Case Manager, RN - CA

Acentra Health, LLC•Sacramento, CA

3d•Remote

About The Position

Acentra Health is seeking a Nurse Case Manager to evaluate beneficiaries’ needs, develop individualized care plans, and coordinate healthcare team members to support optimal outcomes while adhering to payer requirements. The role facilitates integrated case and disease management activities based on CMSA principles, with the goal of stabilizing beneficiaries’ health and avoiding long-term care placement. This is a remote position. Candidates must reside in California; candidates in the Los Angeles or San Diego area are preferred. The position primarily involves desk work and using a computer for extended periods. The pay range is USD $67,300 to $93,050 per year, with placement depending on factors such as applicable experience and skill level.

Requirements

Bachelor’s degree or BSN.
Active, unrestricted RN license in California.
At least 3 years of clinical experience.
At least 1 year of case management review experience.
Must reside in California.
Strong written and verbal communication skills, with a customer-service focus and ability to build and maintain relationships with internal and external customers.
Ability to work independently and as part of a team.
Ability to maintain a high level of confidentiality.
Ability to maintain departmental metrics and goals.

Nice To Haves

Bilingual in Spanish.
Ability to assist members and conduct outreach to members without prior engagement.
Strong cultural competency and ability to work effectively with diverse populations.
Flexibility and strong organizational skills.
Ability to multitask and prioritize variable and sometimes conflicting deadlines, with strong attention to detail and demonstrated decision-making ability.
Professionalism, flexibility, and dependability under pressure.
Ability to research, identify, and apply appropriate standards of care.
Interest in continuous learning and commitment to staying informed about regulatory changes.

Responsibilities

Assess, plan, implement, monitor, and evaluate care options and services with beneficiaries across the continuum of care.
Use clinical knowledge, communication, problem-solving, and conflict-resolution skills to support beneficiary outcomes while considering client requirements.
Develop beneficiary-centered care plans.
Promote shared accountability among beneficiaries, caregivers, and providers.
Collaborate with beneficiaries, providers, and other healthcare team members to coordinate care.
Address identified gaps in care or compliance.
Maintain strict confidentiality of client and client-related information and comply with applicable organizational, state, and federal confidentiality requirements.
Manage caseloads and complete required documentation and assessment-result entries in the web-based database accurately and on time, following regulatory requirements and company policies and procedures.
Maintain open communication with appropriate parties.
Pursue ongoing education, certification, and self-development to stay current with case management standards.
Read, understand, and follow corporate policies, including HIPAA Privacy and Security Rules.
Perform other duties as assigned.