Remote Clinical Care Manager (RN) – California

Job Overview

  • Clinical License RN
  • State(s) CA

Full job description

We’re a local non-profit County Organized Health System (COHS) dedicated to the health of more than 160,000 low-income residents of San Mateo County, including all of its Medi-Cal beneficiaries. We believe that healthy is for everyone and need passionate, caring employees who share our passion to join us.

The Clinical Care Manager helps improve HPSM members’ health outcomes by performing comprehensive assessments, developing individualized care plans and coordinating interdisciplinary case conferences with network providers. They also ensure seamless care transitions and efficient utilization of resources by collaborating with various departments, providers, programs and community partners. A remote work option is available for California residents. This position is not eligible for sponsorship.

Position overview

  • Manage a panel of assigned members, guiding them along the continuum of care to enhance their functional level and overall quality of life.
  • Conduct thorough assessments, addressing psychosocial, physical health, functional abilities, and social determinants of health.
  • Develop individualized care plans aligned with program guidelines and policies, identifying the need for LTSS programs, Behavioral Health Services, and community supports.
  • Maintain open communication with physicians, healthcare professionals, and social service workers, ensuring the confidentiality of member information.
  • Facilitate clinical huddles, interdisciplinary care team meetings, and care transitions, promoting clear communication among the care team.
  • Provide education, linkages to resources, and interventions to members, caregivers, and volunteers, ensuring a comprehensive understanding of benefits and medications.

Requirements
These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply.
Education and experience

  • Bachelor or Associates degree.
  • Two (2) years clinical experience.
  • Three (3) years of managed care experience, preferably in Care Coordination.
  • Valid California license as an RN, LCSW, LMFT. PHN preferred. Will consider unlicensed Masters Level Social Worker (MSW/ASW).
  • Certification as Certified Case Manager (CCM) preferred.

Knowledge of:

  • Proficiency in Microsoft Office Suite applications.
  • Case management principles and practices.
  • Strong knowledge of Medicare and Medi-Cal programs and benefits.
  • Familiarity with community resources, social determinants of health, and care transitions.
  • Understanding of HIPAA and applicable federal and state regulations for confidentiality.

Ability to:

  • Adapt to changes in requirements and priorities for daily and specialized tasks.
  • Work autonomously, accountable for the practice of case management.
  • Collaborate effectively with diverse teams and support team decisions.
  • Utilize a member-centric approach to care coordination in a dynamic environment.

Skills:

  • Member, provider, and interdisciplinary team-focused interpersonal skills.
  • Effective written, verbal, and listening communication skills.
  • Conflict resolution, assertiveness, and collaboration skills.
  • Bilingual skills highly preferred, particularly Spanish, Tagalog, or Chinese.

Salary and benefits
The starting salary range is $43.05-$57.05/hour, depending on the candidate’s work experience.

Excellent benefits package includes:

  • HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums)
  • Fully paid life, AD&D and LTD insurance
  • Retirement plan (HPSM contributes equivalent of 10% of annual compensation)
  • 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year
  • Tuition reimbursement plan
  • Employee wellness program

It is HPSM’s policy to provide equal employment opportunity for all applicants and employees. HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law. HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.

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