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California Licensed Care Manager

8/20/2025

Remote

Job Summary

A company is looking for a Care Manager to oversee complex case management and care coordination for at-risk patient populations.

Key Responsibilities
  • Conduct risk stratification and develop individualized care plans for complex patients
  • Coordinate care and facilitate transitions for high-risk members, ensuring effective communication among all stakeholders
  • Perform concurrent reviews and maintain electronic case management records while adhering to departmental standards
Required Qualifications
  • High School Diploma or GED equivalent; BSN degree from an accredited university preferred
  • Minimum of 2 years of case management experience in a managed care environment
  • At least 1 year of experience in complex case management
  • Knowledge of CMS and NCQA requirements for documentation and communication
  • Licensure as a Registered Nurse (RN) required; Certified Case Manager (CCM) preferred

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