Part-Time Registered Nurse - Clinical Case Consultant - ECM

$45 / hour

Department: Enhanced Care Management (ECM) Reports To: ECM Program Manager Work Arrangement: Hybrid - CA Compensation: $45/hourly Schedule: Monday – Friday | 8:00am - 1:00pm (*flexible) 25 - 29 hrs per week About Pacific Health Group At Pacific Health Group, we are transforming healthcare by addressing social determinants of health and delivering innovative, community-based solutions that improve lives. Through programs such as Enhanced Care Management (ECM), Community Supports, Behavioral Health Services, Community Health Workers, Street Medicine, and other whole-person care initiatives, we help individuals navigate complex healthcare systems and access the resources they need to thrive. We meet individuals where they are—with compassion, dignity, respect, and a commitment to whole-person care. Our work focuses on improving outcomes for individuals experiencing homelessness, serious mental illness, substance use disorders, chronic health conditions, justice involvement, and other complex social and medical challenges. If you are passionate about improving healthcare outcomes and supporting vulnerable populations through innovative community-based care, we invite you to join our team. Our Core Values Speak with integrity—clear, respectful, and honest in every interaction. Embrace innovation by trying new ideas, learning quickly, and continuously improving. Own our roles by remaining accountable for outcomes and documentation. Build genuine connections through empathy, compassion, and cultural humility. Lead with trust through consistency, transparency, and follow-through. Celebrate wins together and recognize team achievements. Collaborate with purpose across departments, providers, and community partners. Ask for support and offer support because thriving together strengthens our ability to serve our members. Position Summary The Registered Nurse – Clinical Case Consultant serves as the clinical subject matter expert for Pacific Health Group's CalAIM Enhanced Care Management (ECM) program. This position provides clinical guidance, consultation, oversight, and support to interdisciplinary care teams serving high-risk Medi-Cal members with complex medical, behavioral health, and social needs. The Clinical Case Consultant works closely with Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, Behavioral Health staff, healthcare providers, health plans, hospitals, and community-based organizations to ensure members receive coordinated, high-quality, person-centered care. This role combines clinical expertise, care coordination, quality improvement, staff development, field-based oversight, and community collaboration to improve health outcomes, reduce avoidable utilization, and support compliance with CalAIM ECM requirements and best practices. This position serves as the clinical leader for field-based care management activities, providing direct supervision and clinical oversight of Licensed Vocational Nurses (LVNs), conducting field visits and ride-alongs with Lead Care Managers (LCMs), Community Health Workers (CHWs), and other care team members, and ensuring the delivery of safe, high-quality, member-centered services throughout hiring county. Essential Duties and ResponsibilitiesClinical Leadership & Consultation Serve as the primary clinical resource for ECM care teams. Provide clinical consultation and guidance to Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, and interdisciplinary team members. Review complex member cases and provide recommendations regarding care planning, interventions, risk mitigation, and treatment coordination. Participate in interdisciplinary case reviews, case conferences, and care team meetings. Assist care teams in identifying clinical risks and developing appropriate intervention strategies. Support development of individualized, member-centered care plans that align with CalAIM ECM requirements and member goals. Promote evidence-based practices and whole-person care approaches. Assist leadership with clinical decision-making and complex case management strategies. Enhanced Care Management (ECM) Support Support implementation and ongoing success of CalAIM Enhanced Care Management services. Ensure clinical interventions align with ECM program requirements, contractual obligations, and best practices. Collaborate with health plans, providers, hospitals, behavioral health agencies, and community-based organizations to coordinate care and improve outcomes. Assist care teams in navigating complex healthcare systems and addressing barriers to care. Support care transitions following hospitalizations, emergency department visits, skilled nursing facility discharges, and other significant healthcare events. Monitor high-risk members and provide recommendations to prevent avoidable utilization and adverse outcomes. Field-Based Clinical Support & Quality Oversight Conduct regular field visits with Lead Care Managers (LCMs), Community Health Workers (CHWs), Licensed Vocational Nurses (LVNs), and other care team members to observe service delivery and provide clinical guidance. Shadow care team members during member visits to assess care coordination effectiveness, member engagement, documentation practices, safety considerations, and adherence to program standards. Provide real-time coaching, mentorship, and clinical consultation during field-based activities. Evaluate field operations and identify opportunities to improve member outcomes, care coordination practices, workflow efficiency, and service quality. Support staff in managing complex member situations, high-risk cases, crisis intervention needs, and care transitions. Conduct quality assurance reviews of field-based activities and provide recommendations for improvement. Participate in joint member visits when clinical support, member education, care coordination, or provider collaboration is needed. Monitor field-based documentation and ensure compliance with Medi-Cal ECM requirements, organizational standards, and regulatory expectations. LVN Supervision & Clinical Oversight Provide direct clinical supervision and oversight for Licensed Vocational Nurses (LVNs) in accordance with California nursing regulations and Pacific Health Group policies. Review and monitor LVN clinical activities, documentation, assessments, care coordination efforts, and member interactions. Provide ongoing coaching, education, mentorship, and professional development to LVNs. Support competency development and clinical skill enhancement among LVN staff. Ensure delegated nursing functions are performed appropriately and within scope of practice. Collaborate with leadership regarding LVN performance, development needs, and clinical support requirements. Promote adherence to clinical standards, documentation requirements, quality measures, and regulatory expectations. Assist with performance evaluations, corrective action recommendations, and clinical competency assessments as needed. Care Coordination & Community Collaboration Collaborate with primary care providers, specialists, behavioral health providers, hospitals, managed care plans, and community organizations. Facilitate communication among interdisciplinary team members to ensure continuity of care. Assist in identifying and resolving gaps in care, treatment adherence challenges, and service coordination issues. Support linkage to