Case Manager - RN or LVN

Position Overview

The Case Management Manager serves under the Director of Clinical Operations for day-to-day operations and collaborates with the SVP of Clinical Operations on clinical matters. This leadership role is responsible for overseeing all case management programs, with a strong emphasis on enhancing patient outcomes through effective care coordination, planning, education, and advocacy.

Primary Responsibilities

Provide leadership and guidance to inpatient and outpatient case managers in care reviews, discharge planning, and care transitions

Manage disease management initiatives, complex case management, and Dual Special Needs Plan (DSNP) workflows

Facilitate weekly nursing team meetings and encourage innovative approaches to reduce hospital admissions

Assess training needs and foster professional development within the team

Enhance case management systems and contribute to platform improvements

Lead recruitment, retention, and performance management of case management staff

Conduct regular performance evaluations and offer coaching and support

Assist with budget planning and monitor staffing levels and productivity metrics

Qualifications

Demonstrated compassion and commitment to patient-centered care

Active RN or LVN license in California

Bachelor's degree preferred; Master's degree in nursing or a related health field is a plus

Certified Case Manager (CCM) certification is desirable

Minimum of 5 years of utilization or case management experience in IPA, PMG, or HMO environments

Prior leadership or management experience is preferred

Strong knowledge of HIPAA regulations and confidentiality standards

Proven ability to lead both on-site and remote teams effectively

Benefits&Other

EXCELLENT COMPANY BENEFITS INCLUDING 100% Paid Medical HMO - with optional coverages available as well

Various Reimbursements and Work-Life Balance incentives - 401k - FSA - Tuition Reimbursement & More

Desired Skills and Experience

The Case Management Manager serves under the Director of Clinical Operations for day-to-day operations and collaborates with the SVP of Clinical Operations on clinical matters. This leadership role is responsible for overseeing all case management programs, with a strong emphasis on enhancing patient outcomes through effective care coordination, planning, education, and advocacy.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county , to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.