RN Case Manager

🕒 vor 13 Tagen

🏄 California – Remote

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💵 $90.000 - $110.000 / Jahr

⏰ Vollzeit

🟢 Junior

🟡 Mittelstufe

👔 Manager

👻 Geisterscore 0%

infoinfo

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Serene Health

Serene Health

201 - 500 Mitarbeiter

Gegründet 2000

🏥 Gesundheitswesen

☁️ SaaS

🤖 Künstliche Intelligenz

Healthcare • SaaS • Artificial Intelligence

Serene Health ist ein Anbieter für psychische Gesundheit und Behavioral Healthcare. Das Unternehmen bietet evidenzbasierte, ganzheitliche Behandlung an – sowohl an Präsenzstandorten in Kalifornien, Illinois, Georgia und Arizona als auch über eine Telehealth-Plattform. Das Angebot umfasst Behandlungen bei Angststörungen, ADHS, Depressionen, Autismus-Spektrum-Störungen, bipolarer Störung, Schizophrenie und Trauma/PTSD sowie integrative Psychiatrie, Familien-, Einzel- und Paartherapie, Enhanced Care Management, Community Support, Remote Patient Monitoring und prTMS. Serene Health setzt auf eine kosteneffiziente Versorgung in Kombination mit proprietärer Software und AI-basierten Tools – darunter Scheduling, On-Demand-Therapie, Mood Tracking, Journaling, AI-gestützte Chat-Aktivitäten und Umfragen. So sollen der Zugang zur Versorgung und die Behandlungsergebnisse verbessert sowie die Zusammenarbeit mit großen Versicherern wie Aetna, Cigna, UnitedHealthcare, Optum, Tricare, BCBS und Medicare koordiniert werden.

Beschreibung

• Serve as the RN of record for approximately 500 Enhanced Care Management members • Provide clinical oversight and documentation review for care plans, assessments, and progress notes • Respond to clinical escalations and ensure compliance with legal and payer guidelines • Provide clinical sign-off on individualized whole-person care plans • Collaborate with primary care, specialists, hospitals, behavioral health, and community agencies • Monitor member progress and outcomes, adjust care plans, and ensure follow-up through remote documentation review and telehealth workflows • Facilitate care transitions, discharge planning, follow-up appointments, and home-based care coordination • Advocate for timely access to treatments, medications, and support services • Review utilization patterns and design interventions to reduce avoidable hospital and emergency department visits • Analyze payer and quality performance reports to identify care gaps and implement improvement strategies • Train team members on quality improvement, safety, and case management best practices • Maintain compliance with Medi-Cal, HEDIS, and quality standards while advancing health equity • Perform additional duties as required

🎯 Anforderungen

• Active California RN license in good standing, required regardless of the RN's physical location • Minimum 2 years of experience as a Registered Nurse • Strong understanding of Medi-Cal, care coordination, and social determinants of health • Excellent analytical, clinical judgment, interpersonal, and communication skills • Proficiency in MS Office (Excel, Word, Outlook) and electronic health record systems • Ability to work 8:30 a.m.–5:00 p.m. PST, regardless of home time zone • Reliable high-speed internet and a private, HIPAA-compliant home workspace • Compassionate, nonjudgmental, and culturally sensitive approach • Successful pre-employment drug screening and background check required • Occasional evening or weekend work within a 40-hour week • Bachelor's or Associate degree in Nursing, RN license preferred • Bilingual, Spanish preferred • Certified Case Manager (CCM) or equivalent certification preferred • Managed Care, Community Health, or Behavioral Health experience preferred • Motivational Interviewing or empathy-based communication certification or experience preferred

🏖️ Vorteile

• Medical, Dental, & Vision Benefits after 60 days of employment • Short & Long-Term Disability Benefits • Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans • Flexible Spending Accounts • Employee Assistance Program (EAP) • 401(K), effective after 1 year of employment • Paid Vacation and Sick Leave • Paid Holidays • Employee Referral Program • Company Discount Program

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