healthcare services, behavioral health services, housing resources, community supports, and social service programs. Participate in field-based consultations and community meetings as needed. Documentation, Compliance & Quality Assurance Maintain accurate, timely, and compliant documentation of clinical reviews, recommendations, consultations, and member interactions. Review care team documentation for quality, completeness, and compliance with Medi-Cal and ECM standards. Ensure documentation supports audit readiness and contractual compliance. Monitor clinical quality indicators and identify opportunities for improvement. Assist leadership in preparing for audits, quality reviews, and compliance monitoring activities. Promote data integrity and accountability throughout the care management process. Training & Staff Development Develop and deliver clinical training to non-clinical staff, including Community Health Workers, Care Coordinators, and Lead Care Managers. Provide education on chronic disease management, medication safety, behavioral health conditions, symptom recognition, healthcare navigation, and clinical best practices. Mentor staff to enhance clinical understanding and confidence in supporting members with complex needs. Support onboarding and ongoing professional development initiatives. Quality Improvement & Program Development Analyze clinical and programmatic outcomes to identify trends, barriers, risks, and opportunities for improvement. Participate in quality improvement initiatives focused on member outcomes, care coordination, compliance, and operational effectiveness. Assist in developing clinical workflows, policies, procedures, and best practices. Collaborate with leadership to improve program performance and service delivery. Support organizational initiatives related to innovation, quality, and population health management. Reporting & Clinical Analytics Monitor and evaluate member outcomes, utilization trends, and care coordination effectiveness. Provide clinical insights and recommendations to leadership regarding program performance. Assist with reporting related to quality metrics, care management outcomes, and compliance indicators. Identify opportunities to improve member engagement, healthcare utilization, and clinical outcomes. Key Performance Indicators (KPIs) Success in this role may be measured through: Reduction in avoidable emergency department utilization. Reduction in hospital admissions and readmissions. Improvement in member engagement and care plan completion. Timely completion of clinical reviews and consultations. Compliance with CalAIM ECM documentation standards. Audit readiness and documentation quality. Staff training completion and clinical competency development. Successful oversight and development of LVN staff. Quality outcomes identified through field visits and shadowing activities. Improved interdisciplinary collaboration and care coordination. Positive member outcomes and stabilization metrics. Achievement of organizational quality and performance goals. Minimum Qualifications Active and unrestricted Registered Nurse (RN) license in the State of California. Minimum two (2) years of direct clinical experience in community health, managed care, acute care, post-acute care, public health, behavioral health, or substance use disorder treatment settings. Experience working with Medi-Cal populations and individuals with complex medical, behavioral health, and social needs. Experience supporting populations experiencing homelessness, justice involvement, serious mental illness (SMI), substance use disorders (SUD), or multiple chronic conditions. Experience providing clinical guidance, consultation, mentoring, or supervision to interdisciplinary care teams preferred. Strong understanding of care coordination, population health, and interdisciplinary team-based care. Excellent communication, organizational, and problem-solving skills. Ability to work independently and collaboratively in a fast-paced environment. Proficiency with electronic health records (EHRs), care management platforms, and Microsoft Office applications. Preferred Qualifications Experience working within CalAIM Enhanced Care Management (ECM), Whole Person Care (WPC), Health Homes Program (HHP), or similar care management models. Case Management Certification (CCM, ACM, or equivalent). Experience supervising LVNs or other clinical support staff. Experience working with managed care plans and value-based care programs. Experience in community-based healthcare delivery. Bilingual proficiency in Spanish, Mandarin, Vietnamese, Tagalog, or other languages commonly spoken within the communities served. Experience mentoring interdisciplinary care teams. Requirements Reliable personal vehicle for daily work use Successful completion of background check (including MVR)| Must be able to travel up to 60-70% within the county to conduct in person visits Must successfully complete a Testlify skills assessment Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received Must have effective Time Management skills Must have internet speed of - 300+ mbps download and 25+mbps upload Must be proficient in technology, including documentation systems, case management platforms, and communication tools Work Environment & Travel Requirements This is a hybrid position requiring a combination of remote work, office-based work, and extensive field-based activities. Approximately 50% of work time will involve travel throughout hiring county to conduct field visits, shadow Lead Care Managers and other care team members, provide clinical supervision and coaching, support member care coordination activities, participate in community-based meetings, collaborate with healthcare providers and community partners, and conduct quality assurance reviews. The position may require attendance at case conferences, provider meetings, health plan meetings, leadership meetings, training events, and community-based activities. Frequent local travel is required. Must be willing to work occasional evenings and weekends as needed. Time Off & Leave Paid Time Off 12 Paid Holidays, including Birthday Holiday One Floating Holiday after one year of employment Four (4) Paid Volunteer Hours per Month Bereavement Leave, including Pet Bereavement Leave Health & Wellness 90% Employer-Paid Employee-Only Medical Coverage Dental and Vision Insurance Flexible Spending Account (FSA) Short-Term Disability, Long-Term Disability, and AD&D Coverage Employee Assistance Program (EAP) Financial & Professional Growth 401(k) with Company Match Monthly Stipend Professional Development Opportunities Career Advancement and Internal Growth Opportunities Culture & Employee Experience Hybrid Work Environment Quarterly In-Person Team and Company Events Employee Discount Programs through Great Work Perks and Perks at Work Mission-Driven Culture Focused on Compassion, Innovation, Accountability, Collaboration, and Growth Equal Opportunity Employer Pacific Health Group is an Equal Opportunity Employer committed to fostering an inclusive workplace where all employees are treated with dignity and respect. We celebrate diversity and are committed to creating an environment where individuals from all backgrounds can thrive. All qualified applicants will receive consideration for employment without regard to any protected characteristic protected under applicable federal, state, or local law.

