Case Management Nurse - 248743 New

Bilingual Nurse Case Manager– Korean

Schedule: Monday–Friday, 8:00 AM–5:00 PM

Work Location: Hybrid (Primarily Remote)

Required: Must be local to Arcadia or Huntington Beach, CA

Travel: Must be able to attend 6–8 member events per year across Southern California

Job Summary

The Case Manager plays a critical role in promoting quality, cost-effective care for an assigned member population. This position supports members across the care continuum by facilitating collaboration among healthcare providers, assessing needs, developing care plans, and ensuring members receive the services and resources necessary to achieve positive health and social outcomes. The ideal candidate delivers patient-centered, medically appropriate, and cost-efficient care while monitoring progress and advocating for necessary interventions.

Key Responsibilities

• Conduct comprehensive assessments of medical, social, and behavioral needs within regulated timelines.
• Determine case management eligibility based on clinical judgment, condition changes, and assessment triggers.
• Develop and implement individualized care plans in collaboration with members, caregivers, providers, and support networks.
• Perform telephonic and face-to-face/virtual visits as required.
• Monitor interventions and evaluate progress, adjusting care plans as needed.
• Maintain an active member caseload with regular outreach and care management.
• Promote integration of services including behavioral health, LTSS, and community-based supports.
• Utilize motivational interviewing and clinical guidelines to educate and engage members.
• Identify and address barriers to care; provide coordination and resource assistance.
• Complete timely documentation and uphold compliance standards.
• Perform additional duties as assigned.

Qualifications

Education & Experience

• 2–3 years of experience in case management, disease management, managed care, or medical/behavioral health environments.

Licensure & Certifications

• Active, unrestricted California Registered Nurse (RN) or Licensed Vocational Nurse (LVN) license (required).

Skills & Competencies

• Strong critical thinking and problem-solving abilities.
• Excellent verbal and written communication skills.
• Highly organized, adaptable, and self-motivated.
• Ability to work independently in a fast-paced environment.
• Strong work ethic with a positive, professional attitude.
• Ability to manage multiple priorities and follow directions effectively.
• Bilingual in Korean (must).