Virtual Centene Rn Jobs in California (NOW HIRING)

Description

We’re building a better health system! At Nice, we’re making healthcare accessible by delivering integrated primary, musculoskeletal, and mental health care to patients when they want it through a combination of in-home and virtual visits while also improving the quality of care by eliminating the complexity, poor management and time constraints that hold clinicians captive.

The Care Coordination team at Nice Healthcare has an exciting opportunity for an experienced Registered Nurse (RN) Care Coordinator in the PST Time Zone!

We are looking for a motivated, resourceful and organized individual to provide amazing services through patient care coordination and Provider support. In this role, the RN Care Coordinator will work independently providing professional appropriate telehealth nursing services to patients and/or their family members.This is done by utilizing a systematic approach to nursing practice incorporating assessment, planning, nursing diagnosis, implementation and evaluation in accordance with the Nurse Practice Act and its recognized professional standards. You’ll work collaboratively with the clinical team to help support our Physician Assistants and Nurse Practitioners to provide the best healthcare for our patients.

What you’ll do at Nice: 

Key Responsibilities

Patient Triage & Communication:

• Utilize Nice Healthcare’s messaging app, EMR, and chat platforms for patient and staff communication.
• Execute advanced triage communication following established protocols, including initiating diagnostic and therapeutic interventions before referral to a provider.
• Serve as a liaison among providers, patients, and staff.

Case Management:

• Manage a longitudinal patient panel by monitoring clinical data trends for chronic conditions.
• Evaluate progress against treatment plans and proactively adjust interventions to improve health outcomes and prevent acute escalations.
• Educate patients regarding their conditions and facilitate connections with appropriate healthcare providers.
• Utilization Review: Understanding "medical necessity" and how to justify care to insurance providers.

Clinical Support:

• Initiate patient referrals to specialty clinics via electronic fax submission.
• Triage laboratory and imaging results, promptly notifying providers of abnormal or critical values.
• Perform medication refills and process prior authorizations.
• Troubleshoot and meticulously track pharmacy-related errors.

Team & Advocacy:

• Act as a patient advocate, upholding patient confidentiality and rights.
• Address and resolve patient concerns and complaints with professionalism.
• Function as a mentor and collaborate with the team to resolve department or guideline issues.

Required Qualifications and Experience

Licensure:

• Active, unrestricted RN Multi-State (Compact) License required.
• Active Minnesota RN License required (or in final stages of reciprocity).
• Willingness and ability to obtain additional state licenses as the patient population grows.

Experience:

• 3-5 years of experience as a Registered Nurse in an ambulatory setting.
• At least one year of experience as a Registered Nurse in a virtual or ambulatory primary care setting.
• Prior experience with RN case management.
• Prior experience in triage and clinical practice within ambulatory, virtual, or telephone triage settings is highly preferred.

Skills:

• Demonstrated strong attention to detail, proficiency in prioritization, organization, and self-discipline.
• Proven critical thinking skills, including the ability to navigate multifaceted processes.
• Highly effective communication skills for a virtual team environment.
• Proficiency with technology, including web-based communication, virtual teleconferencing, MS Office, and Google Suite.

Requirements

• Strong Internet signal with a secure wifi
• A dedicated work space/office, free from interruptions is required
• 3-5 years experience as a Registered Nurse in an ambulatory setting
• At least one year experience as a Registered Nurse in a virtual or ambulatory primary care setting.
• Hold an active RN license in the NLC compact states required
• Hold an active license in the state of Minnesota and Nevada required

What You\'ll Love about Nice:

• 100% remote work environment 
• Comprehensive Benefits: Medical, Dental, and Vision coverage
• Security: Life insurance, short-term disability, and long-term disability coverage
• Future Planning: 401k with 3% employer contribution
• Time for You: Up to 25 days of accrued PTO that we actively encourage you to use
• 11 Company holidays
• Growing Together: Opportunities for professional development
• Care for your Loved Ones: A robust parental leave policy. Access to Nice Healthcare for you and your dependents (in eligible cities)
• Work-Life Presence: Flexibility to balance your personal and professional life, with support to thrive in both areas
• The nicest team members: Join a team that truly cares about one another and our patients

Salary Range: $80,000 - $90,000, commensurate with experience.

Building a better health system for all requires the input and perspectives of everyone. At Nice Healthcare, inclusivity starts with recruitment, and we actively seek a diverse mix of beliefs, backgrounds, education, and viewpoints to drive better, more informed decisions. We are committed to creating an equitable workplace where everyone feels valued, respected, and empowered to bring their whole selves to work. 

If you require a reasonable accommodation throughout the application process, please reach out to us at peopleteam@nice.healthcare.

Candidates must currently reside in the United States and be legally authorized to work in the U.S. without the need for current or future visa sponsorship. Please note that Nice Healthcare does not offer relocation assistance for this role.