RN Case Manager (Remote)

We need to output HTML fragment with sections: headings

for sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We must include only sections that have real specific content. We must not repeat job title. Must not include Job ID etc. Must preserve all substantive info, no boilerplate. Remove cookie/navigation/legal/EEO etc. Also remove duplicated lines, application instructions. Must not create Pay/Schedule/Benefits unless posting actually states them. Pay is present: "Pay range: $90,000 USD - $110,000 USD". Benefits present. Schedule? Not explicitly given; there is ability to work required hours 8:30 a.m.–5:00 p.m. PST. That's schedule info. So we can include Schedule section with that. Also maybe "Physical and Work Requirements" could be part of Requirements or Qualifications. We'll decide sections: About the role (maybe from mission statement?), Responsibilities (Key Responsibilities), Qualifications (Required and Preferred), Skills (maybe from qualifications?), Benefits, Pay, Schedule. We need to avoid filler like "commensurate with experience". Not present. We need to preserve all substantive info: mission description, job summary, responsibilities bullet list, qualifications required and preferred, physical/work requirements, benefits list, pay range, schedule (hours). Also maybe "Population Management" part of responsibilities. We must not include EEO, drug-free workplace, pre-employment etc. Remove those. We must not include duplicated lines. Ensure we capture all content. Let's extract content: Mission/intro: "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!" That's about the role/organization. Could be "About the role" or "About Optima MMG". We'll use

About the role

and put that paragraph(s) in

. Job Summary: "The RN Clinical Care Manager (CCM) is the clinical anchor of a dedicated care pod within the Enhanced Care Management (ECM) program, holding full documentation and clinical oversight responsibility for a cohort of approximately 500 ECM members. Working as an integral, fully remote member of the pod's interdisciplinary Care Team, alongside Lead Care Managers, MAs, and Community Health Workers, the RN CCM ensures that every member's care plan, assessment, and clinical record reflects sound nursing judgment and meets payer and regulatory standards. This role combines the relational, member-engagement strengths of the Lead Care Manager with the clinical expertise, documentation rigor, and oversight responsibilities of an RN Case Manager. Under the general supervision of Enhanced Care Management Leadership, the RN Clinical Care Manager provides clinical oversight and documentation review for all care plans, assessments, and clinical notes generated within the pod, working remotely alongside the Lead Care Managers and Community Health Workers, a who conduct direct member engagement. Through collaboration with Primary Care Providers (PCPs), interdisciplinary Care Team members, and community partners, the CCM ensures that members receive the right care, at the right time, in the right place—supporting improved outcomes and health equity for diverse Medi-Cal populations across the assigned 500-member cohort." We could incorporate this into About the role or separate "Job Summary". But headings limited to given list; we could put under About the role. Or we could create a separate section "Responsibilities" for duties. The job summary is more overview; could be part of About the role. Key Responsibilities: list under "Pod Nursing, Documentation, and Clinical Oversight", "Care Coordination and Clinical Oversight", "Clinical Leadership and Quality Improvement", "Population Management". We'll extract bullet points. Let's list responsibilities: - Serve as the RN of record for a cohort of approximately 500 ECM members, holding full responsibility for the accuracy, completeness, and clinical soundness of all documentation within the pod. - Function as an integral, fully remote member of the pod Care Team, partnering closely with Lead Care Managers, MAs, and Community Health Workers who conduct direct member engagement. - Review and provide clinical oversight of care plans, assessments, and progress notes entered by pod team members, ensuring clinical accuracy and appropriateness of the plan of care. - Respond promptly and professionally to clinical escalations from the pod team, ensuring documentation and service delivery adhere to legal and payer guidelines. - Provide clinical sign-off on individualized, whole-person care plans based on comprehensive assessments addressing physical health, behavioral health, substance use, long-term care, housing, and social service needs across the assigned cohort. - Work collaboratively across the healthcare continuum—primary care, specialists, hospitals, behavioral health, and community agencies—to integrate medical and social support. - Monitor member progress and outcomes across the pod's cohort, adjust care plans as needed, and ensure regular follow-up through remote documentation review and telehealth workflows. - Facilitate and identify candidates for safe and effective care transitions, including discharge planning, follow-up appointments, and home-based care coordination. - Advocate for timely access to appropriate treatments, medications, and support services. - Review utilization patterns of high-risk patients and work with healthcare teams to design interventions that reduce avoidable hospital and ED visits. - Analyze payer and quality performance reports to identify care gaps and implement improvement strategies. - Participate in developing and training team members on quality improvement, safety, and case management best practices. - Maintain compliance with Medi-Cal, HEDIS, and quality standards while advancing health equity across all populations. - Hold clinical oversight for the pod’s cohort of approximately 500 ECM members across ECM’s populations of focus, including but not limited to: - Individuals experiencing homelessness - Those with serious mental illness and/or substance use disorders - Individuals transitioning from incarceration - High utilizers of emergency services - Adults at risk of institutionalization or transitioning from nursing facilities - Pregnant/postpartum individuals facing racial or ethnic birth inequities - Children and youth in child welfare or California Children’s Services (CCS) - Perform additional duties as required. We'll put these under

