Insurance Case Manager Remote Jobs in Anaheim, CA

RN Case Manager

Remote (Full Time) *Must reside in California*

Compensation: $85,000

About Us

Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the one-size-fits-all healthcare system. We partner with health plans, providers, and community organizations to deliver culturally competent primary care, behavioral health, and social care.

Our model is built for populations with high medical and social complexity, where fragmented care drives poor outcomes and unnecessary cost. We combine local, community-based teams with virtual care and modern technology to deliver coordinated, whole-person care where members live and receive support.

Founded in 2021, Zócalo Health is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations. We are building a durable care platform designed to perform in constrained healthcare environments and to lead the shift toward accountable, value-based care.

Role Description

The RN Case Manager will join Zócalo Health during a period of rapid growth and increasing operational complexity. This role exists to provide clinical care management and care coordination services for members with complex medical, behavioral, and social needs.

As part of an interdisciplinary care team led by a Nurse Practitioner, the RN Case Manager will be responsible for assessing member needs, developing care plans, coordinating services, managing transitions of care, and supporting members in achieving their health goals. The RN serves as the primary clinical coordinator within the care team and works closely with Community Health Workers, Care Coordinators, Behavioral Health staff, providers, caregivers, and community partners.

The RN Case Manager will contribute in the following ways:

• Conduct comprehensive clinical assessments and identify medical, behavioral, and social barriers to health.
• Develop, implement, and monitor individualized care plans for high-risk members.
• Manage a panel of members with complex healthcare needs across multiple settings and providers.
• Coordinate transitions of care following emergency department visits, hospitalizations, and skilled nursing stays.
• Collaborate closely with Community Health Workers to ensure members receive both clinical and community-based support.
• Identify gaps in care and proactively intervene to prevent avoidable utilization and adverse outcomes.
• Provide health coaching, disease management education, medication support, and self-management training.
• Participate in interdisciplinary care team meetings and case reviews.
• Maintain accurate documentation and regulatory compliance requirements associated with ECM and related programs.
• Support quality, utilization, and member outcome goals established by the organization and health plan partners.

Qualifications

• Active Registered Nurse license in California.
• 3+ years of nursing experience in care management, case management, population health, home health, primary care, managed care, or related settings.
• Experience managing medically complex and high-risk populations.
• Strong understanding of care coordination, utilization management, transitions of care, and chronic disease management.
• Excellent communication and relationship-building skills.
• Ability to work effectively in interdisciplinary and remote care environments.
• Required: Fluency in English and Spanish, including the ability to communicate effectively both verbally and in writing.

What you can expect from Zócalo Health

• Comprehensive benefits including medical, dental, and vision
• 401k with 4% match
• Flexible PTO policy - take the time you need to recharge
• $1,000 home office stipend
• We provide the equipment needed for this role.
• Opportunity for rapid career progression with plenty of room for personal growth.

You must be authorized to work in the United States. Remote Work can be done from anywhere in the U.S.

At Zócalo Health Inc., we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at Zócalo Health are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. 

Those seeking employment at Zócalo Health are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.