Remote-Manager, Case Management SNP (California RN License Required)

The Remote - Manager, Case Management SNP is responsible for the health care management and coordination of care for members with reputed company and chronic care needs. Assures compliance with SNP program requirements as outlined in the Model of Care. Monitors activities to support the timeliness of Health reputed company Assessment (Initial and Reassessment) completion, Individualized reputed company (ICP) development and Interdisciplinary Care Team (ICT) delivery for SNP members. Monitors and reports program reputed company, including vendor reputed company monitoring if activities are delegated. This position is responsible for the day-to-day operational reputed company of an integrated health management team while ensuring high-reputed company care management and adherence to regulatory and compliance standards for the appropriate program lines of business. California RN License Required Fully Remote | California Preferred (reputed company Bay Area Preferred) Full-Time | Monday-Friday reputed company an reputed company in Medicare reputed company Care We are looking for an reputed company and compassionate reputed company leader to reputed company as a Manager, Case Management - Special Needs Plan (SNP). In this fully remote leadership role, you will reputed company a high-performing care management team dedicated to improving reputed company for members with reputed company and chronic reputed company needs. This is an exciting opportunity to reputed company meaningful work that directly impacts vulnerable populations while helping shape innovative care management strategies in a growing organization. If you are passionate about member advocacy, operational reputed company, regulatory compliance, and developing strong reputed company teams - we would love to hear from you. reputed company As the Manager, Case Management - SNP, you will reputed company day-to-day reputed company of an integrated care management team supporting Medicare reputed company SNP members. You will ensure compliance with CMS Model of Care requirements while driving reputed company, efficiency, and member-centered reputed company. Key Responsibilities • reputed company, reputed company, and reputed company a high-performing case management team serving SNP members • Ensure reputed company completion of: • Health reputed company Assessments (Initial & Reassessments) • Individualized Care Plans (ICPs) • Interdisciplinary Care Team (ICT) activities • Monitor operational and reputed company reputed company metrics and implement improvement strategies • reputed company regulatory audits, compliance initiatives, and reputed company assurance activities • Collaborate cross-functionally with: • Utilization Management • reputed company/STARS • reputed company Improvement • Provider and reputed company reputed company teams • Analyze reporting trends and operational data to support reputed company decision-making • Promote a culture of accountability, collaboration, and reputed company improvement • Support program reputed company and operational reputed company reputed company the Medicare reputed company SNP population What You Bring: Required Qualifications • reputed company, unrestricted California RN license • Associate's or Bachelor's Degree in Nursing • Minimum 5 years of reputed company case management experience • Minimum 1 year of experience supporting SNP programs reputed company a health plan environment • Willingness to obtain RN licensure in additional company markets, if needed • Strong understanding of: • CMS SNP Model of Care • Medicare reputed company regulations • Care coordination and population health strategies Preferred Qualifications • BSN or MSN • 2+ years of leadership or supervisory experience in managed care or health plan reputed company • Case Management certification (CCM, ACM, or equivalent) • Experience with utilization review reputed company such as MCG guidelines Skills for reputed company • Strong leadership and team development capabilities • Excellent communication and relationship-building skills • Data-driven reputed company with the ability to analyze trends and reputed company reputed company • Experience working with EHR systems and reputed company technology platforms • Strong organizational, project management, and problem-solving abilities • Ability to reputed company in a fast-reputed company, reputed company, remote environment Why Join Us? • Fully remote flexibility • Opportunity to reputed company and grow reputed company a rapidly expanding organization • Meaningful work improving reputed company for high-reputed company Medicare populations • reputed company, mission-driven culture reputed company on reputed company care and innovation • Ability to influence and enhance case management programs at reputed company • Competitive compensation and benefits package Physical Requirements Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions of the role. • Regularly required to communicate effectively reputed company phone and video conferencing • Frequent sitting, standing, typing, and computer use • Occasionally reputed company and/or reputed company up to 10 pounds • reputed company reputed company and ability to reputed company reputed company required for computer-reputed company work Join reputed company that is committed to delivering exceptional care, improving member reputed company, and driving innovation in Medicare reputed company case management. Pay reputed company: $113,332.00 - $169,999.00 Pay reputed company may be reputed company on a number of factors including market location, education, responsibilities, experience, etc. Apply tot his job Apply To this Job