Responsibilities

with

• . Qualifications Required: list: - Active California RN license in good standing (required, regardless of the RN's physical location). - Minimum 2 years of experience as a Registered Nurse; case management or Enhanced Care Management (ECM) experience preferred. - Strong understanding of Medi-Cal, care coordination, and social determinants of health. - Excellent analytical, clinical judgment, interpersonal, and communication skills. - Proficiency in MS Office (Excel, Word, Outlook) and electronic health record systems. - Ability to consistently work required hours of 8:30 a.m.–5:00 p.m. PST, regardless of the RN's home time zone. - Reliable high-speed internet and a private, HIPAA-compliant home workspace suitable for a fully remote clinical role. - Compassionate, nonjudgmental, and culturally sensitive approach. Preferred: - Bachelor’s or Associate degree in Nursing, RN license. - Bilingual, Spanish. - Certified Case Manager (CCM) or equivalent certification. - Experience in Managed Care, Community Health, or Behavioral Health settings. - Certification or experience using Motivational Interviewing or empathy-based communication strategies. - Familiarity with regional health disparities and principles of self-management support for chronic conditions. Physical and Work Requirements: - Prolonged periods sitting at a home workstation performing documentation review and computer-based work. - Frequent computer usage; must be able to lift up to 10 pounds. - Occasional evening or weekend work within a 40-hour week. We could incorporate physical/work requirements into Qualifications or Requirements. Since we have a "Requirements" heading possible, we could put required qualifications there, and maybe "Skills" for proficiencies. But we need to follow headings list: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide mapping. Option: About the role = mission/intro + job summary. Responsibilities = key responsibilities. Requirements = required qualifications (maybe plus physical/work requirements). Qualifications = preferred qualifications. Skills = maybe proficiencies like MS Office, EHR, communication etc. But those are already in required qualifications. Could split: Required qualifications (license, experience) under Requirements; Skills under Skills (proficiency, analytical, communication). But we must not invent headings with filler. We need to ensure each section has real content. Let's think: The posting includes "Required" and "Preferred" qualifications. Also includes "Physical and Work Requirements". Could map: - Requirements: Required qualifications + Physical and Work Requirements. - Qualifications: Preferred qualifications. - Skills: maybe not needed; we could omit Skills section if no distinct skill list beyond what's already covered. But we have "Proficiency in MS Office (Excel, Word, Outlook) and electronic health record systems." and "Excellent analytical, clinical judgment, interpersonal, and communication skills." Those could be considered skills. Could put them under Skills. Thus: About the role: mission/intro + job summary. Responsibilities: as above. Requirements: Required qualifications (license, 2 years experience, understanding of Medi-Cal, etc.) plus maybe ability to work hours, reliable internet, workspace, compassionate approach. Qualifications: Preferred qualifications (degree, bilingual, CCM, etc.) Skills: Proficiency in MS Office/EHR, analytical, clinical judgment, interpersonal, communication skills. Benefits: list. Pay: Pay range. Schedule: Ability to work required hours 8:30 a.m.–5:00 p.m. PST (maybe also occasional evening/weekend work). We'll put schedule. We must not include filler like "commensurate with experience". Not present. Now produce HTML fragment. We'll need to wrap each section in

  heading then content. For lists, use

  • . For prose, use

    . We must not include any extra text outside HTML. Let's craft. First, About the role: combine mission/intro paragraph(s) and job summary. Could be multiple

    tags. We'll put mission/intro as one

    . Then job summary as another

    . Responsibilities:

    with each responsibility as
    • . Ensure we include all bullet points. Requirements:
      with required qualifications plus physical/work requirements. Qualifications:
      with preferred. Skills:
      with proficiency and analytical etc. Benefits:
      with benefits list. Pay:

      with pay range. Schedule:

      with schedule info (hours and occasional evening/weekend). Check for duplication: Ensure we didn't repeat any content inadvertently. Let's list required qualifications bullet points: - Active California RN license in good standing (required, regardless of the RN's physical location). - Minimum 2 years of experience as a Registered Nurse; case management or Enhanced Care Management (ECM) experience preferred. - Strong understanding of Medi