[Hiring] RN Clinical Care Manager @Serene Health

Role Description

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. 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.

Key Responsibilities

• Pod Nursing, Documentation, and Clinical Oversight
  • 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.
• Care Coordination and Clinical Oversight
  • 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.
• Clinical Leadership and Quality Improvement
  • 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.
• Population Management
  • 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)

Qualifications

• 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.

Pay range

$90,000 — $110,000 USD

Benefits

• Medical, Dental, & Vision Benefits: 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.