Care Manager I, RN

🔥 9 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $78k - $91k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

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Astrana Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

📦 Logistics

🏥 Healthcare

Consulting • Logistics • Healthcare

Astrana Health is a healthcare company that operates community-focused clinics and a provider-facing technology platform to coordinate care across primary, urgent, and multi-specialty services. It supports providers and local communities by streamlining access to care, automating prior authorizations, and connecting patients with in-network clinicians. Astrana combines clinical services with doctor-built technology to improve patient experience and provider workflows.

📋 Description

• Develop and initiate comprehensive, client-centered Individual Care Plans consistent with program guidelines and policies • Identify, arrange, and monitor appropriate community services using knowledge of Medicare, Medicaid, and other entitlement programs • Coordinate and facilitate patient care through assessment, evaluation, planning, and implementation • Communicate patient needs to care team members and follow up accordingly • Manage discharge plans upon completion of treatment • Collaborate with patients, families, physicians, and nurses to ensure high-quality care • Advocate for patients regarding insurance coverage and financial assistance • Maintain comprehensive clinical records through detailed documentation • Coordinate interdisciplinary care to support timely access, continuity among providers, and appropriate resource utilization • Apply care-transition principles, follow members through the continuum of care, and coordinate warm hand-offs to appropriate providers or health plans • Assist the UM Manager and participate in internal and external audits • Serve as primary liaison with contracted health plans for case management activities • Ensure privacy and security of PHI in accordance with HIPAA and organizational policies • Perform other duties and special projects as assigned

🎯 Requirements

• Registered Nurse, Licensed Vocational Nurse, or Medical Assistant required • At least two years of experience in utilization management required • Experience applying evidence-based clinical criteria and benefit plans required • At least three years of clinical experience, preferably in case management or related experience, required • Bachelor's degree in nursing or a related health services field preferred • Certified Case Management (CCM) certification is a plus • Fluency in Tagalog or Ilocano is a plus • Knowledge of Medicare, Medicaid, and other entitlement programs • Knowledge of HIPAA and protected health information requirements

🏖️ Benefits

• Remote position • Total compensation target pay range of $78,000–$91,000 per year • Equal Employment Opportunity and Affirmative Action employer • Reasonable accommodation available for applicants with disabilities