RN Case Manager

Senior Nurse Case Manager (Medicare – Complex Case Management)

Location: Central Sacramento (Hybrid – Telephonic & Field-Based)

Travel: Up to 50% within a 50‑mile radius

Schedule: Full-Time

Job Summary

Under the direction and oversight of the Manager of Inpatient Review and Case Management, the Senior Nurse Case Manager is responsible for the coordination and management of care for Medicare members with complex and chronic conditions. This role partners with physicians, providers, health plans, and interdisciplinary teams to ensure patient-centered, cost-effective, and high-quality care across the continuum.

The Senior Nurse Case Manager serves as a clinical subject matter expert, manages high-risk cases, supports utilization management and discharge planning, and plays a leadership role in mentoring nurses and supporting department initiatives.

Key Responsibilities

• Manage complex, high-risk Medicare cases from identification through stabilization or maintenance
• Conduct comprehensive initial and ongoing clinical assessments
• Develop, implement, monitor, and adjust individualized care plans
• Coordinate care across providers, facilities, community resources, and health plans
• Apply managed care and utilization management principles within established criteria
• Lead or participate in care conferences, rounds, and interdisciplinary workgroups
• Serve as a clinical resource and proctor for new hires and lower-level nurses
• Assist with development of care management policies, procedures, and quality initiatives
• Identify cases requiring peer review for medical necessity or quality-of-care concerns
• Support discharge planning telephonically and through on-site visits (hospital, home, provider offices)
• Ensure accurate, timely documentation in the EMR every shift
• Meet all productivity and quality metrics
• Assist with UM/QI case preparation and regulatory audits
• Maintain compliance with IPA, Health Plan, and regulatory standards
• Perform additional job-related duties as assigned

Competencies & Qualifications

Required:

• 4 years of professional nursing experience in an acute care setting
• 4 years of complex case management experience
• Active and unrestricted California RN license
• Graduate of an accredited school of nursing
• Strong knowledge of medical management, managed care products, and member benefits
• Excellent communication, critical thinking, and analytical skills
• Ability to work independently and within a multidisciplinary team
• Strong organizational, time management, and documentation skills
• Proficiency in Microsoft Word, Excel, PowerPoint; EMR experience required
• Active and unrestricted California Driver’s License
• Regular attendance and ability to travel as required

Preferred:

• Medicare experience
• Managed care background
• Case Management Certification (CCM or equivalent)
• Experience serving as a mentor, trainer, or lead nurse

Work Environment & Expectations

• Telephonic and field-based care management
• Travel up to 50% within Central Sacramento
• Fast-paced, collaborative healthcare environment
• High level of autonomy and professional accountability

Why Join Us

• Make a meaningful impact on complex Medicare populations
• Work within a collaborative, multidisciplinary care model
• Opportunity for leadership, mentorship, and professional growth
• Mission-driven organization focused on quality, patient-centered outcomes

This is a Contract to Hire position based out of Sacramento, CA.

The pay range for this position is $53.50 - $53.50/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

This is a hybrid position in Sacramento,CA.

This position is anticipated to close on May 12, 2026.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I is embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

Actalent is an equal opportunity employer.

About Actalent

Actalent is a global leader in engineering and sciences services. For more than 40 years, we’ve helped visionary companies advance their goals. Headquartered in the United States, our teams span 150 offices across North America, EMEA, and APAC—with four delivery centers in India led by 1,000 extraordinary employees who connect their passion with purpose every day.

Our Bangalore, Hyderabad, Pune, and Chennai delivery centers are hubs of engineering expertise, with core capabilities in mechanical and electrical engineering, systems and software, and manufacturing engineering. Our teams deliver work across multiple industries including transportation, consumer and industrial products, and life sciences. We serve more than 4,500 clients, including many Fortune 500 brands. Learn more about how we can work together at actalentservices.com.

Salary : $54