Registered Nurse Case Manager

Registered Nurse Case Manager (257695) San Jose, California Salary: USD54 - USD69 per hour Registered Nurse – Case Manager Job ID: 257695 Location: San Jose, CA Schedule: Monday–Friday, 8:30 AM–5:00 PM Work Setting: Hybrid — Will work 3 days onsite, 2 days remote Pay Rate: $54–$69/hour Contract: 6 months Start Date: 09/14/2026 Hours: 40 hours/week Why Consider This Opportunity? Opportunity to work in a managed care environment focused on member advocacy and whole-person care. Strong opportunity for experienced RNs to utilize their clinical skills outside of traditional bedside nursing. Role supports care coordination, utilization management, and individualized member outcomes. Role Overview We are seeking an experienced Registered Nurse Case Manager to provide ongoing case management services and support members in achieving their healthcare goals. This role focuses on comprehensive clinical and psychosocial assessments, individualized care planning, care coordination, and member advocacy across the healthcare and social services continuum. Key Responsibilities Conduct, review, and document comprehensive clinical and psychosocial assessments. Perform ongoing follow-up and monitor progress toward individualized goals. Maintain accurate case files in accordance with organizational, state, federal, and audit requirements. Engage members and families in developing and implementing individualized care plans. Coordinate care with PCPs, specialists, behavioral health providers, and long-term services and supports. Facilitate transitions between healthcare settings and coordinate related services. Support transitions from nursing facilities to lower levels of care or community settings when assigned to MLTSS. Coordinate medical appointments, pharmacy assistance, and utilization review. Conduct telephonic assessments. Help members access appropriate healthcare benefits, resources, and services. Required Qualifications Minimum 3 years of experience in case management, discharge planning, education, or equivalent experience. Knowledge of managed care principles, particularly Case Management and/or Utilization Management . Strong clinical knowledge and critical-thinking skills. Ability to assess whole-person needs and develop effective care plans. Strong computer skills, including Outlook, Word, Excel, and case management software. #J-18808-Ljbffr Medix