Registered Nurse - Clinical Case Consultant - ECM

Pacific Health Group San Joaquin, CA

$85,000 - $95,000 / year

Department: Enhanced Care Management (ECM) Reports To: ECM Program Manager Classification: Exempt Work Arrangement: Hybrid - CA Compensation: $85,000.00 - $95,000.00 annually Schedule: Monday – Friday | Full-Time About Pacific Health Group At Pacific Health Group, we are transforming healthcare by addressing social determinants of health and delivering innovative, community-based solutions that improve lives. Through programs such as Enhanced Care Management (ECM), Community Supports, Behavioral Health Services, Community Health Workers, Street Medicine, and other whole-person care initiatives, we help individuals navigate complex healthcare systems and access the resources they need to thrive. We meet individuals where they are—with compassion, dignity, respect, and a commitment to whole-person care. Our work focuses on improving outcomes for individuals experiencing homelessness, serious mental illness, substance use disorders, chronic health conditions, justice involvement, and other complex social and medical challenges. If you are passionate about improving healthcare outcomes and supporting vulnerable populations through innovative community-based care, we invite you to join our team. Our Core Values Speak with integrity—clear, respectful, and honest in every interaction. Embrace innovation by trying new ideas, learning quickly, and continuously improving. Own our roles by remaining accountable for outcomes and documentation. Build genuine connections through empathy, compassion, and cultural humility. Lead with trust through consistency, transparency, and follow-through. Celebrate wins together and recognize team achievements. Collaborate with purpose across departments, providers, and community partners. Ask for support and offer support because thriving together strengthens our ability to serve our members. Position Summary The Registered Nurse – Clinical Case Consultant serves as the clinical subject matter expert for Pacific Health Group's CalAIM Enhanced Care Management (ECM) program. This position provides clinical guidance, consultation, oversight, and support to interdisciplinary care teams serving high-risk Medi-Cal members with complex medical, behavioral health, and social needs. The Clinical Case Consultant works closely with Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, Behavioral Health staff, healthcare providers, health plans, hospitals, and community-based organizations to ensure members receive coordinated, high-quality, person-centered care. This role combines clinical expertise, care coordination, quality improvement, staff development, field-based oversight, and community collaboration to improve health outcomes, reduce avoidable utilization, and support compliance with CalAIM ECM requirements and best practices. This position serves as the clinical leader for field-based care management activities, providing direct supervision and clinical oversight of Licensed Vocational Nurses (LVNs), conducting field visits and ride-alongs with Lead Care Managers (LCMs), Community Health Workers (CHWs), and other care team members, and ensuring the delivery of safe, high-quality, member-centered services throughout hiring county. Essential Duties and ResponsibilitiesClinical Leadership & Consultation Serve as the primary clinical resource for ECM care teams. Provide clinical consultation and guidance to Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, and interdisciplinary team members. Review complex member cases and provide recommendations regarding care planning, interventions, risk mitigation, and treatment coordination. Participate in interdisciplinary case reviews, case conferences, and care team meetings. Assist care teams in identifying clinical risks and developing appropriate intervention strategies. Support development of individualized, member-centered care plans that align with CalAIM ECM requirements and member goals. Promote evidence-based practices and whole-person care approaches. Assist leadership with clinical decision-making and complex case management strategies. Enhanced Care Management (ECM) Support Support implementation and ongoing success of CalAIM Enhanced Care Management services. Ensure clinical interventions align with ECM program requirements, contractual obligations, and best practices. Collaborate with health plans, providers, hospitals, behavioral health agencies, and community-based organizations to coordinate care and improve outcomes. Assist care teams in navigating complex healthcare systems and addressing barriers to care. Support care transitions following hospitalizations, emergency department visits, skilled nursing facility discharges, and other significant healthcare events. Monitor high-risk members and provide recommendations to prevent avoidable utilization and adverse outcomes. Field-Based Clinical Support & Quality Oversight Conduct regular field visits with Lead Care Managers (LCMs), Community Health Workers (CHWs), Licensed Vocational Nurses (LVNs), and other care team members to observe service delivery and provide clinical guidance. Shadow care team members during member visits to assess care coordination effectiveness, member engagement, documentation practices, safety considerations, and adherence to program standards. Provide real-time coaching, mentorship, and clinical consultation during field-based activities. Evaluate field operations and identify opportunities to improve member outcomes, care coordination practices, workflow efficiency, and service quality. Support staff in managing complex member situations, high-risk cases, crisis intervention needs, and care transitions. Conduct quality assurance reviews of field-based activities and provide recommendations for improvement. Participate in joint member visits when clinical support, member education, care coordination, or provider collaboration is needed. Monitor field-based documentation and ensure compliance with Medi-Cal ECM requirements, organizational standards, and regulatory expectations. LVN Supervision & Clinical Oversight Provide direct clinical supervision and oversight for Licensed Vocational Nurses (LVNs) in accordance with California nursing regulations and Pacific Health Group policies. Review and monitor LVN clinical activities, documentation, assessments, care coordination efforts, and member interactions. Provide ongoing coaching, education, mentorship, and professional development to LVNs. Support competency development and clinical skill enhancement among LVN staff. Ensure delegated nursing functions are performed appropriately and within scope of practice. Collaborate with leadership regarding LVN performance, development needs, and clinical support requirements. Promote adherence to clinical standards, documentation requirements, quality measures, and regulatory expectations. Assist with performance evaluations, corrective action recommendations, and clinical competency assessments as needed. Care Coordination & Community Collaboration Collaborate with primary care providers, specialists, behavioral health providers, hospitals, managed care plans, and community organizations. Facilitate communication among interdisciplinary team members to ensure continuity of care. Assist in identifying and resolving gaps in care, treatment adherence challenges, and service coordination issues. Support linkage to healthcare services, behavioral health services, housing resources, community supports, and social service programs. Participate in field-based consultations and community meetings as needed. Documentation, Compliance & Quality Assurance Maintain accurate, timely, and compliant documentation of clinical reviews, recommendations, consultations, and member interactions. Review care team documentation for quality, completeness, and compliance with Medi-Cal and ECM standards. Ensure documentation supports audit readiness and contractual compliance. Monitor clinical quality indicators and identify opportunities for improvement. Assist leadership in preparing for audits, quality reviews, and compliance monitoring activities. Promote data integrity and accountability throughout the care management process. Training & Staff Development Develop and deliver clinical training to non-clinical staff, including Community Health Workers, Care Coordinators, and Lead Care Managers. Provide education on chronic disease management, medication safety, behavioral health conditions, symptom recognition, healthcare navigation, and clinical best practices. Mentor staff to enhance clinical understanding and confidence in supporting members with complex needs. Support onboarding and ongoing professional development initiatives. Quality Improvement & Program Development Analyze clinical and programmatic outcomes to identify trends, barriers, risks, and opportunities for improvement. Participate in quality improvement initiatives focused on member outcomes, care coordination, compliance, and operational effectiveness. Assist in developing clinical workflows, policies, procedures, and best practices. Collaborate with leadership to improve program performance and service delivery. Support organizational initiatives related to innovation, quality, and population health management. Reporting & Clinical Analytics Monitor and evaluate member outcomes, utilization trends, and care coordination effectiveness. Provide clinical insights and recommendations to leadership regarding program performance. Assist with reporting related to quality metrics, care management outcomes, and compliance indicators. Identify opportunities to improve member engagement, healthcare utilization, and clinical outcomes. Key Performance Indicators (KPIs) Success in this role may be measured through: Reduction in avoidable emergency department utilization. Reduction in hospital admissions and readmissions. Improvement in member engagement and care plan completion. Timely completion of clinical reviews and consultations. Compliance