RN- Medical Case Manager

Aroha Technologies, Inc; Orange (CA); On-site; USD 90,820 - 145,312; Full time

Job summary

A leading healthcare provider in California seeks a Medical Case Manager to deliver comprehensive member-centered care. Responsibilities include conducting assessments, coordinating care, and developing individual care plans. Candidates must hold an Associate Degree in Nursing with 3+ years of experience, and be bilingual in English and Spanish. This role offers a full office work arrangement and competitive compensation ranging from approximately $90,820 to $145,312 annually.

Qualifications

• Minimum of 3 years of clinical and/or managed care experience.
• Bilingual in English and Spanish required.
• Current, unrestricted Registered Nurse (RN) license in California.

Responsibilities

• Conduct health needs and risk assessments.
• Coordinate follow-up provider care and ensure appointments.
• Develop and maintain individualized care plans.

Skills

Strong independent judgment and decision-making skills

Clear verbal and written communication skills

Ability to establish effective working relationships

Proficiency in Microsoft Office

Organizational and problem-solving skills

Ability to manage multiple priorities

Education

Associate Degree in Nursing (ADN)

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Microsoft PowerPoint

Job description

Job Details

Job Title: Medical Case Manager
Department: Case Management
Work Arrangement: Full Office
Work Schedule: Monday–Friday, 8:00 AM – 5:00 PM
Compensation Range: $90,820 – $145,312 annually (Approx. $43.66 – $69.86 per hour)

Position Summary

The Medical Case Manager is responsible for delivering comprehensive, member-centered care management services. This role includes clinical assessment, care coordination, post-discharge follow-up, and collaboration with interdisciplinary teams to ensure high-quality, culturally appropriate, and cost-effective care for members.

Duties & Responsibilities

• Care Management (85%)
  • Conduct standardized health needs and risk assessments for assigned members.
  • Perform comprehensive, disease-specific clinical assessments, including:
    • Physical, functional, social, and psychological status
    • Cultural and linguistic needs
    • Caregiver resources and available benefits
  • Complete post-hospital and post-emergency department discharge assessments.
  • Coordinate follow-up provider care and ensure scheduled appointments.
  • Arrange durable medical equipment, supplies, and community resources.
  • Develop, implement, and maintain individualized care plans with SMART goals.
  • Review and update care plans at least annually or upon change in condition.
  • Conduct follow-ups to monitor progress and address barriers to care.
  • Provide regular outreach to members in accordance with department contact standards.
  • Coordinate care with members, family members, providers, community agencies, and vendors.
  • Facilitate referrals to behavioral health, substance use disorder services, LTSS, and community supports.
  • Participate in interdisciplinary team meetings as applicable.
  • Escalate cases requiring leadership or medical director review and close cases timely per guidelines.
  • Advocate for members regarding funding, treatment alternatives, timelines, and coordination of care.
• Administrative Support (10%)
  • Support a mission-driven culture focused on quality, dignity, accountability, and customer service.
  • Collaborate with team members to achieve departmental goals.
  • Document all case interventions according to organizational protocols.
  • Maintain accurate and timely clinical documentation within care plans.
• Other Duties (5%)
  • Complete special projects and other duties as assigned.

Minimum Qualifications

• Associate Degree in Nursing (ADN) or related field required
• Minimum of 3 years of clinical and/or managed care experience (Equivalent education and experience may be considered)
• Bilingual in English and Spanish required

Preferred Qualifications

• Bachelor of Science in Nursing (BSN) or related field
• Case Management Certification (CCM)

Required Licensure

• Current, unrestricted Registered Nurse (RN) license in the State of California

Knowledge, Skills & Abilities

• Ability to establish effective working relationships with diverse stakeholders.
• Strong independent judgment and decision-making skills.
• Clear verbal and written communication skills.
• Ability to work flexible schedules, including evenings or weekends as needed.
• Strong organizational, analytical, and problem‑solving skills.
• Ability to manage multiple priorities in a fast‑paced environment.
• Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint) and job‑specific systems.

Physical Requirements

• Ability to read computer screens and printed materials.
• Clear verbal communication and adequate hearing for phone and in‑person interactions.
• Manual dexterity for typing, writing, standing, walking, bending, kneeling, and prolonged sitting.
• Ability to lift and move objects, patients, or equipment weighing 10–25 pounds.

Work Environment

• Office / Remote Locations: Indoor, sedentary environment with occasional travel; moderate noise level.
• PACE Locations: Clinical setting serving frail and elderly populations; potential exposure to hazardous conditions.
• Community-Based Work: Indoor and outdoor work with travel; variable environmental conditions.

Contact Information

Team Lead (Recruiting Team)
Ashu
Direct: 510-455-4427
Aroha Technologies Inc.
5000 Hopyard Rd Suite - 415
Pleasanton, CA - 94588