California Licensed Care Management Manager

Managing the daily operations of inpatient and care management staff, the full-time California Licensed Care Management Manager will oversee concurrent and retrospective inpatient reviews, discharge planning, and transitional care programs while ensuring compliance with federal, state, and health plan requirements in a remote setting. Key responsibilities Oversee the management of inpatient and care management staff to ensure effective workflow and resource utilization Develop and implement policies and procedures to enhance department performance and customer satisfaction Monitor department performance against compliance requirements and serve as a resource for staff on complex issues Required qualifications Current RN license in the State of California BSN or Bachelor's Degree in a healthcare-related field Minimum of 2 years of supervisory experience in a medical group or health plan setting At least 2 years of experience in Inpatient Case Management and/or Outpatient Care Management Understanding of nationally recognized criteria such as Milliman Care Guidelines, Interqual, or CMS