Registered Nurse - Clinical Case Consultant (CalAIM ECM Program) Santa Clara
About The Position
At Pacific Health Group, we believe that every Californian deserves access to compassionate, coordinated, and person-centered care. As a Registered Nurse – Clinical Case Consultant in our CalAIM Enhanced Care Management (ECM) program, you will be a catalyst for better health outcomes among the state’s most vulnerable populations—those experiencing homelessness, living with serious mental illness (SMI), substance use disorders (SUD), or multiple chronic conditions. You will serve as the clinical cornerstone of a multidisciplinary team, ensuring that every care plan is clinically sound, culturally responsive, and designed to help members live healthier, more stable lives.
Requirements
- 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
- 50% Travel / Field Work (Required)
Nice To Haves
- 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.
Responsibilities
- Provide clinical oversight to ECM Care Coordinators, Community Health Workers (CHWs), and Case Managers.
- Conduct case consultations to ensure care plans are safe, evidence-based, and aligned with each member’s goals.
- Participate in interdisciplinary case rounds to support integrated decision-making and problem-solving.
- Offer clinical insight on risk assessments, screenings, and care prioritization.
- Support seamless transitions of care from hospital to home or community-based settings.
- Collaborate with providers, health plans, behavioral health agencies, and community organizations to bridge service gaps.
- Proactively identify members at risk for adverse outcomes and guide timely interventions.
- Maintain accurate, timely documentation of clinical reviews, recommendations, and member interactions in the EHR.
- Review care team documentation to ensure compliance with Medi-Cal ECM standards and audit readiness.
- Promote accountability and data integrity across the team.
- Lead trainings for non-clinical staff on chronic disease management, medication safety, and symptom recognition.
- Mentor care team members, fostering confidence and clinical understanding in the field.
- Analyze outcomes to identify trends, barriers, and opportunities for improvement.
- Contribute to policy and protocol development for ECM clinical best practices.
- Collaborate with leadership to refine workflows that improve efficiency and impact.
Benefits
- 160 Hours of Paid Time Off (PTO)
- 12 Paid Holidays per year, including your birthday and one floating holiday granted after 1 year of employment
- 4 Paid Volunteer Hours per Month to support causes you care about
- Bereavement Leave, including Fur Baby Bereavement
- 90% Employer-paid Employee-Only Medical Benefits
- FSA | Dependent Care Account
- 401(k) with Company Match
- Monthly Stipend
- Short-Term & Long-Term Disability | AD&D
- Employee Assistance Program (EAP)
- Employee Discounts via Great Work Perks and Perks at Work
- Quarterly In-Person Events
- Fully remote work within California
- Opportunities for professional development and internal growth
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
