Case Manager, RN - CA

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. At Acentra Health, we embrace emerging technologies, including artificial intelligence and advanced analytics that can be utilized to improve processes, enhance decision-making, and drive better health outcomes. We value professionals who are curious about new technologies and motivated to use innovative tools to increase efficiency, quality, and impact in their roles. Acentra Health is looking for a Nurse Case Manager to join our growing team now! The Nurse Case Manager will evaluate beneficiaries' needs, develop individualized care plans, and coordinates healthcare team members to ensure optimal client outcomes while adhering to payer requirements. They also facilitate integrated case and disease management activities based on CMSA principles, aiming to stabilize beneficiaries' health and avoid long-term care placement. **Position is remote, but candidates must reside in California, preferably in Los Angeles or San Diego area. ** Assess, plan, implement, monitor, and evaluate options and services to affect an appropriate, individualized plan with the beneficiary across the continuum of care. Develop beneficiary-centered care plans. Work collaboratively with the beneficiary, provider, and other Health Care team members to coordinate care. Address identified gaps in care or compliance. Comply with all organizational, state, and federal regulations and policies on confidentiality. Manage caseload to ensure all required documentation and entry of assessment results into the web-based database are completed accurately and timely, following regulatory requirements and company policies and procedures. Pursue ongoing education, certification, and self-development to remain current with case management standards. Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules This position primarily involves working at a desk and using a computer for extended periods of time The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time. Bachelor’s degree/BSN. Active, unrestricted RN (Register Nurse) license in CA A minimum of 1+ years of case management review experience. Successful communication (written/verbal), with a strong focus on customer service, including building and maintaining relationships with internal/external customers. Bilingual in Spanish Ability to assist members and conduct outreach to members without prior engagement. Ability to research/identify and apply appropriate standards of care. Interest in continuous learning and a commitment to staying informed on regulatory changes. We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. As part of our recruitment process, candidates may be asked to participate in identity verification measures to help ensure the integrity of the hiring process. ~ The Acentra Health Talent Acquisition Team EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.