Clever Care Community Centers are now open in San Gabriel, Westminster, and Koreatown! Click here to learn more.

About Clever Care Health Plan

Clever Care Health Plan is a newly founded Medicare Advantage health plan serving Medicare beneficiaries in Southern California. Our employees are passionate in providing best services to our members and healthcare providers. Our three office locations are in Arcadia (Los Angeles County), Huntington Beach (Orange County) and New York City.

Job Summary

Clever Care Health Plan (Clever Care) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. Clever Care staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost‐effective based on the severity of illness and the site of service.

Functions and Job Responsibilities

  • Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member’s health or psychosocial wellness, and triggers identified in the assessment.
  • Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member’s support network to address the member needs and goals.
  • Conducts face‐to‐face or home visits as
  • Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
  • Maintains ongoing member case load for regular outreach and
  • Promotes integration of services for members including behavioral health care and long-term services and supports/home and community to enhance the continuity of care for Clever Care
  • Uses motivational interviewing and Clever Care clinical guideposts to educate, support and motivate change during member contacts.
  • Assesses for barriers to care, provides care coordination and assistance to member to address
  • RNs provide consultation, recommendations and education as appropriate to non‐RN case
  • RNs are assigned cases with members who have complex medical conditions and medication regimens
  • RNs conduct medication reconciliation when

Education and Experience

  • Graduate from an Accredited School of Bachelor’s Degree in Nursing preferred.
  • 1‐3 years in case management, disease management, managed care or medical or behavioral health settings.

Knowledge, Skills, and Abilities

  • Active, unrestricted State Registered Nursing (RN) license in good
  • Certified Case Manager (CCM) preferred

Physical & Working Environment

Typical Physical Demands.
Position requires a great amount of sitting and standing. Some lifting, stooping, bending, or reaching is required. May require lifting up to 15‐30 pounds. Requires manual dexterity sufficient to operate a computer, calculator and telephone. Requires normal range of hearing and vision. Requires the ability to type and file.

Typical Working Conditions.
Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. Work may be stressful at times. May occasionally work some irregular hours.

Apply for the Case Manager RN position at Clever Care Health Plan