Job Description

Job Location: Hybrid, CA 95206-1234
Position Type: Full TimeEducation
Level: 4 Year Degree
Salary Range: $85,000.00 - $95,000.00 Salary/year
Job Category: Health CareJob description

Position Summary
Pacific Health Group is seeking a compassionate and skilled Registered Nurse (RN) (CA Based) to serve as a Clinical Case Consultant for the California Advancing and Innovating Medi-Cal (CalAIM) Enhanced Care Management (ECM) program. This role is ideal for a nurse who thrives in a community-focused setting and is passionate about improving health outcomes for underserved populations, including those experiencing homelessness, serious mental illness (SMI), substance use disorders (SUD), and multiple chronic conditions.
You will act as the clinical anchor within a care team, providing direct support to frontline staff and ensuring that each member receives coordinated, timely, and clinically appropriate care that reflects the principles of person-centered and trauma-informed care.
Key Responsibilities
1. Clinical Consultation & Oversight
- Provide clinical oversight and guidance to ECM Care Coordinators, Community Health Workers (CHWs), and Case Managers.
- Example: Reviewing medication regimens for a client with both diabetes and schizophrenia to ensure there are no interactions and that the care plan aligns with best practices.
- Participate in complex case rounds to support interdisciplinary decision-making.
- Example: Joining weekly case review meetings with behavioral health clinicians, housing navigators, and peer specialists to develop care strategies for high-need members.
- Offer clinical input on risk assessments, health screenings, and needs identification tools.
2. Care Coordination Support
- Support smooth transitions of care, including hospital discharges and movement between care settings.
- Example: Assisting a member recently discharged from the ER by scheduling a follow-up with their primary care provider, ensuring medication access, and arranging transportation.
- Coordinate with health plans, behavioral health providers, dental providers, and community-based organizations (CBOs).
- Example: Connecting a member with advanced COPD to in-home oxygen support, Meals on Wheels, and pulmonary rehab services.
- Identify members with gaps in care and assist in facilitating timely interventions.
3. Documentation & Compliance
- Document all clinical reviews, recommendations, and member interactions in the Electronic Health Record (EHR) in compliance with ECM and Medi-Cal standards.
- Example: Completing clinical consultation notes after reviewing care plans for members referred to intensive case management.
- Monitor care team documentation to ensure adherence to ECM contractual obligations and audit-readiness.
- Example: Reviewing and validating care plan entries to ensure they include SMART goals, time-bound interventions, and member input.
4. Training & Capacity Building
- Provide training sessions for non-clinical staff on health topics such as chronic disease management, medication adherence, and recognizing symptoms of decompensation.
- Example: Leading a training for CHWs on how to recognize early signs of diabetic ketoacidosis (DKA) and when to escalate to the RN or PCP.
- Mentor new care team members to improve their understanding of clinical workflows and interdisciplinary collaboration.
5. Quality Improvement & Program Development
- Analyze trends in member outcomes and service delivery to identify opportunities for improvement.
- Example: Noticing a pattern of frequent ER utilization among unhoused members with behavioral health needs and working with the team to develop a targeted outreach and education plan.
- Participate in developing and updating policies and procedures for ECM clinical practice.
Core Competencies
- Clinical judgment: Ability to interpret complex clinical information and make evidence-based decisions.
- Collaboration: Comfortable working with diverse team members including peer support specialists, housing navigators, and behavioral health clinicians.
- Communication: Able to explain clinical concepts to non-clinical staff and engage effectively with members with low health literacy.
- Cultural humility: Understands how trauma, racism, poverty, and systemic barriers affect health outcomes.
- Organizational skills: Capable of managing multiple consultations and priorities in a fast-paced, member-driven environment.
What We Offer
- Competitive salary and benefits package
- Supportive and mission-driven work environment
- Opportunities for professional growth and continued education
- The chance to make a tangible impact in the lives of California’s most vulnerable populations
Job Type: Full-time
Pay: $85,000.00 - $95,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Referral program
- Vision insurance
Medical Specialty:
- Public Health
Work Location: Remote

Qualifications

Required Qualifications
- Active and unrestricted Registered Nurse (RN) license in California.
- 2+ years of direct clinical experience in settings such as:
- Community health centers
- Acute or post-acute care
- Public health programs
- Behavioral health or SUD treatment programs
- Experience working with Medi-Cal populations, including individuals who are:
- Homeless or at risk of homelessness
- Justice-involved
- Living with SMI/SUD
- Facing multiple chronic health conditions
Preferred

Qualifications
- Experience with CalAIM ECM, Whole Person Care (WPC), or Health Homes Program.
- Familiarity with managed care workflows and interdisciplinary team collaboration.
- Bilingual proficiency (especially in Spanish, Mandarin, Vietnamese, or Tagalog) is a plus.
Certification in Case Management (CCM, ACM, or similar) is an asset.