with CalAIM ECM documentation standards. Audit readiness and documentation quality. Staff training completion and clinical competency development. Successful oversight and development of LVN staff. Quality outcomes identified through field visits and shadowing activities. Improved interdisciplinary collaboration and care coordination. Positive member outcomes and stabilization metrics. Achievement of organizational quality and performance goals. Minimum Qualifications Active and unrestricted Registered Nurse (RN) license in the State of California. Minimum two (2) years of direct clinical experience in community health, managed care, acute care, post-acute care, public health, behavioral health, or substance use disorder treatment settings. Experience working with Medi-Cal populations and individuals with complex medical, behavioral health, and social needs. Experience supporting populations experiencing homelessness, justice involvement, serious mental illness (SMI), substance use disorders (SUD), or multiple chronic conditions. Experience providing clinical guidance, consultation, mentoring, or supervision to interdisciplinary care teams preferred. Strong understanding of care coordination, population health, and interdisciplinary team-based care. Excellent communication, organizational, and problem-solving skills. Ability to work independently and collaboratively in a fast-paced environment. Proficiency with electronic health records (EHRs), care management platforms, and Microsoft Office applications. Preferred Qualifications Experience working within CalAIM Enhanced Care Management (ECM), Whole Person Care (WPC), Health Homes Program (HHP), or similar care management models. Case Management Certification (CCM, ACM, or equivalent). Experience supervising LVNs or other clinical support staff. Experience working with managed care plans and value-based care programs. Experience in community-based healthcare delivery. Bilingual proficiency in Spanish, Mandarin, Vietnamese, Tagalog, or other languages commonly spoken within the communities served. Experience mentoring interdisciplinary care teams. Requirements Reliable personal vehicle for daily work use Successful completion of background check (including MVR)| Must be able to travel up to 60-70% within the county to conduct in person visits Must successfully complete a Testlify skills assessment Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received Must have effective Time Management skills Must have internet speed of - 300+ mbps download and 25+mbps upload Must be proficient in technology, including documentation systems, case management platforms, and communication tools Work Environment & Travel Requirements This is a hybrid position requiring a combination of remote work, office-based work, and extensive field-based activities. Approximately 50% of work time will involve travel throughout hiring county to conduct field visits, shadow Lead Care Managers and other care team members, provide clinical supervision and coaching, support member care coordination activities, participate in community-based meetings, collaborate with healthcare providers and community partners, and conduct quality assurance reviews. The position may require attendance at case conferences, provider meetings, health plan meetings, leadership meetings, training events, and community-based activities. Frequent local travel is required. Must be willing to work occasional evenings and weekends as needed. Compensation & Benefits Salary Range: $85,000.00 - $95,000.00 annually Compensation is commensurate with experience, licensure, certifications, qualifications, and demonstrated clinical expertise. Time Off & Leave 160 Hours of Paid Time Off (PTO) 12 Paid Holidays, including Birthday Holiday One Floating Holiday after one year of employment Four (4) Paid Volunteer Hours per Month Bereavement Leave, including Pet Bereavement Leave Health & Wellness 90% Employer-Paid Employee-Only Medical Coverage Dental and Vision Insurance Flexible Spending Account (FSA) Short-Term Disability, Long-Term Disability, and AD&D Coverage Employee Assistance Program (EAP) Financial & Professional Growth 401(k) with Company Match Monthly Stipend Professional Development Opportunities Career Advancement and Internal Growth Opportunities Culture & Employee Experience Hybrid Work Environment Quarterly In-Person Team and Company Events Employee Discount Programs through Great Work Perks and Perks at Work Mission-Driven Culture Focused on Compassion, Innovation, Accountability, Collaboration, and Growth Equal Opportunity Employer Pacific Health Group is an Equal Opportunity Employer committed to fostering an inclusive workplace where all employees are treated with dignity and respect. We celebrate diversity and are committed to creating an environment where individuals from all backgrounds can thrive. All qualified applicants will receive consideration for employment without regard to any protected characteristic protected under applicable federal, state, or local law.

