Senior Transitions of Care RN II - Hybrid, Mentoring

Clever Care Health Plan; Huntington Beach (CA); Hybrid; USD 82,000 - 100,000; Full time

Job summary

Clever Care Health Plan in Southern California is seeking a Transitions of Care Registered Nurse II to coordinate care for members with complex needs. This hybrid role requires 3 days onsite at Monrovia or Huntington Beach and remote work when feasible, collaborating across care teams to drive quality, compliance, and patient outcomes.

You’ll mentor nursing staff, participate in quality initiatives, and support CMS/NCQA readiness while advancing health equity for diverse communities.

Qualifications

• Active, unrestricted California RN license.
• Minimum of four years of progressive clinical nursing experience.
• Minimum of two years in care management or transitional care.
• Experience with CMS, NCQA, or quality-improvement initiatives preferred.

Responsibilities

• Perform comprehensive assessments for members during transitions of care.
• Manage a complex caseload with advanced clinical decision-making.
• Develop and revise individualized transition plans based on goals.
• Coordinate services across hospitals, clinics, home health, and community partners.
• Mentor staff and support department orientation.
• Identify high-risk members and implement care coordination strategies.
• Promote evidence-based practices and CMS/compliance standards.

Skills

Medicare Advantage

Care coordination

Interdisciplinary teamwork

Clinical assessment

Regulatory compliance

Quality improvement

Mentoring

Tools

Electronic Health Records (EHR)

Care management platforms

Microsoft Office Suite

Healthcare technology applications

Job description

Clever Care Health Plan in Southern California is seeking a Transitions of Care Registered Nurse II to coordinate care for members with complex needs. This hybrid role requires 3 days onsite at Monrovia or Huntington Beach and remote work when feasible, collaborating across care teams to drive quality, compliance, and patient outcomes.

You’ll mentor nursing staff, participate in quality initiatives, and support CMS/NCQA readiness while advancing health equity for diverse communities.