Senior Complex Case Manager (RN) - D-SNP (Temporary)

Central California Alliance for Health (Remote); California (MO); On-site; USD 82,656 - 88,166; Full time

Job summary

The Central California Alliance for Health is looking for a Senior Complex Case Manager (RN) for a temporary role. This full-time position involves managing care for Medicare Dual Eligible Special Needs Plan members and requires strong experience in clinical nursing and case management.

With a focus on quality care, you will collaborate with various stakeholders to promote optimally achievable health outcomes. This position includes responsibilities such as developing care plans and educating families, operating remotely with some in-person tasks as needed.

Eligible candidates must hold a valid California RN license and prefer a strong background in case management.

Qualifications

• Unrestricted RN license issued by California.
• Minimum of seven years in patient care, including one year in case management.
• Acute or outpatient experience required.

Responsibilities

• Develop and manage care plans for Medicare members.
• Educate members and families about case management programs.
• Participate in quality improvement studies.
• Provide oversight and support for the D-SNP program.
• Act as a liaison with providers and agencies.

Skills

Clinical nursing principles

Case management practices

Motivational interviewing

Evidence-based guidelines

Care management

Complex chronic conditions

Health improvement strategies

Electronic health record platforms

Education

Valid California RN License

Associate’s degree in Nursing

Job description

Senior Complex Case Manager (RN) - D-SNP (Temporary)

OUR COMMITMENT TO A HUMAN HIRING PROCESS

We believe every candidate deserves thoughtful consideration. That’s why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer — and we genuinely appreciate your patience as we work through applications carefully and respectfully.

SERVICE AREA PREFERENCE

While we encourage all interested applicants to apply, we do give priority to those who live in or near our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment.

ABOUT THIS TEMP POSITION

This is a temporary position and the length of assignment is estimated to go from July 2026 through December 2026. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.

This is a full-time (40 hours/week) temporary assignment.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Medicare Care Management Manager (RN), this position:

• Develops and manages an individualized comprehensive plan of care for Medicare Dual Eligible Special Needs Plan (D‑SNP) members referred into the Case Management Program with the goal of promoting optimal, achievable outcomes in the most cost effective and appropriate manner
• Works with and educates members, families, providers, external agencies, and internal departments on the D‑SNP Case Management Program
• Participates in Quality Improvement studies, to continually evaluate the program’s effectiveness and ability in promoting quality driven, cost effective, achievable goals and outcomes for members
• Performs D‑SNP Program oversight and support activities
• Acts as a liaison between the D‑SNP Program and providers and community agencies to promote effective implementation of program objectives and requirements

WHAT YOU'LL NEED TO BE SUCCESSFUL

Knowledge of:

• The principles and practices of clinical nursing
• The principles and practices of case management, including motivational interviewing and evidence-based guidelines
• Care management and coordination
• Complex chronic conditions, geriatric care, and psychosocial factors impacting health outcomes
• The principles and practices of developing and implementing health improvement strategies to address social determinants of health
• Evidence-based practice guidelines in the development of care plans
• Electronic health record and/or care management platforms

Ability to:

• Assess member risk, define problems, develop care plans, and collaborate across disciplines
• Demonstrate strong critical thinking and problem‑solving skills
• Interpret and apply policies and regulations
• Define issues, conduct research, interpret data, and identify and evaluate options
• Evaluate medical records and other health care data
• Organize work, manage complex priorities, and document with accuracy and timeliness
• Communicate effectively with a diverse population of members, including those with behavioral health issues

Education and Experience:

• Current unrestricted license as a Registered Nurse issued by the State of California
• Associate’s degree in Nursing and a minimum of seven years of experience in a patient care setting, including a minimum of one year of case management experience (a Bachelor’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying
• A minimum of one year of the required patient care experience must be in an acute or outpatient environment, working with adults and/or dual‑eligible populations

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company‑wide events or department meetings will be expected.
• In‑office or in‑community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

COMPENSATION INFORMATION

• Zone 1 Pay Range: $60.00 - $64.00 USD (Typical areas: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas)
• Zone 2 Pay Range: $56.00 - $60.00 USD (Typical areas: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento))

The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it’s not one of the typical areas listed. You can reach out to [e-mail], and a member from our Talent Acquisition team will be in touch.

The posted hiring ranges represent a good‑faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location).

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E‑Verify participating employer.

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.