Part-Time Registered Nurse - Clinical Case Consultant - ECM

Pacific Health Group CA

$45 / hour

Department: Enhanced Care Management (ECM) Reports To: ECM Program Manager Work Arrangement: Hybrid - CA Compensation: $45/hourly Schedule: Monday – Friday | 8:00am - 1:00pm (*flexible) 25 - 29 hrs per week About Pacific Health Group At Pacific Health Group, we are transforming healthcare by addressing social determinants of health and delivering innovative, community-based solutions that improve lives. Through programs such as Enhanced Care Management (ECM), Community Supports, Behavioral Health Services, Community Health Workers, Street Medicine, and other whole-person care initiatives, we help individuals navigate complex healthcare systems and access the resources they need to thrive. We meet individuals where they are—with compassion, dignity, respect, and a commitment to whole-person care. Our work focuses on improving outcomes for individuals experiencing homelessness, serious mental illness, substance use disorders, chronic health conditions, justice involvement, and other complex social and medical challenges. If you are passionate about improving healthcare outcomes and supporting vulnerable populations through innovative community-based care, we invite you to join our team. Our Core Values Speak with integrity—clear, respectful, and honest in every interaction. Embrace innovation by trying new ideas, learning quickly, and continuously improving. Own our roles by remaining accountable for outcomes and documentation. Build genuine connections through empathy, compassion, and cultural humility. Lead with trust through consistency, transparency, and follow-through. Celebrate wins together and recognize team achievements. Collaborate with purpose across departments, providers, and community partners. Ask for support and offer support because thriving together strengthens our ability to serve our members. Position Summary The Registered Nurse – Clinical Case Consultant serves as the clinical subject matter expert for Pacific Health Group's CalAIM Enhanced Care Management (ECM) program. This position provides clinical guidance, consultation, oversight, and support to interdisciplinary care teams serving high-risk Medi-Cal members with complex medical, behavioral health, and social needs. The Clinical Case Consultant works closely with Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, Behavioral Health staff, healthcare providers, health plans, hospitals, and community-based organizations to ensure members receive coordinated, high-quality, person-centered care. This role combines clinical expertise, care coordination, quality improvement, staff development, field-based oversight, and community collaboration to improve health outcomes, reduce avoidable utilization, and support compliance with CalAIM ECM requirements and best practices. This position serves as the clinical leader for field-based care management activities, providing direct supervision and clinical oversight of Licensed Vocational Nurses (LVNs), conducting field visits and ride-alongs with Lead Care Managers (LCMs), Community Health Workers (CHWs), and other care team members, and ensuring the delivery of safe, high-quality, member-centered services throughout hiring county. Essential Duties and ResponsibilitiesClinical Leadership & Consultation Serve as the primary clinical resource for ECM care teams. Provide clinical consultation and guidance to Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, and interdisciplinary team members. Review complex member cases and provide recommendations regarding care planning, interventions, risk mitigation, and treatment coordination. Participate in interdisciplinary case reviews, case conferences, and care team meetings. Assist care teams in identifying clinical risks and developing appropriate intervention strategies. Support development of individualized, member-centered care plans that align with CalAIM ECM requirements and member goals. Promote evidence-based practices and whole-person care approaches. Assist leadership with clinical decision-making and complex case management strategies. Enhanced Care Management (ECM) Support Support implementation and ongoing success of CalAIM Enhanced Care Management services. Ensure clinical interventions align with ECM program requirements, contractual obligations, and best practices. Collaborate with health plans, providers, hospitals, behavioral health agencies, and community-based organizations to coordinate care and improve outcomes. Assist care teams in navigating complex healthcare systems and addressing barriers to care. Support care transitions following hospitalizations, emergency department visits, skilled nursing facility discharges, and other significant healthcare events. Monitor high-risk members and provide recommendations to prevent avoidable utilization and adverse outcomes. Field-Based Clinical Support & Quality Oversight Conduct regular field visits with Lead Care Managers (LCMs), Community Health Workers (CHWs), Licensed Vocational Nurses (LVNs), and other care team members to observe service delivery and provide clinical guidance. Shadow care team members during member visits to assess care coordination effectiveness, member engagement, documentation practices, safety considerations, and adherence to program standards. Provide real-time coaching, mentorship, and clinical consultation during field-based activities. Evaluate field operations and identify opportunities to improve member outcomes, care coordination practices, workflow efficiency, and service quality. Support staff in managing complex member situations, high-risk cases, crisis intervention needs, and care transitions. Conduct quality assurance reviews of field-based activities and provide recommendations for improvement. Participate in joint member visits when clinical support, member education, care coordination, or provider collaboration is needed. Monitor field-based documentation and ensure compliance with Medi-Cal ECM requirements, organizational standards, and regulatory expectations. LVN Supervision & Clinical Oversight Provide direct clinical supervision and oversight for Licensed Vocational Nurses (LVNs) in accordance with California nursing regulations and Pacific Health Group policies. Review and monitor LVN clinical activities, documentation, assessments, care coordination efforts, and member interactions. Provide ongoing coaching, education, mentorship, and professional development to LVNs. Support competency development and clinical skill enhancement among LVN staff. Ensure delegated nursing functions are performed appropriately and within scope of practice. Collaborate with leadership regarding LVN performance, development needs, and clinical support requirements. Promote adherence to clinical standards, documentation requirements, quality measures, and regulatory expectations. Assist with performance evaluations, corrective action recommendations, and clinical competency assessments as needed. Care Coordination & Community Collaboration Collaborate with primary care providers, specialists, behavioral health providers, hospitals, managed care plans, and community organizations. Facilitate communication among interdisciplinary team members to ensure continuity of care. Assist in identifying and resolving gaps in care, treatment adherence challenges, and service coordination issues. Support