider Engagement
• Establish and maintain professional relationships with clients, caregivers, facilities, and medical providers.
• Identify and address service access issues, ensuring participants receive necessary care.
• Coordinate with facility caregiving supervisors or administrators to ensure compliance and service delivery.
• Maintain confidentiality and compliance with HIPAA regulations.
• Follow all agency policies on conduct, safety, and participant care.
• Be available for in-person visits if requested by the participant, even if a virtual visit was initially scheduled.

Minimum Required Qualifications

• Active California Registered Nurse (RN) license in good standing.
• Minimum two years of experience in case management or community-based care.

Preferred Qualifications

• Experience with HCBS waiver programs preferred.

Additional Details

Length of assignment: 12 months

Shift / Hours per week: Full-time (40 hours), flexible shifts

Systems: Apricot (Case Management Software)

Start Date: 6/30/2025

Facility Location

Riverside, California — a vibrant city known for its rich history, cultural presence, and quality of life, close to mountains and beaches.

Job Benefits

• Medical, dental, and vision benefits
• Earned time off and paid holidays
• Paid continuing education
• 401(K) retirement plan
• Short-term disability, life insurance, paid jury duty
• Access to extensive network of facilities and providers
• Workforce management team with industry experience
• Licensure and certification reimbursement