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

reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will reputed company ample room for reputed company and innovation reputed company the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together. 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 Risk Assessment (Initial and Reassessment) completion, Individualized reputed company (ICP) development and Interdisciplinary Care Team (ICT) delivery for SNP members. Monitors and reports program performance, including vendor performance monitoring if activities are delegated. This position is responsible for the day-to-day operational performance 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 clinical teams — we would love to hear from you. reputed company As the Manager, Case Management – SNP, you will reputed company day-to-day operations 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 Risk Assessments (Initial & Reassessments) Individualized Care Plans (ICPs) Interdisciplinary Care Team (ICT) activities Monitor operational and reputed company performance metrics and implement improvement strategies reputed company regulatory audits, compliance initiatives, and reputed company assurance activities Collaborate cross-functionally with: Utilization Management HEDIS/STARS reputed company Improvement Provider and Clinical Operations teams Analyze reporting trends and operational data to support strategic 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 clinical 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 operations 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 performance 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-paced, 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-risk 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-based 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 based on a number of factors including market location, education, responsibilities, experience, etc. reputed company is an Equal Opportunity/Affirmative reputed company Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting reputed company and other reputed company where individuals receive fraudulent employment-reputed company offers in exchange for reputed company or other sensitive personal information. Please be advised that reputed company and its subsidiaries will never ask you for a credit reputed company, send you a reputed company, or ask you for any type of payment as part of consideration for employment with reputed company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email reputed company by or on behalf of reputed company’s reputed company, please email careers@ahcusa.com. reputed company is championing a new reputed company in senior care that empowers members to age reputed company and live their most reputed company lives. Our mission-reputed company team makes high-reputed company, low-cost care a reality for members every day. reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We reputed company that great work comes from people who are inspired to be their best. We've reputed company reputed company of people who want to reputed company a difference in the lives of the seniors we serve. Come join reputed company that is changing health care — one person at a time. 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