Role OverviewSeeking a Senior Complex Case Manager Registered Nurse (RN) for a temporary project-focused assignment running through December 2026 (with potential extension into 2027). Instead of managing a traditional patient caseload, this role focuses on high-impact care integration projects, evaluating California Children's Services (CCS) medical eligibility against Title 22 standards, and facilitating critical referrals under the Whole Child Model.
Equipment (laptop, monitor, headset) will be provided. While this role is fully remote, candidates must reside within a couple-hour driving distance of a regional office (Scotts Valley, Salinas, Merced, or Mariposa) for rare, occasional on-site needs.
Pay Rates - Zone 1 (Santa Cruz, Monterey, Bay Area, Sacramento, LA, San Diego): $49.00 - $63.00 / hour
- Zone 2 (Merced, Mariposa, Central Valley, Fresno, San Luis Obispo): $46.00 - $59.00 / hour
Key Responsibilities - Execute project-based case management initiatives to support optimal health outcomes rather than maintaining a daily clinical caseload.
- Evaluate pediatric medical records and clinical diagnoses against Title 22 CCS eligibility requirements to ensure high-quality program admissions.
- Authorize outpatient and inpatient services while leveraging evidence-based criteria (MCG guidelines, CCS numbered letters).
- Collaborate directly with physicians, ancillary providers, and county agencies to streamline care integration under the Whole Child Model.
- Participate in Quality Improvement studies to measure program efficacy and promote cost-effective care standards.
Required Qualifications - Active, unrestricted Registered Nurse (RN) license issued by the State of California.
- Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN).
- 5+ years of total RN experience, including at least 1+ year of dedicated Case Management experience.
- Minimum of 1 year of recent patient care experience in an acute or outpatient setting serving the assigned population (e.g., Pediatrics).
- Strong clinical judgment, quality review experience, and meticulous documentation skills.
Preferred Qualifications - Bachelor of Science in Nursing (BSN).
- Direct experience or knowledge of California's Whole Child Model (WCM) and Title 22 CCS regulations.
- Clinical background in Critical Care, Emergency Room, Telemetry, or Pediatrics.
- Nationally recognized Case Management certification (CCM or equivalent).
- Bilingual proficiency in English/Spanish or English/Hmong.
Work Schedule - Monday through Friday, 8:00 AM - 5:00 PM (Full-time, Temporary Contract)
