RN Case Manager (Remote)

About the role

Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and its divisions: Serene Health, Community Support, and American TrueCare, the mission is to provide comprehensive support and care that addresses immediate concerns and fosters long-term well-being. The organization aims to lead in member care outcomes, set new standards for excellence and innovation, empower members to achieve self-sufficiency in health, and strengthen families and communities. The work culture is built on pride, passion, and a collective commitment to making a positive difference. Team members are dedicated problem-solvers who bring unique skills and perspectives, working in a collaborative and supportive environment to unlock full potential and provide the best possible care. A career at Optima MMG offers opportunity to be part of a dynamic, forward-thinking organization with continuous learning, professional growth, access to industry experts, cutting‑edge technologies, and a supportive community that values each individual's contributions.

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 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.

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