RN Case Manager

🔥 9 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $90k - $110k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 0%

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Serene Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2000

🏥 Healthcare

☁️ SaaS

🤖 Artificial Intelligence

Healthcare • SaaS • Artificial Intelligence

Serene Health is a behavioral and mental healthcare provider that delivers evidence-based, whole-person treatment through both in-person locations (California, Illinois, Georgia, Arizona) and a telehealth platform. They offer services for anxiety, ADHD, depression, autism spectrum disorder, bipolar disorder, schizophrenia, trauma/PTSD, integrative psychiatry, family/individual/couples therapy, enhanced care management, community support, remote patient monitoring, and prTMS. Serene Health emphasizes cost-effective care combined with proprietary software and AI-driven tools — scheduling, on-demand therapy, mood tracking, journaling, AI chat activities, and surveys — to improve access and outcomes and coordinate with major insurers (Aetna, Cigna, UnitedHealthcare, Optum, Tricare, BCBS, Medicare).

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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