RN Case Manager - Bilingual Spanish

Empowering Wellness, Transforming Lives

Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.

As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.

Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members.

A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work!

Job Summary:

The RN Case Manager oversees comprehensive care coordination for diverse patient cases, utilizing effective communication strategies and cultural sensitivity to engage members and providers. With a focus on chronic conditions, mental health, and homelessness, they assess, develop, and implement care plans while ensuring regulatory compliance and compassionate patient support.

Supervisory Responsibilities:

• Supervise the care management staff, including assisting in the development, training, network development, and assignment of work/projects.
• Supervises and evaluates appropriateness of care coordination and directs the case management staff to modify plans as needed.
  
  

Duties/Responsibilities:

• Utilize medical interventions to enhance members' self-management of health.
• Engage with ECM Lead Care Managers via phone or in-person for assessment and care plan development.
• Provide training for ECM Team Members on medical conditions and treatments.
• Coordinate with internal and external partners to support members' comprehensive care.
• Coordinate clinical care for ECM Program clients and establish care plan goals.
• Organize and monitor services needed by recipients.
• Perform bio-psycho-social assessments and develop care plans.
• Oversee care plan implementation and monitor treatment adherence.
• Provide coaching for behavior change and health improvement.
• Document interactions and interventions accurately.
• Collaborate with executives and assist in staff training for safety and quality assurance.
• Design and execute training programs for Lead Care Managers.
• Prepare formal responses and reports for regulatory agencies.
• Establish effective processes and ensure compliance with regulations.
• Assist in maintaining operational efficiency and quality care for patients.
• Performs other duties as assigned.
  
  

Education and Experience:

• Registered Nurse with a valid CA license from an accredited nursing school.
• Associate degree in Nursing from an accredited institution required.
• Bachelor’s degree in nursing from an accredited institution preferred. Experience in a Health Care Organization or experience in Managed Care setting preferred.
• 1-2 years of case management experience with low-income populations, focusing on complex chronic conditions, mental illness, and homelessness.
• 2 years of experience with homeless, low-income, and mentally ill populations, including substance abuse.
• Experience in Medicare and Medi-Cal environments preferred.
  
  

Required Skills/Abilities:

• Bilingual in English / Spanish Required
• Proficient in evidenced-based communication techniques like Motivational Interviewing.
• Understanding and sensitivity to multicultural communities.
• Knowledgeable in self-management practices for chronic conditions.
• Skilled in phone-based engagement with members and providers.
• Proficiency in data interpretation and learning new software systems.
• Strong attention to detail, analytical thinking, and interpersonal skills.
• Ability to work autonomously and as part of a team.
• Exceptional organizational and time management abilities.
• Compassionate and empathetic approach to patient care.
• Ability to analyze situations and act ethically and in compliance with regulations.
• Flexibility to adapt to changing environments
  
  

Physical Requirements:

• Willingness to travel to different locations.
• Prolonged periods sitting at a desk and working on a computer.
• Must be able to lift up to 10 pounds at times.
  
  

Pay range: $90,000 USD - $100,000 USD

Benefits

Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:

Medical, Dental, & Vision Benefits: We have various insurance options for you and your family.

Short & Long-Term Disability Benefits: Protection when you need it most.

Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.

Flexible Spending Accounts: Manage your finances with flexibility.

Employee Assistance Program (EAP): Support when life throws challenges your way.

401(K): Building your financial future with us. Effective after 1 year of employment.

Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.

Paid Holidays: Quality time to enjoy celebrations.

Employee Referral Program: Share the opportunities and reap the rewards.

Company Discount Program: Enjoy savings on everyday expenses and memberships.

Equal Employment Opportunity

Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities.

Pre-Employment

Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.