Care Manager I - RN Astrana Health Remote
Overview
The Care Manager I - RN leads development and execution of client‑centered Individual Care Plans that align with Medicare Medicaid and other entitlement program guidelines. They identify community services monitor patient progress collaborate with multidisciplinary teams manage discharge plans act as patient advocates and maintain comprehensive clinical records. This role drives continuity of care across providers and ensures privacy compliance while supporting population health initiatives.
What You'll Do9
- 1Design Build and deliver evidence‑based care plans that meet regulatory standards
- 2Coordinate community resources and verify eligibility for Medicare Medicaid and other programs
- 3Assess patient needs evaluate options and implement treatment plans within 90 days
- 4Facilitate communication among physicians nurses social workers and insurance representatives
- 5Document all interactions and maintain accurate electronic health records
- 6Lead discharge planning and ensure seamless transition to post‑treatment services
- 7Advocate for patients regarding insurance coverage and financial assistance
- 8Partner with UM Manager to oversee audits and liaise with contracted health plans
- 9Promote population health strategies and optimize resource utilization
Requirements9
- 1Registered Nurse Licensed Vocational Nurse or Medical Assistant with bachelor’s degree in nursing preferred
- 2Minimum two years experience in utilization management applying clinical criteria and benefit plans
- 3At least three years clinical experience especially in case management
- 4Certified Case Management CCM certification
- 5Fluency in Tagalog or Ilocano
- 6Remote work capability from home office in Monterey Park California
- 7Strong understanding of HIPAA regulations and PHI security
- 8Excellent written and verbal communication skills
- 9Ability to thrive in fast‑paced environment
Salary Insight
$78 - $91k per year
Location
Required Skills
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