linkage to healthcare services, behavioral health services, housing resources, community supports, and social service programs. Participate in field-based consultations and community meetings as needed. Documentation, Compliance & Quality Assurance Maintain accurate, timely, and compliant documentation of clinical reviews, recommendations, consultations, and member interactions. Review care team documentation for quality, completeness, and compliance with Medi-Cal and ECM standards. Ensure documentation supports audit readiness and contractual compliance. Monitor clinical quality indicators and identify opportunities for improvement. Assist leadership in preparing for audits, quality reviews, and compliance monitoring activities. Promote data integrity and accountability throughout the care management process. Training & Staff Development Develop and deliver clinical training to non-clinical staff, including Community Health Workers, Care Coordinators, and Lead Care Managers. Provide education on chronic disease management, medication safety, behavioral health conditions, symptom recognition, healthcare navigation, and clinical best practices. Mentor staff to enhance clinical understanding and confidence in supporting members with complex needs. Support onboarding and ongoing professional development initiatives. Quality Improvement & Program Development Analyze clinical and programmatic outcomes to identify trends, barriers, risks, and opportunities for improvement. Participate in quality improvement initiatives focused on member outcomes, care coordination, compliance, and operational effectiveness. Assist in developing clinical workflows, policies, procedures, and best practices. Collaborate with leadership to improve program performance and service delivery. Support organizational initiatives related to innovation, quality, and population health management. Reporting & Clinical Analytics Monitor and evaluate member outcomes, utilization trends, and care coordination effectiveness. Provide clinical insights and recommendations to leadership regarding program performance. Assist with reporting related to quality metrics, care management outcomes, and compliance indicators. Identify opportunities to improve member engagement, healthcare utilization, and clinical outcomes. Key Performance Indicators (KPIs) Success in this role may be measured through: Reduction in avoidable emergency department utilization. Reduction in hospital admissions and readmissions. Improvement in member engagement and care plan completion. Timely completion of clinical reviews and consultations. Compliance with CalAIM ECM documentation standards. Audit readiness and documentation quality. Staff training completion and clinical competency development. Successful oversight and development of LVN staff. Quality outcomes identified through field visits and shadowing activities. Improved interdisciplinary collaboration and care coordination. Positive member outcomes and stabilization metrics. Achievement of organizational quality and performance goals. Minimum Qualifications Active and unrestricted Registered Nurse (RN) license in the State of California. Minimum two (2) years of direct clinical experience in community health, managed care, acute care, post-acute care, public health, behavioral health, or substance use disorder treatment settings. Experience working with Medi-Cal populations and individuals with complex medical, behavioral health, and social needs. Experience supporting populations experiencing homelessness, justice involvement, serious mental illness (SMI), substance use disorders (SUD), or multiple chronic conditions. Experience providing clinical guidance, consultation, mentoring, or supervision to interdisciplinary care teams preferred. Strong understanding of care coordination, population health, and interdisciplinary team-based care. Excellent communication, organizational, and problem-solving skills. Ability to work independently and collaboratively in a fast-paced environment. Proficiency with electronic health records (EHRs), care management platforms, and Microsoft Office applications. Preferred Qualifications Experience working within CalAIM Enhanced Care Management (ECM), Whole Person Care (WPC), Health Homes Program (HHP), or similar care management models. Case Management Certification (CCM, ACM, or equivalent). Experience supervising LVNs or other clinical support staff. Experience working with managed care plans and value-based care programs. Experience in community-based healthcare delivery. Bilingual proficiency in Spanish, Mandarin, Vietnamese, Tagalog, or other languages commonly spoken within the communities served. Experience mentoring interdisciplinary care teams. Requirements Reliable personal vehicle for daily work use Successful completion of background check (including MVR)| Must be able to travel up to 60-70% within the county to conduct in person visits Must successfully complete a Testlify skills assessment Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received Must have effective Time Management skills Must have internet speed of - 300+ mbps download and 25+mbps upload Must be proficient in technology, including documentation systems, case management platforms, and communication tools Work Environment & Travel Requirements This is a hybrid position requiring a combination of remote work, office-based work, and extensive field-based activities. Approximately 50% of work time will involve travel throughout hiring county to conduct field visits, shadow Lead Care Managers and other care team members, provide clinical supervision and coaching, support member care coordination activities, participate in community-based meetings, collaborate with healthcare providers and community partners, and conduct quality assurance reviews. The position may require attendance at case conferences, provider meetings, health plan meetings, leadership meetings, training events, and community-based activities. Frequent local travel is required. Must be willing to work occasional evenings and weekends as needed. Time Off & Leave Paid Time Off 12 Paid Holidays, including Birthday Holiday One Floating Holiday after one year of employment Four (4) Paid Volunteer Hours per Month Bereavement Leave, including Pet Bereavement Leave Health & Wellness 90% Employer-Paid Employee-Only Medical Coverage Dental and Vision Insurance Flexible Spending Account (FSA) Short-Term Disability, Long-Term Disability, and AD&D Coverage Employee Assistance Program (EAP) Financial & Professional Growth 401(k) with Company Match Monthly Stipend Professional Development Opportunities Career Advancement and Internal Growth Opportunities Culture & Employee Experience Hybrid Work Environment Quarterly In-Person Team and Company Events Employee Discount Programs through Great Work Perks and Perks at Work Mission-Driven Culture Focused on Compassion, Innovation, Accountability, Collaboration, and Growth Equal Opportunity Employer Pacific Health Group is an Equal Opportunity Employer committed to fostering an inclusive workplace where all employees are treated with dignity and respect. We celebrate diversity and are committed to creating an environment where individuals from all backgrounds can thrive. All qualified applicants will receive consideration for employment without regard to any protected characteristic protected under applicable federal, state, or local law.

