Job Title: Registered Nurse Case Manager
Duration: Contract 6+ Months
Shift: Mon - Fri | 8:00 a.m. to 5:00 p.m.
Work Arrangement: Fully Onsite
Location: Orange, CA 92868
Pay Rate Range: $43.66 - $69.86 per hr. on W2
Role & Responsibilities:
85% - Care Management:
- Assesses member needs using a standardized health needs assessment or health risk assessment.
- Performs comprehensive, disease specific, clinical assessments of all identified cases, which includes but is not limited to, assessment of:
- Member's physical, functional, social and psychological status
- Member's cultural and linguistic needs
- Caregiver resources and available benefits
- Performs post-discharge assessments to identify member's post-hospital or post-emergency department discharge needs including but not limited to:
- Member's physical, functional, social and psychological status
- Member's cultural and linguistic needs
- Caregiver resources and available benefits
- Follow-up provider care and ensuring scheduled appointments
- Durable medical equipment and supplies
- Community resources
- Develops and implements a member's specific care plan which includes prioritized Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) goals.
- Reviews, modifies and updates care plans continuously to reflect the member's needs, at minimum, annually or upon change in condition.
- Schedules follow-ups to assess progress towards goals and identifies barriers to meeting goals.
- Provides regular outreach to assigned members along with members from a worklist and evaluates quality of service given to members according to department contact standards.
- Coordinates care and services with members, members' family members/representatives and other providers, as appropriate, including community supports and Long-Term Services and Supports (LTSS).
- Communicates with member's physicians, specialists, community agencies and vendors to ensure coordination of services.
- Facilitates referrals to behavioral health/substance use disorder services and identifies and makes referrals to LTSS department, community supports and community resources.
- Facilitates and participates in Interdisciplinary Team meetings as applicable.
- Collaborates with interdepartmental staff in case resolution as needed.
- Identifies cases needing supervisor, manager, director or medical director review or input, routes accordingly and closes cases according to procedures and guidelines in a timely manner.
- Advocates in the member's best interest for necessary funding, treatment alternatives, timelines and coordination of care and frequent evaluations of progress and goals.
10% - Administrative Support:
- Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
- Follows CalOptima Health's protocol for documenting all case interventions.
- Prepares and maintains appropriate documentation of patient care and progress within the care plan.
5% - Other:
- Completes other projects and duties as assigned.
Minimum Qualifications:
- Associate degree in nursing (ADN) or related field required PLUS 3 years of clinical experience and/or managed care experience required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
- Bilingual in English and Spanish, one of CalOptima Health's defined threshold languages required.
Preferred Qualifications:
- Bachelor of Science in Nursing (BSN) degree or related field.
- Case Management Certification (CCM).
Required Licensure / Certifications:
- Current, unrestricted Registered Nurse (RN) license to practice in the state of California required.
Knowledge & Abilities:
- Develop rapport and establish and maintain effective working relationships with Client's leadership and staff and external contacts at all levels and with diverse backgrounds.
- Work independently and exercise sound judgment.
- Communicate clearly and concisely, both orally and in writing.
- Work a flexible schedule; available to participate in evening and weekend events.
- Organize, be analytical, problem-solve and possess project management skills.
- Work in a fast-paced environment and in an efficient manner.
- Manage multiple projects and identify opportunities for internal and external collaboration.
- Motivate and lead multi-program teams and external committees/coalitions.
- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
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22nd Century Technologies, Inc.
$43.66 - $69.86 per hr. on W2
Jan 15, 2026