RN- Medical Case Manager

Job Details

Job Title: Medical Case Manager
Department: Case Management
Work Arrangement: Full Office
Work Schedule: Monday–Friday, 8:00 AM – 5:00 PM
Compensation Range: $90,820 – $145,312 annually (Approx. $43.66 – $69.86 per hour)

The Medical Case Manager is responsible for delivering comprehensive, member-centered care management services. This role includes clinical assessment, care coordination, post-discharge follow-up, and collaboration with interdisciplinary teams to ensure high-quality, culturally appropriate, and cost-effective care for members.

• Care Management (85%)
  • Conduct standardized health needs and risk assessments for assigned members.
  • Perform comprehensive, disease-specific clinical assessments, including:
    • Physical, functional, social, and psychological status
    • Cultural and linguistic needs
    • Caregiver resources and available benefits
  • Complete post-hospital and post-emergency department discharge assessments.
  • Coordinate follow-up provider care and ensure scheduled appointments.
  • Arrange durable medical equipment, supplies, and community resources.
  • Develop, implement, and maintain individualized care plans with SMART goals.
  • Review and update care plans at least annually or upon change in condition.
  • Conduct follow-ups to monitor progress and address barriers to care.
  • Provide regular outreach to members in accordance with department contact standards.
  • Coordinate care with members, family members, providers, community agencies, and vendors.
  • Facilitate referrals to behavioral health, substance use disorder services, LTSS, and community supports.
  • Participate in interdisciplinary team meetings as applicable.
  • Escalate cases requiring leadership or medical director review and close cases timely per guidelines.
  • Advocate for members regarding funding, treatment alternatives, timelines, and coordination of care.
• Administrative Support (10%)
  • Support a mission-driven culture focused on quality, dignity, accountability, and customer service.
  • Collaborate with team members to achieve departmental goals.
  • Document all case interventions according to organizational protocols.
  • Maintain accurate and timely clinical documentation within care plans.
• Other Duties (5%)
  • Complete special projects and other duties as assigned.

• Associate Degree in Nursing (ADN) or related field required
• Minimum of 3 years of clinical and/or managed care experience (Equivalent education and experience may be considered)
• Bilingual in English and Spanish required

• Bachelor of Science in Nursing (BSN) or related field
• Case Management Certification (CCM)

• Current, unrestricted Registered Nurse (RN) license in the State of California

• Ability to establish effective working relationships with diverse stakeholders.
• Strong independent judgment and decision-making skills.
• Clear verbal and written communication skills.
• Ability to work flexible schedules, including evenings or weekends as needed.
• Strong organizational, analytical, and problem‑solving skills.
• Ability to manage multiple priorities in a fast‑paced environment.
• Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint) and job‑specific systems.

• Ability to read computer screens and printed materials.
• Clear verbal communication and adequate hearing for phone and in‑person interactions.
• Manual dexterity for typing, writing, standing, walking, bending, kneeling, and prolonged sitting.
• Ability to lift and move objects, patients, or equipment weighing 10–25 pounds.

• Office / Remote Locations: Indoor, sedentary environment with occasional travel; moderate noise level.
• PACE Locations: Clinical setting serving frail and elderly populations; potential exposure to hazardous conditions.
• Community-Based Work: Indoor and outdoor work with travel; variable environmental conditions.

Team Lead (Recruiting Team)
Ashu
Direct:
Aroha Technologies Inc.
5000 Hopyard Rd Suite - 415
Pleasanton, CA - 94588