Chief Nursing Officer (CNO)

UHS Madera, CA

Responsibilities Chief Nursing Officer Opportunity River Vista Behavioral Health is a newer, 128-bed state-of-the-art inpatient psychiatric hospital in Madera, CA. The hospital opened in early 2023 and continues to expand services as we near our two year anniversary. River Vista provides a full continuum of inpatient services, including units to serve children and adolescents. Specialty programs for adults with co-occurring behavioral health and substance use issues are offered to meet the unique needs of this patient population. In addition, we offer robust outpatient programs to address the most prevalent behavioral health concerns, including child, adolescent and family counseling, and treatment for depression, anxiety disorders and other common behavioral health issues. River Vista is also very proud of our specialty programs for Military and Dependendts and LGBTQIA clients. Our Website: https://rivervistabh.com Video Overview: https://www.youtube.com/watch?v=MbSKyNIinIo About The Opportunity: The Chief Nursing Officer is a key member of the River Vista Senior Leadership Team who will integrate and coordinate a patient centric nursing strategy with a keen focus on patient care; ensuring that delivery of high-quality and cost-effective health care is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. The CNO will participate in the hospital’s strategic planning and contributes to the achievement of institutional goals and objectives. The Chief Nursing Officer will focus on 5 key areas: People, Service, Quality, Growth, and Finance. What do our current nursing leaders value at River Vista & UHS? That despite our large company design, each facility is run independently, and so our nurse executives have the autonomy to manage their teams with clinical and educational support from corporate. You are never alone, as you are part of a large network of peer nurse leaders that routinely exchange ideas and review current topics within the industry. That we have an active Nursing Council based on shared governance and evidence-based practice. That we offer internal leadership and clinical education, including a generous annual tuition assistance and continuing education allowance designed to keep you at the top of your practice. That we offer and support real career advancement opportunity, including our COO-in-Training program and a variety of regional and national corporate roles designed to support the field and share advanced experience. And, that UHS offers a competitive salary and comprehensive benefits package that reflects the work/life needs of our senior leaders. Total Rewards for our Senior Leaders include: Annual incentive plan Relocation Support Tuition savings to continue your nursing education with Chamberlain University In-house Psychiatric Nurse Residency Transition-to-Practice Orientation (20 CEUs) Career development opportunities across UHS and our 300+ locations! Diverse programming to expand your experience HealthStream online learning catalogue with plenty of free CEU courses Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan Pet Insurance SoFi Student Loan Refinancing Program More information is available on our Benefits Guest Website: uhsguest.com About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com Qualifications Job Requirements: Licensure: Current license or permit to practice professional nursing in the state of CA. Master of Science in Nursing from a CCNE accredited nursing program. Demonstrated working knowledge of behavioral health nursing clinical practices and management. Experience with a free-standing inpatient setting is strongly preferred. Extensive knowledge of principles and practices relevant to nursing and patient care activities. Demonstrated knowledge of effective management and supervisory practices. Highly developed written and verbal communication skills. Three or more years of progressive nursing management experience in behavioral health setting preferred Ability to plan, direct, and monitor others’ activities with demonstrated leadership abilities that contribute to a positive work environment EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449

PEDIATRIC HOSPICE RN CASE MANAGER

Anchor Health CA

PEDIATRIC HOSPICE RN CASE MANAGER JOB DESCRIPTION Overview The Hospice Pediatric RN Case Manager will work with our Pediatric team. Primarily responsible for providing professional nursing care to assigned patients. With input from the IDT (interdisciplinary team), patient and family, assesses, develops, implements and evaluates the plan of care. Ensures appropriate communication and plan of care coordination to all internal/external customers All successful candidates must be fully vaccinated, subject to certain limited exceptions required by applicable law. Our Mission: To enhance the quality of life for those nearing the end of life’s journey and for those who grieve. We place a high importance on our employees and reward staff in several ways such as: • Competitive hospice industry compensation • Benefits package with multiple plan offerings and generous employer contribution • 401(k) Retirement plan with employer match • Supportive work culture which encourages work life balance • Substantial Paid Time Off, paid holidays & birthday benefit • Employee development program managed by in-house education department to support individualized orientation and professional growth needs. • Monthly mileage reimbursement • Employee Referral Program • Business casual attire for office staff Responsibilities JOB DUTIES/KNOWLEDGE/JOB PERFORMANCE: • Develops written plan of care in coordination with an interdisciplinary Team (IDT). • Oversees implementation of plan, evaluates and changes plan as necessary to meet patient/family needs. • Responsible for the direction of care provided by LVN and HA in accordance with patient’s plan of care. • Responsible for the supervision of services provided by the LVN and HA per TEH policy and regulatory requirements. • Communicates all changes to IDT and primary MD. • Performs job duties in clinical areas as stated in clinical competency checklist, policies/procedures, standards of care, and critical competencies based on Scope of Practice. • Maintains timely patient documentation using “point care” electronic charting. • Implements and maintains established hospice policies and procedures as well as Standards of Care and regulatory requirements. • Provides health care instruction to patient and family members. • Orients, instructs, and trains assigned personnel. • Participates in providing 24 hour, seven days a week coverage to patients/families (on-call and census fluctuation). • Performs admission assessment and admission when necessary. DEGREE OF TRAVEL: • Travel required for patient visits. • Occasional travel for educational purposes. Qualifications: • Must have Associates Degree, Bachelor Degree preferred. • Must have one year of acute or hospice pediatric experience • At least 12 months experience with 1-2 years preferred in acute care. • Current CA RN license. • Current CA driver’s license with proof of insurance. • Current CPR/BLS • Prefer certification as hospice nurse. • Pediatric experience preferred. • Proof of recent TB test result • Bilingual preferred. • Computer skills (word processing), use of adding machine, calculator, fax, photocopier.

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